…ne can only speculate about the multiple causes of pseudoprogression: inter- and intra-rater variability in the EDSS at low scores, assessments at different times of day, intercurrent conditions, variability in fatigue or pain, deconditioning-reconditioning, medication side effects and unrecognized relapses. A more intriguing possibility, for which there is no immunological or pathological evidence at this time, are true fluctuations in secondary…

…o preserve compensatory mechanisms and delay secondary progression. They recommend a combination of early effective DMTs, exercise and diet for all MS patients, including primary-progressive patients. They argue that PPMS and RRMS are the same disease genetically and pathologically. However, there is a window of opportunity to prevent progression with current therapies, as demonstrated by the alemtuzumab Cambridge cohort. In that study, most SPMS…