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Can clinical outcomes be used to detect neuroprotection in multiple sclerosis?

From the Multiple Sclerosis Center and Neuroimaging Laboratory, Department of Neurology, Wayne State University School of Medicine, Detroit, Michigan.

Address correspondence and reprint requests to Dr. Omar Khan, Multiple Sclerosis Center and Neuroimaging Laboratory, Department of Neurology, Wayne State University School of Medicine, 8D University Health Center, 4201 St Antoine, Detroit, MI, 48201 okhan{at}med.wayne.edu

Neuroprotection is a difficult concept to define in the context of multiple sclerosis (MS), a complex heterogeneous disease with an uncertain immunopathogenetic mechanism. Although treatment and natural history studies use clinical determinants and MRI metrics to assess disability, long-term progression, and the effects of disease-modifying drugs, the association between clinical and imaging outcomes is relatively modest. In the future, a composite measure comprising both clinical and imaging markers, along with investigational surrogates derived from molecular genetics and proteomics, may provide an accurate quantitative measure of neuroprotection. However, a consensus definition of "neuroprotection" applicable to MS needs to be established before such a tool can be validated and put to use.

This supplement was supported by an educational grant from Teva Neuroscience. BioScience Communications contributed to the editorial refinement of this article and to the production of this supplement. Authors may have accepted honoraria for their supplement contributions.

Disclosure: The author has received honoraria and grant support from Biogen Idec, Berlex Laboratories, Serono, Teva Neuroscience, and Genentech.

Neurology supplements are not peer-reviewed. Information contained in Neurology supplements represents the opinions of the authors and is not endorsed by nor does it reflect the views of the American Academy of Neurology, Editorial Board, Editor-in-Chief, or Associate Editors of Neurology.

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				G. Birnbaum, T. P. Leist, and F. D. Lublin Commentary II: Clinical aspects of assessing neuronal health in multiple sclerosis Neurology, May 29, 2007; 68(22_suppl_3): S55 - S57. [Full Text] [PDF]