Purpose. To study and evaluate criteria of clinical pathomorphosis in different types of multiple sclerosis against the background of the war in Ukraine.

We examined 45 patients (3 men and 42 women): with a relapsing types (RMS) — 25 individuals; mean age 47.1 ± 1.9 years, mean age at onset 28.0 ± 1.7 years, disease duration 19.1 ± 1.8 years; and with progressive types — 20 patients (secondary progressive type (SPMS), n = 17; primary progressive type (PPMS), n = 3); mean age 54.9 ± 2.1 years, mean age at onset 30.1 ± 2.3 years, disease duration 24.8 ± 1.9 years.

Using a specially developed questionnaire, we assessed changes in key clinical-radiological indicators across MS courses. Evaluation relied on mathematical statistics (standard confidence interval, Wald method, permutation method, Wilcoxon test, McNemar’s test).

Mathematical analysis revealed features of pathomorphosis of clinical-radiological indicators during wartime, characterized by: increased frequency and severity of relapses in RMS; a higher risk of transition from RMS to SPMS; a decrease in neurological deficit (EDSS) during remissions in RMS and an increase during the progression stage in progressive courses; intensification of clinical-radiological dissociation syndrome alongside waning radiological activity in progressive types; and an unfavourable prognosis with further disease progression due to the predominance of a steadily progressive variant in progressive types.