Advances in clinical diagnosis of secondary progressive multiple sclerosis

Multiple sclerosis(MS) is a chronic inflammatory disease of the central nervous system that involves demyelination and axonal degeneration. Usually, MS begins with a relapsing-remitting MS (RRMS) course, and approxi mately will develop into secondary progressive multiple sclerosis (SPMS). At present, the pathogenesis of SPMS is not completely clear, but studies have shown that the occurrence of SPMS is related to the slowly expanding lesions in the central nervous system, leptomeningeal follicle-like structure, chronic inflammation and brain atrophy. In clinical practice, the diagnosis of SPMS is often delayed and retrospective. Up to two-thirds of patients with insidious worsening of disability are still considered to have RRMS. These patients may continue to receive disease-modifying therapies for RRMS, which may not be effective for slowing SPMS. Therefore, early identification and diagnosis of SPMS are essential for their treatment.