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Giancarlo Comi has served as a Biogen, Merck, Mylan, Novartis, Roche, Sanofi\/Genzyme and Teva Advisory Board Member. He received\u00a0congress and travel\/accommodation expense compensations\u00a0or speaker honoraria from Biogen, Merck, Mylan, Novartis, Sanofi\/Genzyme,\u00a0Teva and Fondazione Italiana Sclerosi Multipla (FISM). Massimo Filippi\u00a0is Editor-in-Chief of the\u00a0Journal of Neurology; received compensation for consulting services and\/or speaking activities from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries; and receives research support from Biogen Idec, Merck-Serono, Novartis, Teva Pharmaceutical Industries, Roche, Italian Ministry of Health, Fondazione Italiana Sclerosi Multipla, and ARiSLA (Fondazione Italiana di Ricerca per la SLA). Damiano Paolicelli has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Pietro Iaffaldano has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Mauro Zaffaroni has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Vincenzo Brescia Morra: has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Eleonora Cocco has no conflict of interest. Girolama Alessandra Marfia: has served as an advisory board member and received speaker honoraria, congress, travel and accommodation expense compensations from Merck, Teva, Mylan, Bayer, Novartis, Roche, Almirall, Biogen and Sanofi Genzyme. Luigi Maria Grimaldi: has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Matilde Inglese: received honoraria or consultation fees from Roche, Biogen, Merck-Serono, Novartis, Genzyme and research grants from NIH, NMSS, FISM, and Teva Neuroscience. Simona Bonavita: Speaker and\/or advisory board fee, and7or travel grant from Novartis, Teva, Sanofi-Genzyme, Roche, Biogen-Idec, Merck-Serono. Alessandra Lugaresi has served as a Biogen, Merck, Mylan, Novartis, Roche, Sanofi\/ Genzyme and Teva Advisory Board Member. She received\u00a0congress and travel\/accommodation expense compensations\u00a0or speaker honoraria from Biogen, Merck, Mylan, Novartis, Sanofi\/Genzyme,\u00a0Teva and Fondazione Italiana Sclerosi Multipla (FISM). Her institutions received research grants from Novartis. Paola Cavalla has served as an advisory board member for Almirall, Biogen, Merck-Serono, Sanofi-Genzyme, Roche, Teva; she has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Giuseppe Salemi: has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Giovanna De Luca has no conflict of interest. Salvatore Cottone: has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Antonella Conte: declares no conflict of interest. Patrizia Sola declares no conflict of interest. Umberto Aguglia has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Giorgia Teresa Maniscalco has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Claudio Gasperini declares no conflict of interest. Maria Teresa Ferr\u00f2: has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Ilaria Pesci declares no conflict of interest. Maria Pia Amato has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Marco Rovaris: received travel grants and fees for consulting and public speaking from Almirall, Biogen, Genzyme-Sanofi, Merck Serono, Mylan and Novartis. Claudio Solaro has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Giacomo Lus declares no conflict of interest. Davide Maimone declares no conflict of interest. Roberto Bergamaschi: declares no conflict of interest. Franco Granella has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Alessia Di Sapio received personal compensation for speaking and consulting by Biogen and Novartis and has been reimbursed by Merck, Biogen, Genzyme and Roche for attending several conferences. Antonio Bertolotto has received grants to attend scientific congresses or speaker honoraria from Biogen, Merck-Serono, Novartis, Roche, Sanofi\/Genzyme, Teva. Rocco Totaro: declares no conflict of interest. Marika Vianello declares no conflict of interest. Paolo Bellantonio declares no conflict of interest. Vito Lepore declares no conflict of interest. Francesco Patti has received honoraria for speaking activities by Almirall, Bayer Schering, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA; he also served as advisory board member the following companies: Bayer Schering, Biogen Idec, Merck Serono, Novartis,\u00a0Roche, Sanofi Genzyme, and TEVA; he was also funded by Pfizer and FISM for epidemiological studies; he received grants for congress participation from Almirall, Bayer Schering, Biogen Idec, Merck Serono, Novartis, Roche, Sanofi Genzyme, and TEVA.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"This study protocol was approved by the local Ethical Committee of the University of Catania (Catania 1) and by the Ethical Committee of the participating centers.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Each patient participating to the study signed an Informed Consent specifically designed to participate to the Italian MS Register.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}