Multiple sclerosis: 2024 update

Abstract

Multiple sclerosis (MS) is a complex immune-mediated disease that leads to neurological disability, with ongoing challenges in understanding its initiation, predicting progression, and optimizing personalized treatment. This review article summarizes key research findings from 2024, covering advances in diagnostic criteria, understanding of pathophysiology, and treatment strategies. New studies reinforce the strong link between Epstein-Barr virus (EBV) and MS, while recent data point towards a role of genetics in MS disease progression. The 2024 McDonald criteria revision enhances diagnostic specificity and includes novel MRI markers and facilitates measurement of cerebrospinal fluid biomarkers. Additionally, recent genetic discoveries, advanced imaging techniques, and emerging biomarkers are refining disease monitoring and prognosis. Finally, we highlight promising therapeutic developments, including Bruton Tyrosine Kinase (BTK) inhibitors and CAR T-cell therapies, with the former representing a paradigm shift in the potential of targeting MS progression beyond focal inflammation.