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Related Concept Videos

Multiple Sclerosis l: Introduction01:19

Multiple Sclerosis l: Introduction

16
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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Related Experiment Video

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Detecting clinically-relevant changes in progressive multiple sclerosis.

L V A E Bosma1, J M Sonder1, J J Kragt2

  • 1VU University Medical Center, Amsterdam, The Netherlands.

Multiple Sclerosis (Houndmills, Basingstoke, England)
|July 12, 2014
PubMed
Summary
This summary is machine-generated.

Changes in the Guy's Neurological Disability Scale (GNDS) and Timed 25-Foot Walk (T25FW) most significantly reflect increased disease impact in progressive multiple sclerosis (MS) patients. These measures are crucial for assessing disease progression and patient-reported outcomes.

Keywords:
Clinical outcomedisability testsdisease progressionmultiple sclerosisoutcome measurementpatient reported outcomestudy design

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Area of Science:

  • Neurology
  • Clinical Research
  • Patient-Reported Outcomes

Background:

  • Progressive multiple sclerosis (MS) is characterized by accumulating disability.
  • Assessing the true disease impact from the patient's perspective is crucial for effective management.
  • Identifying key clinical outcome measures that correlate with patient-reported disease impact is essential for clinical trials and patient care.

Purpose of the Study:

  • To determine which clinical outcome measures best capture the increase in disease impact experienced by patients with progressive multiple sclerosis (MS).
  • To identify the most significant contributors to patient-reported disease impact in progressive MS.
  • To explore the relationship between baseline clinical characteristics and changes in disease impact over time.

Main Methods:

  • Prospective cohort study of progressive MS patients with data from two visits, 4-6 years apart.
  • Assessment of changes in Expanded Disability Status Scale (EDSS), Timed 25-Foot Walk (T25FW), 9-Hole Peg Test (9HPT), and Guy's Neurological Disability Scale (GNDS).
  • Utilized the Multiple Sclerosis Impact Scale (MSIS-29) as an anchor to define clinically meaningful change and analyzed GNDS sub-scales.

Main Results:

  • Changes in GNDS, particularly the spinal-plus subscale, were the strongest predictors of increased disease impact.
  • The T25FW also showed a significant contribution to perceived disease impact.
  • Observed specific patterns in T25FW and MSIS changes, with generally lower impact increase in patients with longer disease duration or higher baseline disability. Some patients showed a discrepancy between MSIS-29 impact and objective T25FW worsening.

Conclusions:

  • GNDS (especially spinal-plus) and T25FW are recommended for outcome measurement in progressive MS.
  • Baseline clinical characteristics may influence the degree of disease impact experienced at follow-up.
  • Findings have implications for patient selection in clinical trials for progressive MS.