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Updated: Jan 1, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Disease activity impacts disability progression in primary progressive multiple sclerosis
M Marrodan1, C Bensi1, A Pappolla2
1Department of Neurology, Fleni, Montañeses 2325 (1428), Ciudad Autónoma de Buenos Aires, Buenos Aires, Argentina.
Background:
Although solid information on the natural history of primary progressive multiple sclerosis (PPMS) is available, evidence regarding impact of disease activity on PPMS progression remains controversial.
Objective:
To describe the clinical characteristics, presence or absence of MRI activity, and natural history of a PPMS cohort from two referral centers in Argentina and assess whether clinical and/or radiological disease activity correlated with disability worsening.
Methods:
Retrospective study conducted at two MS clinics in Buenos Aires, Argentina, through comparative analysis of patients with and without evidence of disease activity.
Results:
Clinical and/or radiologic activity was presented in 56 (31%) of 178 patients. When stratified by age at onset, we found that for every 10 years of increase in age at onset, risk of reaching EDSS scores of 4 and 6 increased by 26% and 31%, respectively (EDSS 4: HR 1.26, CI 95%: 1.06-1.50; EDSS 6: HR 1.31, CI 95%: 1.06-1.62). Patients who presented clinical exacerbations reached EDSS scores of 6, 7 and 8 faster than those without associated exacerbations (p = 0.009, p = 0.016 and p = 0.001, respectively). Likewise, patients who presented gadolinium-enhancing lesions during the course of disease reached EDSS scores of 7 earlier (p = 0.002).
Conclusion:
Older age at onset and presence of clinical and/or radiological disease activity correlated with accelerated disability progression in this cohort of PPMS patients.
Insights
Disease activity and older age at onset accelerate disability progression in primary progressive multiple sclerosis (PPMS). This study highlights key factors influencing PPMS worsening, aiding in better patient management.
Area of Science:
- Neurology
- Clinical Research
- Multiple Sclerosis
Background:
- Limited consensus exists on how disease activity impacts the progression of primary progressive multiple sclerosis (PPMS).
- Understanding the natural history and factors influencing PPMS is crucial for effective patient care.
Purpose of the Study:
- To characterize a PPMS cohort in Argentina regarding clinical features, MRI activity, and disease progression.
- To determine if clinical or radiological disease activity correlates with worsening disability in PPMS patients.
Main Methods:
- Retrospective analysis of 178 primary progressive multiple sclerosis patients from two referral centers in Buenos Aires, Argentina.
- Comparative assessment of patients with and without evidence of disease activity.
- Correlation analysis between age at onset, disease activity, and disability progression (EDSS scores).
Main Results:
- 56% of patients (31%) exhibited clinical and/or radiological disease activity.
- Increased age at onset correlated with higher Expanded Disability Status Scale (EDSS) scores.
- Clinical exacerbations and gadolinium-enhancing lesions were associated with faster disability progression.
Conclusions:
- Older age at onset is linked to accelerated disability progression in PPMS.
- Clinical and radiological disease activity significantly correlates with faster worsening of disability in primary progressive multiple sclerosis patients.
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