smoldering MS
A proposed MS phenotype characterized by ongoing tissue damage without evident clinical relapses or new MRI lesions.
Full Definition
Smoldering multiple sclerosis refers to a disease state where there is ongoing central nervous system tissue destruction and clinical progression despite the absence of obvious inflammatory activity such as relapses or new gadolinium-enhancing lesions on MRI. This concept challenges the traditional view that lack of visible inflammation means disease inactivity. Patients may experience subtle cognitive decline, gradual disability progression, or brain atrophy without meeting criteria for secondary progressive MS. The phenomenon may be driven by chronic microglial activation, oxidative stress, or low-grade inflammation below the detection threshold of conventional monitoring methods.
Usage
Usage note: Emerging concept; not yet formally recognized in diagnostic criteria.
In Context
- "Despite no relapses for five years, brain atrophy suggested smoldering MS activity." — Clinical assessment
- "The concept of smoldering MS challenges traditional definitions of disease stability." — Research discussion