The initial course of daily functioning in multiple sclerosis: a three-year follow-up study

Area of Science:

• Neurology
• Clinical Psychology
• Rehabilitation Medicine

Background:

• Multiple sclerosis (MS) significantly impacts daily life and functioning.
• Understanding the initial trajectory of functioning is crucial for early intervention.
• Distinguishing between relapse and non-relapse onset is important for prognosis.

Purpose of the Study:

• To prospectively evaluate the initial three-year course of daily functioning in recently diagnosed multiple sclerosis patients.
• To compare the functional trajectories between patients with relapse onset versus non-relapse onset MS.
• To identify specific domains of functioning most affected in early MS.

Main Methods:

• Prospective cohort study of 156 newly diagnosed MS patients over three years with five measurements.
• Assessment of neurological deficits, physical functioning, mental health, social functioning, and general health.
• Comparison of functional changes between relapse onset (n=128) and non-relapse onset (n=28) groups.

Main Results:

• At baseline, most patients had minor neurological deficits, but significant proportions reported aberrant physical (26.3%), social (38.5%), and general health (25%) functioning.
• Neurological deficits and physical functioning significantly deteriorated over three years.
• Deterioration was more pronounced and clinically relevant in the non-relapse onset group; mental health showed non-clinically relevant decline, while social and general health remained stable.

Conclusions:

• Early-stage MS patients, regardless of onset type, experience daily functioning limitations even with minor neurological deficits.
• Non-relapse onset MS is associated with progressive neurological and physical functioning decline.
• While mental health may decline slightly, social and general health appear stable in the initial three years for most MS patients.