Management of Multiple Sclerosis: Past, Present and Promise

Topic Information

Dear Colleagues,

Multiple Sclerosis (MS) is an autoimmune and degenerative chronic disease of the central nervous system, representing one of the leading causes of neurological disability in young people. Although the disease phenotype was formerly considered to be characterized by a relapsing–remitting (RRMS) disease course followed by secondary progression in most people with MS, more recently, disease phenotypes have been re-considered in light of improved knowledge of pathogenic mechanisms. MS progression is indeed characterized by an unrelenting neurodegenerative process, accompanied by the loss of compensating mechanisms leading to the gradual decline of neurological functions and the accumulation of brain and spine atrophy. Recent advancements in the field of MS treatments have mitigated its dramatic impact on patient activity, daily living, and quality of life by delaying the transition to the overt progressive course and reducing the likelihood of MS relapses and the degree of acquired disability. Despite the efforts of researchers, to date, there are still several unmet needs among both neurologists and people with MS (pwMS). Indeed, the finding of simple, reliable, and convenient biomarkers able to predict MS prognosis remains a challenge since diagnosis is still controversial. Conversely, many pwMS report dissatisfaction despite the many disease-modifying treatments now available since a clear demonstration of effectiveness is still lacking for treating many symptoms. Patients' unmet needs depend in part on the fact that pwMS complain of subtle and irritating symptoms such as fatigue, spasticity, bladder and bowel dysfunctions or psychiatric symptoms that negatively affect quality of life. Moreover, MS-specific sex differences, management of pregnancy, and breastfeeding widen the spectrum of unmet needs in pwMS, and little or no attention has been paid to the social activities of pwMS and their caregivers. In conclusion, even though there have been great strides in the past, many more issues remain to be addressed in the future to guarantee an adequate quality of life for people with MS. Thus, the objective of this Topic is to present the most recent advances in the treatment and care of people with MS. A special focus will be placed on prognostic indicators, to unravel patient’ and caregivers’ unmet needs, and to explore sex differences related to the diseases management, as well as to propose new strategies aimed at improving the management of pregnancy and breastfeeding and quality of life.

Dr. Salvatore Iacono
Dr. Paolo Ragonese
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Brain Sciences brainsci	2.7	4.8	2011	15.6 Days	CHF 2200	Submit
Neurology International neurolint	3.2	3.7	2009	26.5 Days	CHF 1600	Submit
NeuroSci neurosci	1.6	-	2020	19.9 Days	CHF 1000	Submit

Preprints.org is a multidisciplinary platform offering a preprint service designed to facilitate the early sharing of your research. It supports and empowers your research journey from the very beginning.

MDPI Topics is collaborating with Preprints.org and has established a direct connection between MDPI journals and the platform. Authors are encouraged to take advantage of this opportunity by posting their preprints at Preprints.org prior to publication:

1. Share your research immediately: disseminate your ideas prior to publication and establish priority for your work.
2. Safeguard your intellectual contribution: Protect your ideas with a time-stamped preprint that serves as proof of your research timeline.
3. Boost visibility and impact: Increase the reach and influence of your research by making it accessible to a global audience.
4. Gain early feedback: Receive valuable input and insights from peers before submitting to a journal.
5. Ensure broad indexing: Web of Science (Preprint Citation Index), Google Scholar, Crossref, SHARE, PrePubMed, Scilit and Europe PMC.

Published Papers (1 paper)

Order results

Content type Publication Date

Result details

Normal Extended Compact

Journals

All Brain Sciences Neurology International NeuroSci

Show export options expand_more Show export options expand_less

Select all

Export citation of selected articles as:

Plain Text BibTeX BibTeX (without abstracts) Endnote Endnote (without abstracts) Tab-delimited RIS

Error

Oops... you haven't selected anything for export.

Ok

clear

11 pages, 1149 KiB  

Open AccessPerspective

Neurofilament Light Chain and Multiple Sclerosis: Building a Neurofoundational Model of Biomarkers and Diagnosis

by Rany Aburashed, Ansam Eghzawi, Daniel Long, Robert Pace, Ali Madha and Jeanie Cote

Neurol. Int. 2025, 17(4), 56; https://doi.org/10.3390/neurolint17040056 - 11 Apr 2025

Viewed by 335

Abstract

Neurofilament light chain (NfL), an abundant cytoskeletal protein in neurons, has emerged as a promising serum biomarker that indicates non-specific neuronal damage secondary to various neurologic diseases, including multiple sclerosis (MS). Emerging evidence suggests that serum NfL levels correlate with future disability, brain [...] Read more.

Neurofilament light chain (NfL), an abundant cytoskeletal protein in neurons, has emerged as a promising serum biomarker that indicates non-specific neuronal damage secondary to various neurologic diseases, including multiple sclerosis (MS). Emerging evidence suggests that serum NfL levels correlate with future disability, brain atrophy, predict new disease activity, and decrease in response to various disease-modifying therapies. As research continues to validate NfL’s potential role in clinical practice, the need for a practical model to conceptualize and visualize its relevance to MS pathology becomes evident—not only for healthcare providers but also for patients. To address this, we propose the Neurofoundational Model (NFM), which likens a neuron to a home, with various parts of the home representing distinct regions of the central nervous system (CNS). In this model, the home (neuron) experiences scenarios such as a fire, an earthquake, and a slow flood, representing distinct MS disease states. A fire illustrates an MS relapse with good recovery, where serum NfL levels rise during the relapse and subsequently return near baseline. An earthquake represents an MS relapse with poor recovery, where NfL levels increase and remain elevated above baseline. Finally, a slow flood depicts MS in progressive stages, characterized by sustained and gradually increasing serum NfL levels without abrupt clinical changes. This approach offers a clear and relatable visualization for clinicians and patients alike, illustrating the dynamics of serum NfL levels during CNS damage caused by demyelination. By integrating this model into clinical practice, we aim to enhance understanding and communication regarding the role of NfL in MS pathology and its potential utility as a biomarker. Full article

(This article belongs to the Topic Management of Multiple Sclerosis: Past, Present and Promise)

►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less

Select all

Export citation of selected articles as:

Plain Text BibTeX BibTeX (without abstracts) Endnote Endnote (without abstracts) Tab-delimited RIS

 

Error

Oops... you haven't selected anything for export.

Ok

clear

Displaying articles 1-1