Measuring disability in multiple sclerosis

Multiple sclerosis (MS) is a heterogeneous disease, affecting patients’ brains, spinal cords, and optic nerves to varying severities. The Expanded Disability Status Scale (EDSS), and its standardized neurostatus examination, has successfully supported the efforts towards many treatment breakthroughs. Nonetheless, the EDSS is heavily weighted towards ambulation, missing those with worsening disease and impairments within other domains. The MS Functional Composite (MSFC), consisting of 3 timed performance tests, was created to overcome some of the deficiencies of the EDSS.1 Indeed, the IMPACT trial, an early study of an interferon in secondary progressive MS.