Evaluation of follow-up and evolution of multiple sclerosis

The aim of this paper is to review the quantitative methods used for assess ing neurological status in multiple sclerosis patients. The Expanded Disabi lity Status Scale (EDSS) is the most wide used. Its psychometric properties , validity, and inter- and intra-rater reliability are modest and responsiv eness is weak. Similar results are obtained with the other scales used. The recently developed Multiple Sclerosis Functional Composite (MSFC) scale fo r clinical trials satisfies this requirement, but is not suitable for indiv idual evaluation. There is no scale in French for assessment of cognitive disturbances and on ly one, the SEP-90, for quality of life. Brain and spinal cord abnormalities with conventional magnetic resonance im aging parameters (TI, T2-weighted and gadolinium enhanced images) have a we ak relationship with disability. New magnetic resonance techniques (magneti c resonance spectroscopy and magnetized transfer imaging) would be more sen sitive and should be further investigated.