Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Centre d'Esclerosi Múltiple de Catalunya (Cemcat), Servei de Neurologia-Neuroinmunologia, Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Spain.
Curr Opin Neurol. 2018 Dec;31(6):752-759. doi: 10.1097/WCO.0000000000000622.
Multiple sclerosis is a chronic, predominantly immune-mediated disease of the central nervous system, and one of the most common causes of neurological disability in young adults globally. This review will discuss the epidemiology, diagnosis, disease course, and prognosis of multiple sclerosis and will focus on recent evidence and advances in these aspects of the disease.
Multiple sclerosis is increasing in incidence and prevalence globally, even in traditionally low-prevalence regions of the world. Recent revisions have been proposed to the existing multiple sclerosis diagnostic criteria, which will facilitate earlier diagnosis and treatment in appropriate patients. Classifying multiple sclerosis into distinct disease phenotypes can be challenging, and recent refinements have been proposed to clarify existing definitions. The prognosis of multiple sclerosis varies substantially across individual patients, and a combination of clinical, imaging, and laboratory markers can be useful in predicting clinical course and optimizing treatment in individual patients.
A number of recent advances have been made in the clinical diagnosis and prognostication of multiple sclerosis patients. Future research will enable the development of more accurate biomarkers of disease categorization and prognosis, which will enable timely personalized treatment in individual multiple sclerosis patients.
多发性硬化症是一种慢性、主要由免疫介导的中枢神经系统疾病，是全球年轻人中最常见的神经功能障碍原因之一。本综述将讨论多发性硬化症的流行病学、诊断、疾病进程和预后，并将重点关注该疾病这些方面的最新证据和进展。
多发性硬化症的发病率和患病率在全球范围内呈上升趋势，即使在世界传统低患病率地区也是如此。现有的多发性硬化症诊断标准提出了一些修订，这将有助于在适当的患者中更早地进行诊断和治疗。将多发性硬化症分为不同的疾病表型可能具有挑战性，最近提出了一些细化定义的建议。多发性硬化症患者的预后差异很大，结合临床、影像学和实验室标志物可以有助于预测疾病进程，并在个体患者中优化治疗。
多发性硬化症患者的临床诊断和预后方面取得了一些新的进展。未来的研究将使疾病分类和预后的更准确生物标志物的开发成为可能，这将使个体化多发性硬化症患者能够及时进行个性化治疗。
