title: Secondary Progression in Multiple Sclerosis: Neuronal Exhaustion or Distinct Pathology?
abstract: Prevention of progression in neurological diseases, particularly in multiple sclerosis (MS) but also in neurodegenerative diseases, remains a significant challenge. MS patients switch from a relapsing-remitting to a progressive disease course, but it is not understood why and how this conversion occurs and why some patients never experience disease progression. Do aging and accumulation of neuronal damage induce progression, or do cognitive symptoms and accelerated grey matter (GM) atrophy point to distinct processes affecting networks? This review weighs accepted dogma against real data on the secondary progressive phase of the disease, highlighting current challenges in this important field and directions towards development of treatment strategies to slow or prevent progression of disability.
authors.affiliation: Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn(2)), University Medical Centre of the Johannes Gutenberg University Mainz, Germany; Neuroimmunology Unit, Department of Neuroscience, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montréal, Canada.
authors.forename: Catherine
authors.initials: C
authors.lastname: Larochelle
authors.affiliation: Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn(2)), University Medical Centre of the Johannes Gutenberg University Mainz, Germany.
authors.forename: Timo
authors.initials: T
authors.lastname: Uphaus
authors.affiliation: Neuroimmunology Unit, Department of Neuroscience, Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Université de Montréal, Montréal, Canada.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Prat
authors.affiliation: Department of Neurology, Focus Program Translational Neuroscience (FTN) and Immunotherapy (FZI), Rhine-Main Neuroscience Network (rmn(2)), University Medical Centre of the Johannes Gutenberg University Mainz, Germany. Electronic address: frauke.zipp@unimedizin-mainz.de.
authors.forename: Frauke
authors.initials: F
authors.lastname: Zipp
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology*; D018450:Disease Progression; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000000981:diagnostic imaging / Q000473:pathology*; D009474:Neurons / Q000473:pathology*
keywords: conversion; multiple sclerosis; neurodegeneration; progression; secondary progressive; senescence