Alicja Kalinowska, MD, PhD, Poznan University of Medical Sciences, Poznań, Poland, discusses the current challenges for the clinical evaluation of smoldering multiple sclerosis (MS). Radiography is one of the best methods for tracking progression, notably MRI. Research indicates that paramagnetic rim lesions (PRLs) are a promising marker of chronic active inflammation and disease. Slowly expanding lesions (SELs), spinal cord atrophy, and thalamic volume are also good indicators of progressive MS, despite their challenges. Prof. Kalinowska emphasizes that the future should include DIR sequencing to visualize cortical lesions as a marker for progressive MS. PET scans can be used to visualize macrophage activity. Regularly checking in with the patient about their physical condition as well as the possibility of using wearables should be a key part of monitoring disease progression as well. This interview took place at the European Academy of Neurology (EAN) Annual Meeting 2024 in Helsinki, Finland.
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