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A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
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Prodrome in relapsing-remitting and primary progressive multiple sclerosis.

J M A Wijnands1, F Zhu1, E Kingwell1

  • 1Department of Medicine (Neurology), University of British Columbia and The Djavad Mowafaghian Centre for Brain Health, Vancouver, BC.

European Journal of Neurology
|February 5, 2019
PubMed
Summary
This summary is machine-generated.

The multiple sclerosis prodrome is not well understood. This study found that while both relapsing remitting multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS) may have a prodrome, the types of doctor visits before diagnosis differed.

Keywords:
healthcare utilizationmultiple sclerosispopulation-based dataprodrome

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Area of Science:

  • Neurology
  • Epidemiology
  • Health Services Research

Background:

  • The prodromal phase of multiple sclerosis (MS) is largely unknown.
  • Understanding the prodrome can aid in earlier diagnosis and intervention.

Purpose of the Study:

  • To investigate the prodromal period in relapsing remitting multiple sclerosis (RMS) and primary progressive multiple sclerosis (PPMS).
  • To compare healthcare utilization in the five years preceding symptom onset between MS phenotypes and controls.

Main Methods:

  • A matched cohort study design was employed using clinical and health administrative data from two Canadian provinces.
  • Negative binomial regression models were used to compare physician encounters between RMS, PPMS, and matched population controls.
  • Adjustments were made for sex, age, socioeconomic status, and calendar year.

Main Results:

  • 1887 RMS cases, 171 PPMS cases, and 9837 controls were identified.
  • No significant difference in total physician encounters was observed between RMS and PPMS, or their respective controls.
  • PPMS cases showed more nervous system-related encounters (aRR 3.00) and fewer dermatology encounters (aRR 0.53) compared to RMS cases.

Conclusions:

  • Evidence suggests that both RMS and PPMS may have a prodromal phase.
  • The specific clinical manifestations during the prodrome may differ between RMS and PPMS.