Primary progressive MS (PPMS) is the least frequent but possibly the most devastating of the MS phenotypes. The rate of progression and disability accumulation in PPMS has been a matter of debate. In an upcoming issue of JNNP 9Published as first online), Koch and colleagues address the issue of factors governing disability progression. Importantly, older age at onset and bilateral lower limb motor features (spasticity and weakness) seemed to be independent predictors of faster rates of disability accumulation in PPMS. Interestingly, no evidence of distinct phase of disability accumulation were noted in PPMS, contrasting with RRMS. Undoubtedly, this would have impact on the understanding of disease pathogenesis and development of prognostic biomarkers.

Must read more at:http://jnnp.bmj.com/content/early/2014/08/04/jnnp-2014-307948.abstract

• Multiple sclerosis

• Research paper