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Early diagnosis of secondary progressive multiple sclerosis: focus on fluid and neurophysiological biomarkers.

Authors :
Ferrazzano, Gina
Crisafulli, Sebastiano Giuseppe
Baione, Viola
Tartaglia, Matteo
Cortese, Antonio
Frontoni, Marco
Altieri, Marta
Pauri, Flavia
Millefiorini, Enrico
Conte, Antonella
Source :
Journal of Neurology. Oct2021, Vol. 268 Issue 10, p3626-3645. 20p.
Publication Year :
2021

Abstract

Background and aims: Most patients with multiple sclerosis presenting with a relapsing–remitting disease course at diagnosis transition to secondary progressive multiple sclerosis (SPMS) 1–2 decades after onset. SPMS is characterized by predominant neurodegeneration and atrophy. These pathogenic hallmarks result in unsatisfactory treatment response in SPMS patients. Therefore, early diagnosis of SPMS is necessary for prompt treatment decisions. The aim of this review was to assess neurophysiological and fluid biomarkers that have the potential to monitor disease progression and support early SPMS diagnosis. Methods: We performed a systematic review of studies that analyzed the role of neurophysiological techniques and fluid biomarkers in supporting SPMS diagnosis using the preferred reporting items for systematic reviews and meta-analyses statement. Results: From our initial search, we selected 24 relevant articles on neurophysiological biomarkers and 55 articles on fluid biomarkers. Conclusion: To date, no neurophysiological or fluid biomarker is sufficiently validated to support the early diagnosis of SPMS. Neurophysiological measurements, including short interval intracortical inhibition and somatosensory temporal discrimination threshold, and the neurofilament light chain fluid biomarker seem to be the most promising. Cross-sectional studies on an adequate number of patients followed by longitudinal studies are needed to confirm the diagnostic and prognostic value of these biomarkers. A combination of neurophysiological and fluid biomarkers may be more sensitive in detecting SPMS conversion. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03405354
Volume :
268
Issue :
10
Database :
Academic Search Index
Journal :
Journal of Neurology
Publication Type :
Academic Journal
Accession number :
152622954
Full Text :
https://doi.org/10.1007/s00415-020-09964-4