AAN 2026 | The contemporary view of MS as a single disease with distinct biologies

I think that session was kind of interesting because it’s speaking to the contemporary view of multiple sclerosis as a unifying disease. I mean, traditionally, we looked at multiple sclerosis and defined the course of the disease by the clinical observations that we can make. And that leads to the typical relapsing remitting, secondary progressive, and primary progressive. And trying to differentiate those from a biological standpoint becomes very challenging and very difficult. So this new way of looking at multiple sclerosis is a single disease. It’s a unifying concept with very clear different biologies. You have the acute inflammatory biology, these peripherally activated immune cells that come in waves to the CNS, causing some outcomes, including lesions and relapses. Also, you have the more compartmentalized biology within the CNS that perhaps is a consequence of the acute inflammatory biology, but with clear, well-defined mechanisms within the CNS. So I think the concept of looking at MS from inside and outside the CNS as a single disease is very valid to try to, in a sense, unify the way we approach the care of patients and look at mechanisms of actions that perhaps are targeting both processes simultaneously.

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