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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...

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Clinical scales in progressive MS: predicting long-term disability.

Libertje V A E Bosma1, Jolijn J Kragt, Dirk L Knol

  • 1VU University Medical Center, Amsterdam, The Netherlands. l.bosma@vumc.nl

Multiple Sclerosis (Houndmills, Basingstoke, England)
|August 27, 2011
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Short-term changes in the Expanded Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25FW) effectively predict long-term disability in progressive multiple sclerosis (MS). Incorporating T25FW data enhances predictive accuracy for MS progression.

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Area of Science:

  • Neurology
  • Clinical Trials
  • Biostatistics

Background:

  • Progressive multiple sclerosis (MS) requires reliable methods to predict long-term disability.
  • Clinical scales like EDSS, T25FW, 9HPT, and GNDS are used to monitor MS.
  • Identifying early predictive markers is crucial for managing MS progression.

Purpose of the Study:

  • To identify which short-term clinical changes best predict long-term disability in progressive MS.
  • To evaluate the predictive power of EDSS, T25FW, 9HPT, and GNDS changes.
  • To determine if T25FW changes add independent predictive value to EDSS changes.

Main Methods:

  • Longitudinal analysis of progressive MS patients (PPMS and SPMS).
  • Selection based on examinations within a 1-2 year interval (short-term change).
  • Ordinal logistic regression used to assess predictors of long-term EDSS outcome after at least 3 years.

Main Results:

  • 181 patients met the criteria.
  • Early changes in EDSS and T25FW were significant predictors of long-term EDSS.
  • Early EDSS change (R(2) 0.38) was a slightly stronger single predictor than T25FW change (R(2) 0.27).
  • Combining early EDSS and T25FW changes improved prediction (p=0.036).

Conclusions:

  • Both early EDSS and T25FW changes predict long-term EDSS in progressive MS.
  • T25FW provides significant independent information, enhancing prediction models.
  • Early T25FW assessment is recommended for future progressive MS clinical trials.