Table 5.

End pathway recommendations and research priorities.

Gaps	Actions	Outcomes
Full knowledge of MS risk factors that are necessary and sufficient to cause MS and the time frame for exposure	Convene experts to develop a blueprint for accelerating research of risk factors Promote knowledge generation of MS risk factors by research funders	Development of approaches to reduce the risk of MS are developed and validated
Availability of public health interventions that reduce or eliminate exposures to MS risk factors	Partner with other advocacy groups to advocate for testing of interventions that prevent disease similar to MS Test interventions with the strongest potential to reduce or eliminate the risk for MS (e.g., EBV vaccine)	Identification and deployment of public health strategies that reduce the risk for MS in the general population
A complete understanding of the genetic and epigenetic contributions to MS risk and etiology	Build on the progress made by the International MS Genetics Consortium and others to identify the complete genetic/epigenetic risk for MS Focus on understanding the genetic basis of disease heterogeneity Develop a better understanding of gene environment interactions	New approaches for prevention and treatment of MS that reduce the burden of disease
A full understanding of the early pathological pathways that lead to initiation of MS	Coordinate global resources to accelerate progress on elucidating the pathways contributing to the initiation of MS Emphasize studies of pediatric onset MS	New approaches for prevention and treatment of MS that reduce the burden of disease
Fluid/imaging/clinical indicators that identify people at high risk for developing MS	Promote research of biomarkers and clinical indicators of MS risk Integrate fluid, imaging, clinical data into a risk staging algorithm	Development of tools for MS risk staging
Identification/implementation of interventions that prevent onset of MS in the high-risk population	Accelerate research of interventions that could prevent the onset of MS Support the clinical development of interventions that could delay or prevent onset of MS	Develop and deploy strategies that reduce or eliminate the risk for MS in the high-risk population

MS: multiple sclerosis; EBV: Epstein Barr virus.