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Smouldering multiple sclerosis: the 'real MS'

Giovannoni, Gavin; Popescu, Veronica; Wuerfel, Jens; Hellwig, Kerstin; Iacobaeus, Ellen; Jensen, Michael B; García-Domínguez, José Manuel; Sousa, Lívia

Using a philosophical approach or deductive reasoning, we challenge the dominant clinico-radiological worldview that defines multiple sclerosis (MS) as a focal inflammatory disease of the central nervous system (CNS). We provide a range of evidence to argue that the 'real MS' is in fact driven primarily by a smouldering pathological disease process. In natural history studies and clinical trials, relapses and f...


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