{
  "abstract": "People with multiple sclerosis (pwMS) often experience disability progression even when receiving disease-modifying therapies that effectively suppress relapses. This phenomenon is commonly referred to as progression independent of relapse activity (PIRA). Currently, it is challenging to characterize pwMS who are experiencing disability progression in clinical practice. Existing definitions of PIRA rely primarily on the Expanded Disability Status Scale (EDSS), which is biased towards ambulation and does not effectively capture the gradual accumulation of symptoms and signs across other clinical areas associated with disability progression. Here, we propose a step-by-step approach that neurologists can use in clinical practice to identify pwMS experiencing disability progression irrespective of age, EDSS, or disease duration. By using this approach, neurologists can assess the presence or absence of specific variables to help determine if disability is stable or progressing. This could enable appropriate treatments to be implemented in a timely manner, particularly as new disability-targeting therapies become available.",
  "abstract_shown": true,
  "affiliations": [
    "University MS Centre, Hasselt-Pelt, Belgium",
    "Noorderhart Hospitals, Rehabilitation & MS, Pelt, Belgium",
    "Department of Neurology, Hospital Clínico Universitario San Carlos IdISSC, Madrid, Spain",
    "Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain",
    "Department of Neurology, The Danish Multiple Sclerosis Registry, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark",
    "Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital - Rigshospitalet, Glostrup, Denmark",
    "Institute for Clinical Medicine, University of Copenhagen, Copenhagen, Denmark",
    "University of Turku and Turku University Hospital, Turku, Finland",
    "Department of Neurology, Inselspital, University Hospital Bern, Bern University, Bern, Switzerland",
    "Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria",
    "Multiple Sclerosis Center, Second Department of Neurology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece",
    "Department of Neurology, Medical Faculty, Heinrich-Heine-University, Düsseldorf, Germany",
    "Brain and Mind Center, University of Sydney, Sydney, NSW Australia",
    "Department of Neurology, Palacky University Olomouc, Olomouc, Czechia",
    "Department of Neurosciences and Rehabilitation, University of Ferrara, Ferrara, Italy",
    "University of Lille, Inserm U1172, Lille Neuroscience & Cognition, Centre Hospitalier Universitaire de Lille, Fédération Hospitalo-Universitaire Precision Medicine in Psychiatry, Lille, France",
    "Center of Clinical Neuroscience, Department of Neurology, Faculty of Medicine, University Hospital Carl Gustav Carus and Centre for Tactile Internet With Human-in-the-Loop (CeTI), TU Dresden, Dresden, Germany",
    "Clinic of Neurology, University Clinical Center of Serbia, Belgrade, Serbia",
    "Neuroscience Centre of Excellence, King Faisal Specialist Hospital and Research Centre, Riyadh, Kingdom of Saudi Arabia",
    "College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia",
    "Department of Neurology, Ain Shams University, Cairo, Egypt",
    "Faculty of Medicine and Life Sciences, UHasselt, Diepenbeek, Belgium",
    "Department of Human Neurosciences, Sapienza University, Rome, Italy"
  ],
  "article_type": "review article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Bart Van Wijmeersch",
      "orcid": "0000-0003-0528-1545"
    },
    {
      "affs": [
        2,
        3
      ],
      "name": "Celia Oreja-Guevara"
    },
    {
      "affs": [
        4,
        5,
        6
      ],
      "name": "Melinda Magyari"
    },
    {
      "affs": [
        7
      ],
      "name": "Laura Airas"
    },
    {
      "affs": [
        8
      ],
      "name": "Andrew Chan"
    },
    {
      "affs": [
        9
      ],
      "name": "Florian Deisenhammer"
    },
    {
      "affs": [
        10
      ],
      "name": "Nikolaos Grigoriadis"
    },
    {
      "affs": [
        11,
        12,
        13
      ],
      "name": "Hans-Peter Hartung"
    },
    {
      "affs": [
        14
      ],
      "name": "Maura Pugliatti"
    },
    {
      "affs": [
        15
      ],
      "name": "Patrick Vermersch"
    },
    {
      "affs": [
        16
      ],
      "name": "Tjalf Ziemssen"
    },
    {
      "affs": [
        17
      ],
      "name": "Jelena Drulovic"
    },
    {
      "affs": [
        18,
        19
      ],
      "name": "Mona Marwan Alkhawajah"
    },
    {
      "affs": [
        20
      ],
      "name": "Magd Zakaria"
    },
    {
      "affs": [
        1,
        21
      ],
      "name": "Veronica Popescu"
    },
    {
      "affs": [
        22
      ],
      "name": "Carlo Pozzilli"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/4r06tz8t29spb.bib",
  "cited_by": 0,
  "doi": "10.1007/s00415-026-14212-2",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13731484/",
  "id": "4r06tz8t29spb",
  "issns": [
    "0340-5354",
    "1432-1459"
  ],
  "landing_url": "https://doi.org/10.1007/s00415-026-14212-2",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Review"
    ],
    [
      "openalex",
      "2728|Multiple Sclerosis Research Studies"
    ]
  ],
  "openalex": "W7225182628",
  "pdf_url": "https://link.springer.com/content/pdf/10.1007/s00415-026-14212-2.pdf",
  "pmcid": "PMC13731484",
  "pmid": "42975661",
  "published": "2026-11-03",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/4r06tz8t29spb.ris",
  "sources": [
    {
      "first_seen": "2026-11-08T12:21:40Z",
      "native_id": "PMC13731484",
      "source": "pmc",
      "url": "https://doi.org/10.1007/s00415-026-14212-2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2728|Multiple Sclerosis Research Studies",
      "subfield": "neurology"
    }
  ],
  "title": "Uncovering disability progression in people with multiple sclerosis: a practical guide",
  "title_text": "Uncovering disability progression in people with multiple sclerosis: a practical guide",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:21:40Z",
  "url": "https://research.draconitic.com/paper/4r06tz8t29spb",
  "venue": "Journal of Neurology",
  "versions": []
}