Secondary Progression in Multiple Sclerosis: Neuronal Exhaustion or Distinct Pathology?

Trends Neurosci. 2016 May;39(5):325-339. doi: 10.1016/j.tins.2016.02.001. Epub 2016 Mar 15.


Prevention of progression in neurological diseases, particularly in multiple sclerosis (MS) but also in neurodegenerative diseases, remains a significant challenge. MS patients switch from a relapsing-remitting to a progressive disease course, but it is not understood why and how this conversion occurs and why some patients never experience disease progression. Do aging and accumulation of neuronal damage induce progression, or do cognitive symptoms and accelerated grey matter (GM) atrophy point to distinct processes affecting networks? This review weighs accepted dogma against real data on the secondary progressive phase of the disease, highlighting current challenges in this important field and directions towards development of treatment strategies to slow or prevent progression of disability.

Keywords: conversion; multiple sclerosis; neurodegeneration; progression; secondary progressive; senescence.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / diagnostic imaging
  • Brain / pathology*
  • Disease Progression
  • Humans
  • Magnetic Resonance Imaging
  • Multiple Sclerosis / diagnostic imaging
  • Multiple Sclerosis / pathology*
  • Neurons / pathology*

Grant support