Centers of Excellence for Multiple Sclerosis
There is no official registry or certification system for MS centers of excellence in the United States, but patients should seek care at specialized academic medical centers with dedicated MS programs that offer multidisciplinary teams including neurologists, physical/occupational therapists, mental health professionals, and access to disease-modifying therapies and clinical trials. 1, 2
What Defines an MS Center of Excellence
While there are no prescribed standards or associated certifications for MS centers of excellence, these specialized programs should supply exceptionally high concentrations of expertise and related resources centered on MS care, delivered in a comprehensive, interdisciplinary fashion to afford the best patient outcomes possible. 1
Key characteristics to look for include:
Multidisciplinary care teams consisting of neurologists with MS subspecialty training, physical therapists, occupational therapists, speech and language therapists, mental health professionals, pharmacists, and dietitians 3, 4
Access to all classes of disease-modifying therapies including the nine classes available for relapsing-remitting MS and secondary progressive MS with activity, plus ocrelizumab for primary progressive MS 4
Clinical trial participation opportunities to access emerging therapies and contribute to research advancement 2
Advanced neuroimaging capabilities with expertise in applying the 2017 McDonald Criteria for diagnosis and monitoring disease progression 4
Academic affiliation as patients treated at academic centers experience longer survival rates and more frequent access to comprehensive treatment options compared to non-academic facilities 1
How to Identify Quality MS Centers
Patients should prioritize centers that demonstrate:
Personalized treatment approaches with commitment to achieving freedom from disease activity through individualized therapy selection 2
High-volume MS patient care as facility volume correlates with better outcomes and access to comprehensive services 1
Comprehensive symptom management programs addressing bowel and bladder dysfunction, depression, fatigue, movement disorders, and pain 3
Telehealth capabilities for patients in rural or underserved areas who cannot easily access specialized centers in person 1
When to Seek Specialized Center Care
Referral to an MS center of excellence is particularly critical at these decision points:
At initial diagnosis when making important long-term treatment decisions about disease-modifying therapy selection 5, 1
At disease recurrence or progression when treatment changes or escalation strategies are being considered 1, 6
When diagnostic uncertainty exists requiring advanced molecular testing, specialized imaging interpretation, or multidisciplinary review 1, 6
Common Pitfall to Avoid
Do not assume that any neurology practice constitutes specialized MS care. General neurologists may lack the specific expertise in the 10+ approved disease-modifying therapies, their varying benefit-risk profiles, and the nuanced treatment strategies (sequential monotherapy, escalation therapy, induction-maintenance approaches) that MS subspecialists routinely employ. 5, 7