Applying the 2024 Diagnostic Criteria for MS to Enable Earlier Intervention: Erin Longbrake, MD, PhD

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"One of the most important takeaways from the new criteria is that preclinical disease is a thing, and that the pathology of MS starts well before the first clinical symptom that brings someone to medical attention and gets them the label of multiple sclerosis."

Recently, the International Advisory Committee on Clinical Trials in Multiple Sclerosis, cosponsored by the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS) and the National MS Society, released the 2024 updates to the McDonald Diagnostic Criteria for multiple sclerosis (MS) in The Lancet Neurology. The fifth such revision since the criteria were first introduced in 2001, the new recommendations incorporate emerging biomarkers and specialized clinical considerations aimed at improving the speed and accuracy of MS diagnosis.¹

Developed through a formal consensus process, the 2024 revisions reflect input from 56 global experts spanning neurology, radiology, methodology, epidemiology, and patient advocacy. Patient representatives contributed to ensure the updates aligned with both scientific advancements and the lived experiences of people with MS. Since their initial implementation, the McDonald Criteria have significantly shortened the average time from symptom onset to confirmed diagnosis, from roughly 4 years to about 1 year, demonstrating their impact on clinical practice.

At the 2025 ECTRIMS Congress, held September 24-26, in Barcelona, Spain, Erin Longbrake, MD, PhD, an associate professor of neurology at Yale School of Medicine, discussed the paradigm shift introduced by the latest criteria in an interview with NeurologyLive^®. She explained that the 2024 revisions frame MS as a single disease encompassing both inflammatory and neurodegenerative components, highlighting the concept of preclinical MS and the potential benefits of early detection and intervention. Longbrake also emphasized that patients with progressive MS remain an area of unmet need, with ongoing research exploring new treatment approaches.

Click here for more coverage of ECTRIMS 2025.

REFERENCES
1. Revisions to McDonald Diagnostic Criteria for Multiple Sclerosis published. News release. ECTRIMS. September 18, 2025. Accessed September 18, 2025. https://ectrims.eu/press/revisions-to-mcdonald-diagnostic-criteria-for-multiple-sclerosis-published/