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CONy 2023 | Deciphering MS silent progression

In multiple sclerosis (MS), the irreversible accumulation of disability may occur at any stage of the disease and through 2 primary mechanisms: relapse-associated worsening and progression independent of relapse activity (PIRA). Celia Oreja-Guevara, MD, PhD, University Hospital San Carlos, Madrid, Spain, discusses the importance of considering PIRA, also known as “silent progression”, when quantifying disability in MS patients. PIRA is responsible for symptoms such as fatigue, depression, and cognitive changes that can’t be considered in the Expanded Disability Status Scale (EDSS). Therefore, an EDSS score of 0 does not mean no disability or symptoms in any of the functional systems. This interview took place at the 17th World Congress on Controversies in Neurology (CONy) in Dubrovnik, Croatia.

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