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“Expanded Disability Status Scale 0 is not normal”

Presented By
Dr Stephen Krieger, Mount Sinai Hospital, NY, USA
High-challenge tests can reveal performance differences between healthy controls and MS patients with an Expanded Disability Status Scale (EDSS) score of 0. Correlations between challenge task performance and imaging markers (T2LV and nThal) encapsulate both lesional burden of disease and a volumetric measure of brain reserve [1]. Detection of MS in the early stages is complicated due to the absence of above-threshold symptoms. Sub-threshold MS lesions are compensated by functional reserve and yield no physical deficits. The threshold above which clinical deficits are recognised depends on the sensitivity of the assessment techniques. The widely used EDSS defines a score of 0 as ‘neurologically normal.’ “We are only as sensitive as our tests allow,” Dr Stephen Krieger (Mount Sinai Hospital, NY, USA) explained. “The recent concept of silent progression has been highly discussed. But it is only silent if we are not listening.” Recognition of sub-thre...

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