A longitudinal study of symptom botheration in Multiple Sclerosis

Area of Science:

• Neurology
• Clinical Research
• Patient-Reported Outcomes

Background:

• Ambulatory disability progression in Multiple Sclerosis (MS) is well-documented.
• Limited data exists on symptom evolution across other MS-affected domains.
• Understanding long-term symptom changes is crucial for MS patient management.

Purpose of the Study:

• To assess the longitudinal evolution of symptoms in patients with Multiple Sclerosis (MS).
• To evaluate changes in symptom severity across 12 domains using the SymptomMScreen (SyMS) tool.
• To identify patterns and variability in symptom progression over time.

Main Methods:

• Utilized the validated SymptomMScreen (SyMS) tool to assess 12 MS symptom domains.
• Included 1,014 MS patients from two specialized centers with at least 12 months between SyMS assessments.
• Employed statistical analysis, including Markov chain estimates, adjusting for multiple covariates.

Main Results:

• Mean composite SyMS score increased significantly over a mean follow-up of 21 months (p<0.0001).
• Baseline and final composite SyMS scores showed a strong correlation (r=0.81).
• Fatigue was the most severe initial symptom; dexterity, bladder, vision, and pain domains increased, while anxiety and sensory domains decreased.

Conclusions:

• MS symptom burden shows a modest, expected year-to-year increase, consistent with a slowly progressive disease.
• Initial symptom severity is a strong predictor of long-term burden.
• Significant inter-individual variability in symptom severity and progression exists.