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Neurology Service, Veterans Administration Medical Center and Departments of Neurology and of Community Medicine, Georgetown University School of Medicine, Washington, DC.
One method of evaluating the degree of neurologic impairment in MS has been the combination of grades (0 = normal to 5 or 6 = maximal impairment) within 8 Functional Systems (FS) and an overall Disability Status Scale (DSS) that had steps from 0 (normal) to 10 (death due to MS). A new Expanded Disability Status Scale (EDSS) is presented, with each of the former steps (1,2,3 ... 9) now divided into two (1.0, 1.5, 2.0 ... 9.5). The lower portion is obligatorily defined by Functional System grades. The FS are Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, and Other; the Sensory and Bowel & Bladder Systems have been revised. Patterns of FS and relations of FS by type and grade to the DSS are demonstrated.
Address correspondence and reprint requests to Dr. Kurtzke, Chief, Neurology Service (127), Veterans Administration Medical Center, 50 Irving Street, NW, Washington, DC 20422.
Accepted for publication February 9, 1983.
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G Tedeschi, D Dinacci, M Comerci, L Lavorgna, G Savettieri, A Quattrone, P Livrea, F Patti, V Brescia Morra, G Servillo, et al. Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study Multiple Sclerosis, February 1, 2009; 15(2): 204 - 211. [Abstract] [PDF]
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M Kawajiri, M Mogi, N Higaki, T Matsuoka, Y Ohyagi, K Tsukuda, K Kohara, M Horiuchi, T Miki, and J. Kira Angiotensin-converting enzyme (ACE) and ACE2 levels in the cerebrospinal fluid of patients with multiple sclerosis Multiple Sclerosis, February 1, 2009; 15(2): 262 - 265. [Abstract] [PDF]
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P. O'Connor, G. Comi, X. Montalban, J. Antel, E. W. Radue, A. de Vera, H. Pohlmann, L. Kappos, and For the FTY720 D2201 Study Group Oral fingolimod (FTY720) in multiple sclerosis: Two-year results of a phase II extension study Neurology, January 6, 2009; 72(1): 73 - 79. [Abstract] [Full Text] [PDF]
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J. Kragt, B. van Amerongen, J Killestein, C. Dijkstra, B. Uitdehaag, C. Polman, and P Lips Higher levels of 25-hydroxyvitamin D are associated with a lower incidence of multiple sclerosis only in women Multiple Sclerosis, January 1, 2009; 15(1): 9 - 15. [Abstract] [PDF]
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S Johansson, C Ytterberg, K Gottberg, L Widen Holmqvist, and L von Koch Use of health services in people with multiple sclerosis with and without fatigue Multiple Sclerosis, January 1, 2009; 15(1): 88 - 95. [Abstract] [PDF]
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R. Mills, C. Young, R. Nicholas, J. Pallant, and A Tennant Rasch analysis of the Fatigue Severity Scale in multiple sclerosis Multiple Sclerosis, January 1, 2009; 15(1): 81 - 87. [Abstract] [PDF]
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M Calabrese, M Filippi, M Rovaris, V Bernardi, M Atzori, I Mattisi, A Favaretto, P Grossi, L Barachino, L Rinaldi, et al. Evidence for relative cortical sparing in benign multiple sclerosis: a longitudinal magnetic resonance imaging study Multiple Sclerosis, January 1, 2009; 15(1): 36 - 41. [Abstract] [PDF]
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N Shi, Y Kawano, T Matsuoka, F. Mei, T Ishizu, Y Ohyagi, and J Kira Increase of CD4+TNF{alpha}+IL-2-T cells in cerebrospinal fluid of multiple sclerosis patients Multiple Sclerosis, January 1, 2009; 15(1): 120 - 123. [Abstract] [PDF]
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D. T. Okuda, R. Srinivasan, J. R. Oksenberg, D. S. Goodin, S. E. Baranzini, A. Beheshtian, E. Waubant, S. S. Zamvil, D. Leppert, P. Qualley, et al. Genotype-Phenotype correlations in multiple sclerosis: HLA genes influence disease severity inferred by 1HMR spectroscopy and MRI measures Brain, January 1, 2009; 132(1): 250 - 259. [Abstract] [Full Text] [PDF]
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A. W. Chiu, N. Richert, M. Ehrmantraut, J. Ohayon, S. Gupta, G. Bomboi, D. Gaindh, F. K. Cantor, J. A. Frank, H. F. McFarland, et al. Heterogeneity in Response to Interferon Beta in Patients With Multiple Sclerosis: A 3-Year Monthly Imaging Study Arch Neurol, January 1, 2009; 66(1): 39 - 43. [Abstract] [Full Text] [PDF]
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 L. A. Clarke, J. E. Wraith, M. Beck, E. H. Kolodny, G. M. Pastores, J. Muenzer, D. M. Rapoport, K. I. Berger, M. Sidman, E. D. Kakkis, et al. Long-term Efficacy and Safety of Laronidase in the Treatment of Mucopolysaccharidosis I Pediatrics, January 1, 2009; 123(1): 229 - 240. [Abstract] [Full Text] [PDF]
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C E Teunissen, J Killestein, J J Kragt, C H Polman, C D Dijkstra, and H J Blom Serum homocysteine levels in relation to clinical progression in multiple sclerosis J. Neurol. Neurosurg. Psychiatry, December 1, 2008; 79(12): 1349 - 1353. [Abstract] [Full Text] [PDF]
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M. Rovaris, G. Riccitelli, E. Judica, F. Possa, D. Caputo, A. Ghezzi, A. Bertolotto, R. Capra, M. Falautano, F. Mattioli, et al. Cognitive impairment and structural brain damage in benign multiple sclerosis Neurology, November 4, 2008; 71(19): 1521 - 1526. [Abstract] [Full Text] [PDF]
