Despite major advances in understanding multiple sclerosis (MS) pathophysiology and therapeutics, there remains a need for better biomarkers of disease activity, therapeutic response and prognosis. Clinical disability scores such as the Expanded Disability Scale Score (EDSS), lack sensitivity and their use in trials for progressive MS are limited by the lengths of time required to detect meaningful disability progression. Other scores  developed to address these shortcomings have their own limitations. MRI markers of disability progression such as brain atrophy attempt to improve on this but have a poor predictive value . There remains a need for sensitive markers of disease activity, closely related to the underlying neuropathology and predictive of disability progression.
Genomic , metabolomic  and proteomic  approaches to MS biomarkers hold promise. Profiles of putative markers are compared between groups to identify a profile of diagnostic or prognostic value. These techniques generate large datasets requiring tailored multivariate statistical analysis. Individual markers of high predictive value are seldom identified, and the physiological implications are frequently unclear. MicroRNAs, small noncoding RNAs which regulate post-transcriptional gene expression, are an emerging group of micromolecules with potential as biomarkers in MS .