Professor Abdorreza Naser Moghadasi, in his letter “Treatment of Multiple Sclerosis
as a single disease based on the body-pathology-environment Model”, suggests that
multiple sclerosis (MS) should be considered a type of connectomopathy in that the
entire connectome of the brain is involved (
Moghadasi, 2022
). He states the evidence for this can be seen in the extensive involvement of the
brain observed with imaging methods. I would argue that viewing MS as a connectomopathy
only explains the clinical manifestations of the disease which disrupts neuronal connections
(
Moghadasi, 2022
). However, this does not address the definition of MS as a disease entity and what
makes MS unique as a disease. Many MS mimics also disrupt the connectome, but from
a pathological perspective these diseases are not MS, for example, neurosarcoidosis,
neurosyphilis, vasculitis, small vessel disease, adrenomyeloneuropathy and HTLV-1
associated myelopathy (
Miller et al., 2008
).- Miller D.H.
- Weinshenker B.G.
- Filippi M.
- Banwell B.L.
- Cohen J.A.
- Freedman M.S.
- Galetta S.L.
- Hutchinson M.
- Johnson R.T.
- Kappos L.
- Kira J.
- Lublin F.D.
- McFarland H.F.
- Montalban X.
- Panitch H.
- Richert J.R.
- Reingold S.C.
- Polman C.H.
Differential diagnosis of suspected multiple sclerosis: a consensus approach.
Mult. Scler. 2008; 14: 1157-1174
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References
- Nosology and causal necessity; the relation between defining a disease and discovering its necessary cause.Theor. Med. Bioeth. 1999; 20: 577-588
- The diagnostic criteria for multiple sclerosis: from Charcot to McDonald.Mult. Scler. Relat. Disord. 2012; 1: 9-14
- The neurodegenerative prodrome in multiple sclerosis.Lancet Neurol. 2017;
- Multiple sclerosis is one disease.Mult. Scler. Relat. Disord. 2022; 63103961
- Multiple Sclerosis: The History of a Disease.Demos Medical Publishing, 2004
- Primary progressive multiple sclerosis evolving from radiologically isolated syndrome.Ann. Neurol. 2016; 79: 288-294
- Differential diagnosis of suspected multiple sclerosis: a consensus approach.Mult. Scler. 2008; 14: 1157-1174
- Treatment of multiple sclerosis as a single disease based on the body-pathology-environment model.Mult. Scler. Relat. Disord. 2022; (MSARD-D-22-01064)
Article info
Publication history
Published online: October 06, 2022
Accepted:
October 6,
2022
Received:
October 3,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
