Benign Multiple Sclerosis Clinical Features and Prognostic Factors

Benign multiple sclerosis (BMS) represents a subset of relapsing–remitting disease characterised by minimal disability accumulation over an extended period, most commonly defined by an Expanded Disability Status Scale (EDSS) score of 3 or lower after at least ten years of disease. Clinically, patients with BMS exhibit low annual relapse rates, preserved ambulation and limited motor impairment, yet may harbour subtle cognitive dysfunction, fatigue and mood disturbances that escape conventional neurological assessment. Magnetic resonance imaging often reveals a relatively low lesion burden, especially within deep grey matter structures, and stable brain volumes compared with more aggressive forms. Key prognostic factors associated with a benign course include younger age at onset, female sex, lower inflammatory lesion load on MRI, maintained thalamic volume and early initiation of disease-modifying therapies. Nevertheless, emerging evidence suggests that silent neurodegeneration, particularly grey matter atrophy and subclinical optic nerve injury, can occur despite an overall benign phenotype, emphasising the need for sensitive biomarkers and a multidimensional definition of true disease quiescence.

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Benign Multiple Sclerosis Clinical Features and Prognostic Factors publication trend

The graph below shows the total number of articles in benign multiple sclerosis clinical features and prognostic factors across all publications each year (not limited to Nature Index journals).

Technical terms

Expanded Disability Status Scale (EDSS): A standardised scale ranging from 0 (normal neurological exam) to 10 (death due to MS) used to quantify disability in multiple sclerosis.

Optical Coherence Tomography (OCT): A non-invasive imaging technique that uses light waves to obtain high-resolution cross-sectional images of the retina and optic nerve structures.

Grey Matter Atrophy: Loss of neuronal cell bodies and synaptic connections within cortical and subcortical regions, often quantified via volumetric MRI analysis.

Retinal Nerve Fibre Layer (RNFL): The layer of unmyelinated axons in the retina that can be measured by OCT to detect neurodegeneration in multiple sclerosis.

References

1. Factors associated with benign multiple sclerosis in the New York State MS Consortium (NYSMSC). BMC Neurology (2016).
2. Grey matter atrophy in patients with benign multiple sclerosis. Brain and Behavior (2022).
3. Longitudinal Optical Coherence Tomography Measurement of Retinal Ganglion Cell and Nerve Fiber Layer to Assess Benign Course in Multiple Sclerosis. Journal of Clinical Medicine (2023).
4. Cognitive impairment, fatigue and depression in multiple sclerosis: Is there a difference between benign and non-benign MS?. Multiple Sclerosis and Related Disorders (2023).