Tom Fuchs, MD, PhD, is emerging as one of the most promising clinician-scientists in multiple
sclerosis (MS) research. His doctoral training at the Buffalo Neuroimaging Analysis Center
(BNAC) was under the primary mentorship of Michael G. Dwyer, PhD, with Robert Zivadinov,
MD, PhD, and Ralph H. B. Benedict, PhD, serving as secondary mentors. His work at
BNAC—at the intersection of advanced imaging, clinical neurology, and neuropsychology—set
the stage for a career defined by innovation in understanding MS progression. His tireless work
to improve the lives of people with MS bridges technical innovation and clinical relevance,
driven by a deep commitment to making complex concepts useful at the bedside.
Among Fuchs’ most influential contributions is the concept of cognitive progression
independent of relapse activity (Cognitive PIRA). His landmark paper, published in Multiple
Sclerosis Journal (MSJ), demonstrated that cognitive decline in MS may occur independently of
relapses or radiological disease activity. This paradigm-shifting observation, first presented at
ECTRIMS 2023, broadened the definition of progression beyond physical disability. The finding
was soon validated in an independent cohort from Verona, Italy, also published in MSJ, and
extended further with a large-scale validation in the multicenter study, presented as a platform at
ECTRIMS 2025. Together, these efforts firmly established cognitive PIRA as a reproducible and
clinically relevant construct.
In parallel, Fuchs has driven the development of the Disease duration, Age at disease
onset, Age, and EDSS (DAAE) score, a predictive tool designed to identify patients at high risk
of converting to progressive MS. The original article, published in Multiple Sclerosis and
Related Disorders (MSARD) in 2024, was followed by validations in Verona and Prague in 2025.
The online DAAE calculator has already been used more than 3,600 times by 1,800 clinicians
across 21 countries, earning an average usability rating above 90/100. Widely covered in the
news, the score is rapidly becoming a practical aid in patient management and prognosis.
Most recently, Fuchs’ work has extended to the concept of functional network collapse as a
mechanism of MS progression. Initial results were presented at ECTRIMS 2024, with a ten-year
longitudinal follow-up study unveiled at ECTRIMS 2025. These data highlight how deterioration
in brain network efficiency parallels irreversible disability accumulation, offering new insights
into progression pathways.

Fuchs has received significant recognition for his work, including the prestigious ECTRIMS
Research Fellowship, multiple young investigator awards, and invitations to speak at major
international congresses. His trajectory, growing from his early training and research, illustrates
how translational science can be both conceptually bold and clinically grounded at the same
time. His work exemplifies a rare blend of intellectual independence and selfless purpose: an
ongoing international collaboration to ensure that the most advanced ideas in MS research
translate into meaningful change for patients worldwide.