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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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F. Patti, M. Pia Amato, S. Bastianello, L. Caniatti, E. Di Monte, F. Lijoi, B. Goretti, S. Messina, O. Picconi, M. R. Tola, et al. Subcutaneous interferon beta-1a has a positive effect on cognitive performance in mildly disabled patients with relapsing--remitting multiple sclerosis: 2-year results from the COGIMUS study Therapeutic Advances in Neurological Disorders, March 1, 2009; 2(2): 67 - 77. [Abstract] [PDF]
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 E. M Snook, R. W Motl, and R. C Gliottoni The effect of walking mobility on the measurement of physical activity using accelerometry in multiple sclerosis Clinical Rehabilitation, March 1, 2009; 23(3): 248 - 258. [Abstract] [PDF]
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Y. Nilsagard, C. Lundholm, E. Denison, and L-G. Gunnarsson Predicting accidental falls in people with multiple sclerosis -- a longitudinal study Clinical Rehabilitation, March 1, 2009; 23(3): 259 - 269. [Abstract] [PDF]
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O. Gray, H Abdeen, G. McDonnell, C. Patterson, C. Graham, and S. Hawkins An investigation of susceptibility loci in benign, aggressive and primary progressive multiple sclerosis in Northern Irish population Multiple Sclerosis, March 1, 2009; 15(3): 299 - 303. [Abstract] [PDF]
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L. Julian, L Vella, D Frankel, S. Minden, J. Oksenberg, and D. Mohr ApoE alleles, depression and positive affect in multiple sclerosis Multiple Sclerosis, March 1, 2009; 15(3): 311 - 315. [Abstract] [PDF]
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K Poder, K Ghatavi, J. Fisk, T. Campbell, S Kisely, I Sarty, K Stadnyk, and V Bhan Social anxiety in a multiple sclerosis clinic population Multiple Sclerosis, March 1, 2009; 15(3): 393 - 398. [Abstract] [PDF]
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R Antulov, B Weinstock-Guttman, J. Cox, S Hussein, J Durfee, C Caiola, M. Dwyer, N Bergsland, N Abdelrahman, M Stosic, et al. Gender-related differences in MS: a study of conventional and nonconventional MRI measures Multiple Sclerosis, March 1, 2009; 15(3): 345 - 354. [Abstract] [PDF]
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H Doi, T Matsushita, N Isobe, T Matsuoka, M Minohara, H Ochi, and J. Kira Hypercomplementemia at relapse in patients with anti-aquaporin-4 antibody Multiple Sclerosis, March 1, 2009; 15(3): 304 - 310. [Abstract] [PDF]
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S. Broadley, D Vanags, B Williams, B Johnson, D Feeney, L Griffiths, S Shakib, G Brown, A Coulthard, P Mullins, et al. Results of a phase IIa clinical trial of an anti-inflammatory molecule, chaperonin 10, in multiple sclerosis Multiple Sclerosis, March 1, 2009; 15(3): 329 - 336. [Abstract] [PDF]
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A Rico, B Audoin, J Franques, A Eusebio, F Reuter, I Malikova, A Ali Cherif, J Pouget, J Pelletier, and S Attarian Motor evoked potentials in clinically isolated syndrome suggestive of multiple sclerosis Multiple Sclerosis, March 1, 2009; 15(3): 355 - 362. [Abstract] [PDF]
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Y Benesova, A Vasku, H Novotna, J Litzman, P Stourac, M Beranek, Z Kadanka, and J Bednarik Matrix metalloproteinase-9 and matrix metalloproteinase-2 as biomarkers of various courses in multiple sclerosis Multiple Sclerosis, March 1, 2009; 15(3): 316 - 322. [Abstract] [PDF]
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M. Daumer, A. Neuhaus, S. Morrissey, R. Hintzen, and G. C. Ebers MRI as an outcome in multiple sclerosis clinical trials Neurology, February 24, 2009; 72(8): 705 - 711. [Abstract] [Full Text] [PDF]
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S. Sotgiu, A. Giua, M. R Murrighile, and R. Ortu A case of anti-myelin-associated glycoprotein polyneuropathy and multiple sclerosis: one disease instead of two? BMJ Case Reports, February 20, 2009; 2009(feb19_1): bcr0620080212 - bcr0620080212. [Abstract] [Full Text]
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 S. E. Baranzini, J. Wang, R. A. Gibson, N. Galwey, Y. Naegelin, F. Barkhof, E.-W. Radue, R. L.P. Lindberg, B. M.G. Uitdehaag, M. R. Johnson, et al. Genome-wide association analysis of susceptibility and clinical phenotype in multiple sclerosis Hum. Mol. Genet., February 15, 2009; 18(4): 767 - 778. [Abstract] [Full Text] [PDF]
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J. A. Cohen, P. B. Imrey, P. A. Calabresi, K. R. Edwards, T. Eickenhorst, W. L. Felton III, E. Fisher, R. J. Fox, A. D. Goodman, C. Hara-Cleaver, et al. Results of the Avonex Combination Trial (ACT) in relapsing-remitting MS Neurology, February 10, 2009; 72(6): 535 - 541. [Abstract] [Full Text] [PDF]
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B. O. Khatri, S. Man, G. Giovannoni, A. P. Koo, J-C Lee, B. Tucky, F. Lynn, S. Jurgensen, J. Woodworth, S. Goelz, et al. Effect of plasma exchange in accelerating natalizumab clearance and restoring leukocyte function Neurology, February 3, 2009; 72(5): 402 - 409. [Abstract] [Full Text] [PDF]
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O. Stuve, P. D. Cravens, E. M. Frohman, J. T. Phillips, G. M. Remington, G. von Geldern, S. Cepok, M. P. Singh, J. W. Cohen Tervaert, M. De Baets, et al. Immunologic, clinical, and radiologic status 14 months after cessation of natalizumab therapy Neurology, February 3, 2009; 72(5): 396 - 401. [Abstract] [Full Text] [PDF]
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M Debouverie, L Laforest, E Van Ganse, F Guillemin, and for the LORSEP Group Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients Multiple Sclerosis, February 1, 2009; 15(2): 251 - 257. [Abstract] [PDF]
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B. A. C. Cree, D. E. Reich, O. Khan, P. L. De Jager, I. Nakashima, T. Takahashi, A. Bar-Or, C. Tong, S. L. Hauser, and J. R. Oksenberg Modification of Multiple Sclerosis Phenotypes by African Ancestry at HLA Arch Neurol, February 1, 2009; 66(2): 226 - 233. [Abstract] [Full Text] [PDF]
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G Giovannoni, O Barbarash, F Casset-Semanaz, J King, L Metz, G Pardo, J Simsarian, P. Sorensen, B Stubinski, and on behalf of the Rebif(R) New Formulation Study Gr Safety and immunogenicity of a new formulation of interferon {beta}-1a (Rebif(R) New Formulation) in a Phase IIIb study in patients with relapsing multiple sclerosis: 96-week results Multiple Sclerosis, February 1, 2009; 15(2): 219 - 228. [Abstract] [PDF]
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