Access and barriers to diagnosis of multiple sclerosis in Iran - A clinician survey

IF 3 3区医学 Q2 CLINICAL NEUROLOGY

Multiple sclerosis and related disorders Pub Date : 2026-05-01 Epub Date: 2026-02-22 DOI:10.1016/j.msard.2026.107089

Sanaz Khodadadi , Sahar Nikkhah Bahrami , Shima Jahani , Mohammad Ali Sahraian , Andrew J. Solomon

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引用次数: 0

Abstract

Background

Timely diagnosis of multiple sclerosis (MS) is critical for optimal outcomes, but delays are common, particularly in resource-limited settings. This study investigates the barriers to MS diagnosis in Iran from the perspectives of neurologists.

Methods

A cross-sectional study was conducted using a questionnaire adapted from the MS International Federation (MSIF) Atlas of MS, 3rd Edition, and the 2024 Topical Survey, administered via an online platform to Iranian neurologists. Data collection occurred from April 1, 2024, to June 30, 2024.

Results

The survey received responses from 103 neurologists (34.1 % response rate), of whom 64 were general neurologists (GN) and 39 were MS specialists (NMS). Eighty percent reported at least one 'major barrier' to early MS diagnosis. These barriers included a lack of public (43.7 %) and healthcare provider (37.9 %) awareness of MS symptoms and patient reluctance to undergo testing due to social stigma (77.3 %). Access to paraclinical testing, including visual evoked potentials (VEP), optical coherence tomography (OCT), MOG-IgG, and AQP4-IgG testing, was variable. Most respondents (98.05 %) reported adherence to national guidelines, yet 4 % of NMS and 16 % of GN reported that they did not use the McDonald criteria.

Conclusions

Barriers to timely MS diagnosis in Iran are multifactorial, involving public awareness, healthcare professional education, and access to adequate resources. Addressing these issues through targeted education and improved infrastructure is essential.

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伊朗多发性硬化症诊断的途径和障碍-一项临床医生调查

及时诊断多发性硬化症（MS）对于获得最佳结果至关重要，但延迟是常见的，特别是在资源有限的情况下。本研究从神经科医生的角度调查伊朗多发性硬化症诊断的障碍。方法采用MS国际联合会（MSIF）第3版MS地图集和2024年专题调查的问卷进行横断面研究，并通过在线平台向伊朗神经科医生进行管理。数据收集时间为2024年4月1日至2024年6月30日。结果共收到103名神经科医生的反馈，回复率34.1%，其中全科医生64名，多发性专科医生39名。80%的人报告说，早期诊断多发性硬化症至少有一个“主要障碍”。这些障碍包括公众（43.7%）和医疗保健提供者（37.9%）缺乏对MS症状的认识，以及患者因社会耻辱而不愿接受检测（77.3%）。获得临床旁检测，包括视觉诱发电位（VEP）、光学相干断层扫描（OCT）、MOG-IgG和AQP4-IgG检测，是可变的。大多数受访者（98.05%）报告遵守国家指南，但4%的NMS和16%的GN报告他们没有使用麦当劳标准。结论在伊朗，阻碍MS及时诊断的因素是多方面的，包括公众意识、卫生保健专业教育和获得足够的资源。通过有针对性的教育和改善基础设施来解决这些问题至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Multiple sclerosis and related disorders CLINICAL NEUROLOGY-

CiteScore

5.80

自引率

20.00%

发文量

814

审稿时长

66 days

期刊介绍： Multiple Sclerosis is an area of ever expanding research and escalating publications. Multiple Sclerosis and Related Disorders is a wide ranging international journal supported by key researchers from all neuroscience domains that focus on MS and associated disease of the central nervous system. The primary aim of this new journal is the rapid publication of high quality original research in the field. Important secondary aims will be timely updates and editorials on important scientific and clinical care advances, controversies in the field, and invited opinion articles from current thought leaders on topical issues. One section of the journal will focus on teaching, written to enhance the practice of community and academic neurologists involved in the care of MS patients. Summaries of key articles written for a lay audience will be provided as an on-line resource. A team of four chief editors is supported by leading section editors who will commission and appraise original and review articles concerning: clinical neurology, neuroimaging, neuropathology, neuroepidemiology, therapeutics, genetics / transcriptomics, experimental models, neuroimmunology, biomarkers, neuropsychology, neurorehabilitation, measurement scales, teaching, neuroethics and lay communication.