Relationship between symptom change, relapse activity and disability progression in multiple sclerosis.

Area of Science:

• Neurology
• Clinical Research
• Patient-Reported Outcomes

Background:

• Symptom fluctuations in multiple sclerosis (MS) may indicate future disease activity.
• Understanding these changes can inform treatment strategies for MS management.

Purpose of the Study:

• To investigate the association between symptom changes and subsequent relapse activity (RA) and disability progression (DP) in MS patients.
• To determine if symptom worsening predicts clinical outcomes.

Main Methods:

• Utilized a five-year NARCOMS registry dataset.
• Assessed symptom change via symptom worsening (SW) and average Performance Scales (APS) scores.
• Defined disability progression (DP) as a ≥1-point increase in Patient-Determined Disease Steps (PDDS) score; employed logistic regression analysis.

Main Results:

• Both symptom worsening (SW) and average Performance Scales (APS) scores significantly predicted subsequent RA and DP.
• A significant interaction was observed between SW/APS and disability level (Mildly Impaired vs. Highly Impaired) in predicting outcomes.
• Symptom changes predicted RA and DP in mildly impaired individuals, but not in highly impaired MS patients.

Conclusions:

• Self-reported changes in overall symptomatology can precede and predict clinical relapse and future disability progression in MS.
• The predictive value of symptom changes appears limited to individuals with lower levels of disability.