Brain editorial highlights shift toward biological MS subtyping

A new scientific commentary in Brain by Tobias Brummer and Vinzenz Fleischer discusses our recent MRI and blood marker study as part of a wider change in multiple sclerosis (MS) research. The editorial argues that labels such as relapsing-remitting or progressive MS remain useful, but they are based mainly on symptoms seen over time. They do not always capture the biological processes happening in the brain and nervous system.

The commentary describes a move toward a more biological framework for MS: one that combines MRI, blood markers such as serum neurofilament light chain, and machine learning to identify patterns of tissue damage and nerve injury. In plain terms, this means asking not only what symptoms a person has, but what kind of disease activity appears to be unfolding underneath. This could eventually help clinicians estimate prognosis earlier and choose treatments in a more targeted way.

The authors also note that more work is needed before this approach can become routine care. Future studies will need to test these models in more diverse real-world MS populations and connect them to practical clinical tools. Even so, the editorial frames the MRI-serum study as a step toward a broader shift in neurology: moving from symptom-based categories toward molecular and biological descriptions of disease. Read the commentary in Brain: Beyond clinical labels: a molecular-structural framework for multiple sclerosis subtyping.