{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T01:08:41Z","timestamp":1793581721655,"version":"4.5.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Multiple sclerosis care units (MSCUs) are a reference model for multidisciplinary MS care, yet comparable global data on their structure, resources, and performance remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize the global landscape of MS centers and evaluate compliance with multidisciplinary standards using a simplified, scalable classification framework.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An international cross-sectional survey (2020\u20132021) collected validated responses from 198 MS centres across 38 countries. Comparative analyses focused on 168 hospital-based centres. MSCUs were initially classified as type I or II based on fulfilment of \u226580% or 70\u201379% of 22 predefined structural and functional criteria. To enhance reproducibility, a complementary model was developed using 16 essential criteria, one point per fulfilled item; centres meeting \u226514 criteria qualified for classification. Additional thresholds for annual MS patient volume and neurologist staffing differentiated MSCU-I from MSCU-II. Analyses were stratified by region and institution type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Academic centers reported higher workloads: mean annual treatments 1,359.6 vs. 779.3 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0003) and treated relapses 181.4 vs. 84.1 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.0001). Operational data systems were widely used (administrative 81.5%, registries 85.7%), with stronger regional than institutional gradients: Western Europe had greater adoption (e.g., cost-accountability 67.0% vs. 20.6% in Latin America). Serious adverse events averaged 28.9\/year with no regional or institutional differences. Diagnostic and therapeutic capacities (EPs, OCT, high-efficacy DMTs, ASCT) varied markedly by region. Among the 168 hospital centers, 141 met inclusion criteria; 120 (71.4%) met MSCU-I and 21 (12.5%) met MSCU-II criteria, while 27 (16.1%) did not meet the MSCU standards. Region was a stronger predictor of MSCU-I status than academic affiliation (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0001 and\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0458, respectively). Higher national GDP and health expenditure correlated with MSCU-I designation. A minority of mid-volume units (\u2248500\u2013999 patients\/year) with essential staffing may warrant a pragmatic MSCU-III category for benchmarking.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We provide the broadest overview to date of MSCU structure and operations and propose a practical, reproducible 16-criterion classification framework. Regional context outweighs academic status in predicting MSCU adequacy. Because the dataset is driven predominantly by Europe and Latin America, extrapolation of these findings to under-represented regions, particularly North America and the Rest of the World, should be made with caution. The framework supports practical benchmarking, certification, and targeted capacity-building to reduce regional disparities in diagnostics, information systems, and access to high-efficacy therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2026.1812690","type":"journal-article","created":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:24:56Z","timestamp":1780507496000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Global overview of multiple sclerosis care units: an international cross-sectional survey"],"prefix":"10.3389","volume":"17","author":[{"given":"Per Soelberg","family":"S\u00f6rensen","sequence":"first","affiliation":[{"name":"Danish Multiple Sclerosis Center, Department of Neurology, Copenhagen University Hospital Rigshospitalet","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paola F.","family":"Zaratin","sequence":"additional","affiliation":[{"name":"Fondazione Italiana Sclerosi Multipla","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Alberto","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Fondazione Italiana Sclerosi Multipla","place":["Genoa, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gilles","family":"Edan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Rennes University Hospital","place":["Rennes, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Samadzadeh","sequence":"additional","affiliation":[{"name":"Charite \u2013 Universit\u00e4tsmedizin Berlin, Corporate Member of Freie Universit\u00e4t Berlin and Humboldt-Universit\u00e4t zu Berlin, Experimental and Clinical Research Center","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Leocani","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Vita-Salute San Raffaele University","place":["Milan, Italy"]},{"name":"Experimental Neurophysiology Unit, Institute of Experimental Neurology (INSPE) - IRCCS San Raffaele Scientific Institute","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jefferson","family":"Becker","sequence":"additional","affiliation":[{"name":"Department of Neurology and Psychiatry, Pontifical Catholic University of Rio Grande do Sul","place":["Porto Alegre, Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose","family":"Flores","sequence":"additional","affiliation":[{"name":"National Institute of Neurology and Neurosurgery, CAMINEMOS.MX","place":["Mexico City, Mexico"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernando","family":"Hamuy","sequence":"additional","affiliation":[{"name":"National Multiple Sclerosis Center IMT Hospital, Ministry of Health of Paraguay","place":["Asuncion, Paraguay"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edgardo","family":"Cristiano","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Centre Buenos Aires (CemBA)","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liliana","family":"Patrucco","sequence":"additional","affiliation":[{"name":"Multiple Sclerosis Centre Buenos Aires (CemBA)","place":["Buenos Aires, Argentina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Montalb\u00e1n","sequence":"additional","affiliation":[{"name":"Servei de Neurologia and Centre d'Esclerosi M\u00faltiple de Catalunya (Cemcat), Institut de Recerca Vall d'Hebron (VHIR), Hospital Universitari Vall d'Hebron, Universitat Aut\u00f2noma de Barcelona","place":["Barcelona, Spain"]},{"name":"Center for Networked Biomedical Research on Neurodegenerative Diseases (CIBERNED) - ISCIII","place":["Madrid, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans-Peter","family":"Hartung","sequence":"additional","affiliation":[{"name":"Department of Neurology, Heinrich-Heine-University D\u00fcsseldorf","place":["D\u00fcsseldorf, Germany"]},{"name":"Brain and Mind Centre, University of Sydney","place":["Sydney, NSW, Australia"]},{"name":"Department of Neurology, Palacky University Olomou","place":["Olomouc, Czechia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giancarlo","family":"Comi","sequence":"additional","affiliation":[{"name":"Universita Vita Salute San Raffaele","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oscar F.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Medicine, University of Malaga, Institute of Biomedical Research of Malaga (IBIMA)","place":["Malaga, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,3]]},"reference":[{"key":"ref1","year":"2020"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1056\/NEJMra1401483","article-title":"Multiple sclerosis","volume":"378","author":"Reich","year":"2018","journal-title":"N Engl J Med"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1177\/1352458518807082","article-title":"The multiple sclerosis care unit","volume":"25","author":"Soelberg Sorensen","year":"2019","journal-title":"Mult Scler"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1177\/1352458517751049","article-title":"ECTRIMS\/EAN Guideline on the pharmacological treatment of people with multiple sclerosis","volume":"24","author":"Montalban","year":"2018","journal-title":"Mult Scler"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.1016\/s0140-6736(16)30959-x","article-title":"Diagnosis of multiple sclerosis: progress and challenges","volume":"389","author":"Brownlee","year":"2017","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.7224\/1537-2073.2023-079","article-title":"PANORAMA: a 2021 clinician survey of treatment approaches for people with new diagnoses of relapsing-remitting multiple sclerosis in the United Kingdom","volume":"27","author":"Evangelou","year":"2025","journal-title":"Int J MS Care"},{"key":"ref7","year":"2012"},{"key":"ref8","year":"2025"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"3","DOI":"10.5944\/gaps.2022.00003","article-title":"Derivaci\u00f3n De Pacientes. 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