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Some years ago, only the clinical relapses were a valid marker of MS evolution. Today MRI has changed the picture and the concept of NEDA (No Evidence of Disease Activity) has appeared.

First it was NEDA-3 (no MRI activity, no relapses and no clinical progression). Currently it is being replaced by NEDA-4 (same three conditions as before plus no brain shrinkage, http://www.novartis.com.ph/newsroom/201 ... 8_001.html)

And now my complain. The term is misleading and contributes to the ambiguity in MS research. MS should be considered just a specific kind of damage to the CNS, as opposed to the underlying condition that produces it. For example, autopsy brains can present MS, but they would be of course NEDA-4 compliant at the same time.

I think that the term should be changed by something like "no evidence of underlying disease activity". Words are important. This would make clear that the lesions do not need to be something active, and that there is an underlying cause of MS, which should be the target of our efforts.

What do you think about this?

frodo wrote:And now my complaint. The term is misleading and contributes to the ambiguity in MS research. MS should be considered just a specific kind of damage to the CNS, as opposed to the underlying condition that produces it. For example, autopsy brains can present MS, but they would be of course NEDA-4 compliant at the same time.
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What do you think about this?

My estimate of what all the "NEDA" criteria are for, is to be able to predict MS, without the need to cut open the patients brain as done in an autopsy (which would probably cause its own... err... "symptoms" and be uncomfortable for the patient).

Do you know what specifically is found in an autopsy that is not covered (or at least attempted to be covered) in the latest NEDA criteria?

As with most science, its simply the best knowledge we have today. As we lean more, we will change it. I would personally expect it to improve with the newer but yet to be used 4T+ MRI's.

CureOrBust wrote:

frodo wrote:And now my complaint. The term is misleading and contributes to the ambiguity in MS research. MS should be considered just a specific kind of damage to the CNS, as opposed to the underlying condition that produces it. For example, autopsy brains can present MS, but they would be of course NEDA-4 compliant at the same time.
...
What do you think about this?

My estimate of what all the "NEDA" criteria are for, is to be able to predict MS, without the need to cut open the patients brain as done in an autopsy (which would probably cause its own... err... "symptoms" and be uncomfortable for the patient).

Do you know what specifically is found in an autopsy that is not covered (or at least attempted to be covered) in the latest NEDA criteria?

As with most science, its simply the best knowledge we have today. As we lean more, we will change it. I would personally expect it to improve with the newer but yet to be used 4T+ MRI's.

Hey. I don't know what you understood, but my complain was just about the name of NEDA, not about the concept. Read again please.