title: Relapses in multiple sclerosis: Relationship to disability.
abstract: Multiple sclerosis (MS) is a recurrent inflammatory disease of the central nervous system, which ultimately causes substantial disability in many patients. A key clinical feature of this disease is the occurrence of relapses, consisting of episodes of neurological dysfunction followed by periods of remission. This review considers in detail the importance of the occurrence of relapses to the ultimate course of MS and the impact of relap setreatment (both acutely and prophylactically) on the long-term outcome for individuals. The ultimate goal of therapy in MS is the reduction of long-term disability. Clinical trials in MS, however, typically only extend for a very short time period compared to the time it takes for disability to evolve. Consequently, short-term outcome measures that are associated with, and predict, future disability need to be identified. In this regard, not only are relapses a characteristic feature of MS, they have also been proven to be associated with the occurrence of long-term disability. Moreover, treatments that reduce the number and severity of these attacks improve the long-term prognosis.
authors.affiliation: Multiple Sclerosis Center, University of California, San Francisco Medical Center, San Francisco, CA, United States; Department of Neurology, University of California, San Francisco School of Medicine, San Francisco, CA, United States. Electronic address: douglas.goodin@ucsf.edu.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Goodin
authors.affiliation: Department of Neurology, The University of Chicago, Chicago, IL, United States.
authors.forename: Anthony T
authors.initials: AT
authors.lastname: Reder
authors.affiliation: Mellen Center for Multiple Sclerosis, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Robert A
authors.initials: RA
authors.lastname: Bermel
authors.affiliation: Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, United States.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Cutter
authors.affiliation: Mellen Center for Multiple Sclerosis, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fox
authors.affiliation: Multiple Sclerosis Research Laboratory, Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Friedman Brain Institute, New York, NY, United States; Department of Neurology, Mount Sinai School of Medicine, New York, NY, United States.
authors.forename: Gareth R
authors.initials: GR
authors.lastname: John
authors.affiliation: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
authors.forename: Fred D
authors.initials: FD
authors.lastname: Lublin
authors.affiliation: Mayo Clinic College of Medicine, Rochester, MN, United States.
authors.forename: Claudia F
authors.initials: CF
authors.lastname: Lucchinetti
authors.affiliation: Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
authors.forename: Aaron E
authors.initials: AE
authors.lastname: Miller
authors.affiliation: Neuro-Immunology Division and Yale Multiple Sclerosis Center, Advanced Imaging in Multiple Sclerosis (AIMS) Laboratory, Yale University School of Medicine, New Haven, CT, United States.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pelletier
authors.affiliation: Department of Neurology, Wexner Medical Center at The Ohio State University, Columbus, OH, United States.
authors.forename: Michael K
authors.initials: MK
authors.lastname: Racke
authors.affiliation: Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, United States.
authors.forename: Bruce D
authors.initials: BD
authors.lastname: Trapp
authors.affiliation: Judith Jaffe Multiple Sclerosis Center, New York-Presbyterian Hospital/Weill Cornell Medical Center, Weill Cornell Medical College, United States.
authors.forename: Timothy
authors.initials: T
authors.lastname: Vartanian
authors.affiliation: UCSF Regional Pediatric MS Center, Race to Erase MS, San Francisco, CA, United States.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Waubant
mesh_terms: D004185:Disability Evaluation; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*
keywords: Disability; Lesion; MRI; Multiple sclerosis; Relapse; Treatment