Cortical involvement determines impairment 30 years after a clinically isolated syndrome.

However, given the highly significant differences compared to CIS, our findings might offer additional insights: First, that most studies comparing RRMS and SPMS have not been able to match individuals, i.e. the SPMS groups are often older with longer disease durations, and thus observed differences might be partially a function of time that separates RRMS and SPMS.

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