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Updated: Mar 18, 2026
A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Trajectory of MS disease course for men and women over three eras
Stanley Hum1, Yves Lapierre1, Susan C Scott2
1Montreal Neurological Institute and Hospital, McGill University Health Center, Montreal, QC, Canada.
Background:
Heterogeneity in disease course exists within multiple sclerosis (MS) subtypes.
Objective:
The objective was to estimate disease course heterogeneity over three distinct onset periods (pre-1995, 1995-2004, and 2005-present) for men and women.
Methods:
Group-based trajectory model (GBTM) was used to estimate clusters of patients following stable or unstable disease progression trajectories based on the Expanded Disability Status Scale (EDSS). Inception cohorts were generated from the Montreal Neurological Institute MS Clinic registry. Stable trajectories were defined as an EDSS ⩽3.0 and change ⩽1 point over the study period. Annualized relapse rate (ARR) based on the first 5 years of disease was an explanatory variable.
Results:
Proportion of women classified as stable was 0% for pre-1995, 69.0% for 1995-2004, and 83.9% post-2005; for men, these proportions were 18.4%, 41.4%, and 53.8%, respectively. Men had lower percentage of stable disease than women in both post-1995 cohorts (chi-square p < 0.0001). ARR was associated with higher disability trajectories in both post-1995 cohort (odds ratios >1.0) but not in the pre-1995 cohort.
Conclusion:
Large proportions of patients remain stable at their initial disability level for at least 15 years. Higher ARR increases the odds of patients being in a higher disability trajectory in the latter cohorts.
Insights
Most multiple sclerosis (MS) patients experience stable disease, with women showing higher stability than men. Early high relapse rates (ARR) predict worse disease progression in recent cohorts.
Area of Science:
- Neurology
- Epidemiology
- Clinical Research
Background:
- Multiple sclerosis (MS) exhibits significant heterogeneity in disease progression across subtypes.
- Understanding disease course variations is crucial for effective patient management.
Purpose of the Study:
- To analyze disease course heterogeneity in multiple sclerosis (MS) across three distinct onset periods: pre-1995, 1995-2004, and 2005-present.
- To compare disease progression patterns between men and women over these timeframes.
Main Methods:
- Group-based trajectory modeling (GBTM) was employed to identify distinct patient trajectories based on the Expanded Disability Status Scale (EDSS).
- Inception cohorts were derived from the Montreal Neurological Institute MS Clinic registry.
- Stable disease was defined as EDSS ≤3.0 with ≤1 point change over the study period; Annualized Relapse Rate (ARR) in the first 5 years was an explanatory variable.
Main Results:
- The proportion of women with stable MS increased from 0% (pre-1995) to 69.0% (1995-2004) and 83.9% (2005-present).
- For men, stable disease proportions were 18.4% (pre-1995), 41.4% (1995-2004), and 53.8% (2005-present).
- Men consistently showed lower rates of stable disease than women in post-1995 cohorts (p < 0.0001); higher ARR was linked to worse disability trajectories in recent cohorts.
Conclusions:
- A substantial proportion of multiple sclerosis patients maintain a stable disability level for at least 15 years.
- Increased Annualized Relapse Rate (ARR) in recent cohorts is associated with a higher likelihood of progressing to more severe disability trajectories.
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