ABSTRACT
Multiple Sclerosis (MS) is a debilitating neurological disease that affects approximately 2.5 million people globally (Mateen et al., 2012). Clinical diagnosis of MS, versus other similar neurological diseases, and
1 Pediatric Biochemistry Laboratory, University of Texas at San Antonio, San Antonio, TX, 78249. 2 Department of Biology, University of Texas at San Antonio, San Antonio, TX, 78249. 3 Department of Chemistry, University of Texas at San Antonio, San Antonio, TX, 78249. 4 Department of Computer Science, University of Texas at San Antonio, San Antonio, TX, 78249. 5 High Performance Computing, University of Texas at San Antonio, San Antonio, TX, 78249. 6 RCMI Proteomics Core, University of Texas at San Antonio, San Antonio, TX, 78249. 7 RCMI Protein Biomarkers Core, University of Texas at San Antonio, San Antonio, TX, 78249. 8 Center for Interdisciplinary Health Research, University of Texas at San Antonio, San Antonio,
TX, 78249. 9 Center for Research & Training in the Sciences; University of Texas at San Antonio, San
Antonio, TX, 78249. 10 Department of Medicine, Division of Hematology & Medical Oncology, University of Texas
Health Science Center at San Antonio, San Antonio, TX, 78229. 11 Department of Epidemiology & Biostatistics, University of Texas Health Science Center at
San Antonio, San Antonio, TX, 78229. 12 Cancer Therapy & Research Center, University of Texas Health Science Center at San
Antonio, San Antonio, TX, 78229. # These authors contributed equally. * Corresponding authors: WEH.scholar@gmail.com
classifi cation into the following consensus defi nitions of the four major subtypes of MS, is based on a wide variety of tests (Confavreux et al., 2000; Lublin and Reingold, 1996; Noseworthy et al., 2000; Sospedra and Martin, 2005; Steinman, 1996; Thompson et al., 1997): (A) Relapsing-Remitting (RRMS), (B) Secondary Progressive (SPMS), (C) Primary Progressive (PPMS) and (D) Progressive Relapsing (PRMS). Approximately 80% of the patients initially develop the RRMS form of the disease-characterized by clinical attacks (relapses) with diverse neurological dysfunctions, followed by a full recovery or partial recovery with a residual disability. Clinical symptoms include: diffi culty walking, muscle spasms, double vision, loss of balance and incontinence. More than half of RRMS patients will eventually develop SPMS-characterized by a steady worsening of clinical symptoms, with or without attacks during the progressive phase. Less than 15% of all patients have PPMS-characterized either by steady, or by periods of slower or faster, progression of clinical worsening with no attacks. The subgroup of MS with the lowest incidence (less than 5%) is PRMS-characterized by progressive disease course with occasional relapses, with either recovery or no recovery between these attacks. A graphical overview of each of these subtypes of MS is shown in Figure 13.1A-D, adapted from (Thomson, 2006).