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A. C. Lo and E. W. Triche Improving Gait in Multiple Sclerosis Using Robot-Assisted, Body Weight Supported Treadmill Training Neurorehabil Neural Repair, November 1, 2008; 22(6): 661 - 671. [Abstract] [PDF]
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T Matsuoka, T Matsushita, M Osoegawa, Y Kawano, M Minohara, F Mihara, Y Nishimura, Y Ohyagi, and J Kira Association of the HLA-DRB1 alleles with characteristic MRI features of Asian multiple sclerosis Multiple Sclerosis, November 1, 2008; 14(9): 1181 - 1190. [Abstract] [PDF]
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R G Henry, M Shieh, D T Okuda, A Evangelista, M L Gorno-Tempini, and D Pelletier Regional grey matter atrophy in clinically isolated syndromes at presentation J. Neurol. Neurosurg. Psychiatry, November 1, 2008; 79(11): 1236 - 1244. [Abstract] [Full Text] [PDF]
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L Costelloe, A Thompson, C Walsh, N Tubridy, and M Hutchinson Long-term clinical relevance of criteria for designating multiple sclerosis as benign after 10 years of disease J. Neurol. Neurosurg. Psychiatry, November 1, 2008; 79(11): 1245 - 1248. [Abstract] [Full Text] [PDF]
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F Khan, J F Pallant, C Brand, and T J Kilpatrick Effectiveness of rehabilitation intervention in persons with multiple sclerosis: a randomised controlled trial J. Neurol. Neurosurg. Psychiatry, November 1, 2008; 79(11): 1230 - 1235. [Abstract] [Full Text] [PDF]
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M Di Filippo, L A Pini, G P Pelliccioli, P Calabresi, and P Sarchielli Abnormalities in the cerebrospinal fluid levels of endocannabinoids in multiple sclerosis J. Neurol. Neurosurg. Psychiatry, November 1, 2008; 79(11): 1224 - 1229. [Abstract] [Full Text] [PDF]
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G Mamutse, J Woolmore, E Pye, J Partridge, M Boggild, C Young, A Fryer, P. Hoban, N Rukin, J Alldersea, et al. Vitamin D receptor gene polymorphism is associated with reduced disability in multiple sclerosis Multiple Sclerosis, November 1, 2008; 14(9): 1280 - 1283. [Abstract] [PDF]
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B Brochet, M. Deloire, M Bonnet, E Salort-Campana, J. Ouallet, K. Petry, and V Dousset Should SDMT substitute for PASAT in MSFC? A 5-year longitudinal study Multiple Sclerosis, November 1, 2008; 14(9): 1242 - 1249. [Abstract] [PDF]
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H Beckerman, I. van Zee, V de Groot, G. van den Bos, G. Lankhorst, and J Dekker Utilization of health care by patients with multiple sclerosis is based on professional and patient-defined health needs Multiple Sclerosis, November 1, 2008; 14(9): 1269 - 1279. [Abstract] [PDF]
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R. Prakash, E. Snook, J. Lewis, R. Motl, and A. Kramer Cognitive impairments in relapsing-remitting multiple sclerosis: a meta-analysis Multiple Sclerosis, November 1, 2008; 14(9): 1250 - 1261. [Abstract] [PDF]
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C Potagas, C Mitsonis, L Watier, G Dellatolas, A Retziou, P. Mitropoulos, C Sfagos, and D Vassilopoulos Influence of anxiety and reported stressful life events on relapses in multiple sclerosis: a prospective study Multiple Sclerosis, November 1, 2008; 14(9): 1262 - 1268. [Abstract] [PDF]
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M Thangarajh, J Gomez-Rial, A. Hedstrom, J Hillert, J. Alvarez-Cermeno, T Masterman, and L. Villar Lipid-specific immunoglobulin M in CSF predicts adverse long-term outcome in multiple sclerosis Multiple Sclerosis, November 1, 2008; 14(9): 1208 - 1213. [Abstract] [PDF]
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R. Bakshi, M. Neema, B. C. Healy, Z. Liptak, R. A. Betensky, G. J. Buckle, S. A. Gauthier, J. Stankiewicz, D. Meier, S. Egorova, et al. Predicting Clinical Progression in Multiple Sclerosis With the Magnetic Resonance Disease Severity Scale Arch Neurol, November 1, 2008; 65(11): 1449 - 1453. [Abstract] [Full Text] [PDF]
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Z. Khaleeli, D. R. Altmann, M. Cercignani, O. Ciccarelli, D. H. Miller, and A. J. Thompson Magnetization Transfer Ratio in Gray Matter: A Potential Surrogate Marker for Progression in Early Primary Progressive Multiple Sclerosis Arch Neurol, November 1, 2008; 65(11): 1454 - 1459. [Abstract] [Full Text] [PDF]
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K. Ng, J. Howells, J. D. Pollard, and D. Burke Up-regulation of slow K+ channels in peripheral motor axons: a transcriptional channelopathy in multiple sclerosis Brain, November 1, 2008; 131(11): 3062 - 3071. [Abstract] [Full Text] [PDF]
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L. Piccio, C. Buonsanti, M. Cella, I. Tassi, R. E. Schmidt, C. Fenoglio, J. Rinker II, R. T. Naismith, P. Panina-Bordignon, N. Passini, et al. Identification of soluble TREM-2 in the cerebrospinal fluid and its association with multiple sclerosis and CNS inflammation Brain, November 1, 2008; 131(11): 3081 - 3091. [Abstract] [Full Text] [PDF]
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