The biggest issue to progress is the slow process and resistance to change and this can be seen in how the regulators assess efficacy and here for many years people have been fixated with the EDSS clinical assessment, This study looks at technology and they can distinguish people with neurological issues compared to people not having neurological MS and early MSand could distinguish those without neurological issues. Some of the outcomes are centred in yesteryear but it remains to be seen how much and how quickly people adapt to change remains to be seen. There are always early adopters and there are the ludites who are dont want to change.
Cohen M, Mondot L, Ayrignac X, Vukusic S, Bourre B, Maillart E, Zephir H, Michel L, Thouvenot E, Rice P, Hohweiller A, Okuda DT, Landes Château C, Lebrun Frenay C. Comparison of individuals with radiologically isolated syndrome, early multiple sclerosis patients, and healthy controls using a digital neurological examination. Mult Scler. 2026 Feb 22:13524585261418921.
Background: The revised McDonald criteria shifted toward the recognition of the radiologically isolated syndrome (RIS) as the first phase of the multiple sclerosis (MS) spectrum.
Objectives: To characterize differences between RIS individuals, early MS patients, and healthy controls (HCs) using a high-precision clinical assessment tool based on digital technology.
Methods: We performed a multicentric, cross-sectional study involving RIS, early MS patients, and HC. Subjects were assessed using Neuraccure, an iPad application capable of detecting subtle abnormalities in four neurological functions: hand coordination, low-contrast vision, reaction time, and eye movements.
Results: In total, 565 individuals were included (MS: 255, RIS: 146, HC: 164). HC performed better than RIS and MS across all digital measures (p < 0.0001 to 0.03). There was no statistical difference between RIS and MS patients, except for the coordination test, which was slightly worse in MS patients (p = 0.03). The receiver operating characteristic (ROC) analysis indicated that the presence of at least two impaired functions could detect RIS and MS from HC with 83.2% sensitivity and 84.3% specificity. A higher number of impaired functions were associated with lower brain magnetic resonance imaging (MRI) volumes.
Conclusion: High-precision neurological evaluation can distinguish HC from RIS and MS at an individual scale with a good performance.
Source: multiple-sclerosis-research.org