Enhancing Multiple Sclerosis Diagnosis and Early Treatment Strategies: David A. Hafler, MD, FANA

WATCH TIME: 5 minutes

“We know that for every clinical event, there are 10 MRI events. Why wait for a clinical event for a pathologic diagnosis?

The McDonald Diagnostic Criteria, established in 2001 and last revised in 2017, serves as a key resource for neurologists to enhance the accuracy and efficiency of diagnosing multiple sclerosis (MS). Since 2021, an expert panel has been updating the criteria to integrate emerging insights into MS biology, with the goal of enabling earlier detection and improving patient outcomes. These revisions aim to align diagnostic practices more closely with the disease's underlying mechanisms, refining the evaluation process beyond symptom-based assessments.¹

Unveiled at the 40th Congress of the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS), held September 18-20 in Copenhagen, Denmark, the updated recommendations emphasize advanced diagnostic techniques and age-specific criteria for MS diagnosis in younger and older patients. By focusing on deeper biomarkers of disease-related damage, the changes seek to enhance diagnostic precision. The finalized criteria are set to be published in a peer-reviewed journal by early 2025. Following publication, organizations such as the National MS Society and ECTRIMS will collaborate to ensure widespread awareness and implementation of the updated guidelines among clinicians and patients.²

In discussing these advancements, David A. Hafler, MD, FANA, the William S. and Lois Stiles Edgerly Professor of Neurology at Yale School of Medicine, highlighted the transformative potential of integrating advanced biomarkers into MS diagnostic protocols. In an interview with NeurologyLive^®, Hafler emphasized how tools could offer a faster and more reliable alternative to traditional markers. He also noted that identifying MS before the appearance of parenchymal lesions could significantly improve disease management and long-term outcomes. Moreover, he spoke about how ongoing research into first-degree relatives with high genetic risk scores presents an exciting avenue for understanding MS pathogenesis and developing preventive strategies.

REFERENCES
1. Montalban X. 2024 Revisions of the McDonald Criteria. Presented at ECTRIMS Congress; September 18-20, 2024; Copenhagen, Denmark. Scientific Session 1: New diagnostic criteria.
2. European Committee for Treatment and Research in MS. McDonald Diagnostic Criteria. Accessed November 12, 2024. https://ectrims.eu/mcdonald-diagnostic-criteria#