EDSS
Kurtzke Expanded Disability Status Scale
総合障害度スケール（Kurtzke EDSS）
1. Biological & Technical Mechanism
Developed by John Kurtzke, the Expanded Disability Status Scale (EDSS) ranges from 0.0 (normal neurological exam) to 10.0 (death due to MS) in 0.5-point increments. Scores from 1.0 to 4.5 reflect neurological deficits across eight Functional Systems (FS: pyramidal, cerebellar, brainstem, sensory, bowel/bladder, visual, cerebral, and other) in fully ambulatory patients, whereas steps 5.0 to 7.5 are primarily defined by maximum unaided or aided walking distance and wheelchair dependence.
EDSS（Expanded Disability Status Scale）は、多発性硬化症（MS）の臨床試験およびリアルワールドレジストリ（MSDA / MSBase）において最も広く使用されている0.0〜10.0（0.5点刻み）の順序尺度です。スコア1.0〜4.5は8つの機能系（FS：錐体路、小脳、脳幹、感覚、膀胱直腸、視覚、精神機能、その他）の神経所見に基づいて決定され、5.0〜7.5は主に歩行可能距離や補助具（杖・車椅子）の必要度によって規定されます。非線形な順序尺度であるため、ベースライン値に応じた最小確定変化量（0点なら+1.5点、1.0〜5.5点なら+1.0点、6.0点以上なら+0.5点）と24週間以上の持続確認（24w-CDA）が標準的に用いられます。
2. Open Science & Clinical Trial Significance
In longitudinal MS registry and clinical trial analyses, re-baselining EDSS after acute relapses ('roving baseline') is essential to separate Relapse-Associated Worsening (RAW) from Progression Independent of Relapse Activity (PIRA).
MSDA Core Dataset や第3相臨床試験の縦断解析において、急性の再発回復後に基準値を再設定する「Roving Baseline（移動基準点）法」を適用することで、再発に伴う悪化（RAW）と再発に依存しない進行（PIRA）を厳密に分離評価することができます。
Related Neuroscience Terms & Standards
Irreversible accumulation of neurological disability occurring outside of clinical relapses, driven by diffuse smoldering neuroinflammation, chronic active lesions, and neuroaxonal loss in MS.
International consensus diagnostic framework integrating clinical attacks, MRI topography (Dissemination in Space/Time, optic nerve, CVS, PRLs), and CSF oligoclonal bands to diagnose MS.
Open-community clinical data standard that transforms heterogeneous hospital EHR and disease registry databases into a unified relational schema and standardized vocabulary for federated analytics.
Axonal cytoskeletal protein released into CSF and blood upon neuroaxonal injury; a cross-disease biomarker of neurodegeneration rate in ALS, MS, AD, and FTD.
Intermediate filament protein of astrocytes released into CSF and blood during reactive astrogliosis; tracks smoldering PIRA progression in MS and amyloid-induced astrocytic reactivity in Alzheimer's.
Chronic white matter MS lesions bordered by a dense rim of iron-laden, proinflammatory activated microglia/macrophages, visible on T2* phase MRI, SWI, and QSM.
Open Datasets & Research Publications Related to EDSS
MSDA Core Dataset (CDS): Standardized Global Real-World Data Harmonization Framework for Multiple Sclerosis
The MSDA Core Dataset (CDS) establishes a 44-variable international harmonization schema mapped to the OMOP Common Data Model, enabling privacy-preserving federated analytics across global Multiple Sclerosis registries.
MSDA Global Registry & Cohort Metadata Discovery Catalogue (BigMS Network)
A centralized metadata discovery catalogue indexing over 30 national and international MS registries (>120,000 patients), detailing variable availability for EDSS, relapse history, MRI, fluid biomarkers, and DUA governance.
GDSI Mock Data Generator & OMOP Quality Assessment Pipeline
Python-based synthetic clinical data generator developed by MSDA for benchmarking and validating local registry extraction scripts, EDSS roving baseline calculations, and OMOP CDM conformance.
MSBase & BigMS Harmonized Cohort: Quantifying Progression Independent of Relapse Activity (PIRA) Under High-Efficacy DMTs
Multi-center longitudinal real-world evidence study evaluating roving-baseline EDSS trajectories, Relapse-Associated Worsening (RAW) versus PIRA rates, and early anti-CD20 / natalizumab intervention across harmonized international MS registries.
Dental amalgam exposure and multiple sclerosis: authors' response.
Research article from Europe PMC.
The prevalence of comorbid migraine in multiple sclerosis: do multiple sclerosis and migraine really coexist?
BackgroundMultiple sclerosis (MS) is a chronic inflammatory disease causing multifocal demyelination and axonal damage in the central nervous system. Recent studies indicate that MS patients have a higher prevalence of migraine than the general population. This cross-sectional, single-centre study assessed migraine prevalence in MS patients receiving disease-modifying therapies (DMTs).MethodsA total of 205 MS patients were included. All participants were assessed for migraine diagnosis according to the International Classification of Headache Disorders, 3rd edition (ICHD-3), by a qualified physician. Migraine subtypes (episodic or chronic, with or without aura) were determined per ICHD-3 criteria. Each participant provided data on age, gender, current DMT type and duration, previous DMT history, MS-related symptoms, and MS relapses in the past 12 months.ResultsEpisodic migraine was identified in 36 patients, corresponding to a prevalence of 17.56% (95% CI (confidence interval): 12.4%-22.8%). Age-stratified analysis revealed higher prevalence in younger participants: 21.4% in those under 40 years (n = 98) compared to 14.0% in those aged 40 years or older (n = 107). The majority of cases (n = 28) presented without aura, with aura occurring in 8 patients. No chronic migraine was detected in the cohort. A total of 193 patients were diagnosed with relapsing-remitting multiple sclerosis (RRMS), 2 with secondary progressive MS (SPMS), and 10 with primary progressive MS (PPMS). No cases of progressive-relapsing MS (PRMS) were reported. Among the participants, 193 were receiving DMT, while 12 patients were not undergoing chronic immunotherapy. No significant correlations were found between migraine occurrence and MS type, type of DMT, disease duration, or Expanded Disability Status Scale (EDSS) score.ConclusionsMigraine does not seem to be less common in MS patients compared to the general population but further, age-stratified and controlled studies are needed to investigat
Disclaimer: This encyclopedia entry is intended for academic neuroscience research and data science reference only, and does not constitute medical advice.