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The wide global variation in the diagnosis and management of multiple sclerosis (MS)
underpins the need for consensus in the field and provides the backdrop for the development
of a policy. When our global, multidisciplinary group first met to draft a consensus
report, or policy, on MS, we all agreed that ‘Time matters’ in the treatment and management of this disease. We should be aiming to maximize
the lifelong brain health of people with MS through early diagnosis, early treatment,
proactively monitoring and recording disease activity, treating to a target with an
appropriate disease-modifying therapy (DMT), incorporating shared decision-making
and adopting an holistic approach to the management of MS (Fig. 1).
Fig. 1We recommend a therapeutic strategy that aims to preserve CNS tissue and maximize
lifelong neurological reserve (an important component of brain health) by minimizing
disease activity. (CNS, central nervous system; DMT, disease-modifying therapy).
Evidence for axonal pathology and adaptive cortical reorganization in patients at presentation with clinically isolated syndromes suggestive of multiple sclerosis.
