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Published on: December 9, 2015
Predictors of relapse severity in multiple sclerosis
Cavid Baba1, Zuhal Abasiyanik2, Yasemin Simsek3
1Institute of Health Sciences, Dokuz Eylul University, Yenikale Mahallesi Sutculer Caddesi N7 D7 Narlıdere, Izmir, Turkey. cavidbaba@hotmail.com.
Background:
The severity of relapses is one of the determinants of residual disability in multiple sclerosis (MS), contributing to the final progressive state. However, the factors that predict the severity of relapses are not fully understood.
Aim:
To predict relapse severity in MS and investigate the relationship between relapse severity and the degree of improvement in physical, cognitive, and social tests.
Methods:
This observational single-center study prospectively assesses relapse severity in patients with MS. Relapses were classified as mild, moderate, and severe. Before relapse treatment and 1 month into remission four physical tests, four cognitive tests, and six surveys were performed. Multinomial regression analyses were applied to predict relapse severity.
Results:
A total of 126 relapses were studied prospectively. Twenty-two were lost to follow-up. Multiple sclerosis International Quality of Life (MusiQol) questionnaire (r = 0.28, p = 0.006) and Symbol Digit Modalities Test (SDMT, r = 0.23, p = 0.022) improvement statuses were correlated with the severity of the relapse. Higher cases with improvement were observed in the severe relapse group on both MusiQol and SDMT, but no difference for those with a mild relapse. In the predictive model, only disease duration [Odds Ratio (OR) 0.808 95% confidence ınterval (CI) 0.691 to 0.945; p = 0.008] and Body Mass Index (BMI, OR 1.148 95% CI 1.018 to 1.294; p = 0.024) were associated with relapse severity.
Conclusion:
Only disease duration was found to be predictive of relapse severity among disease-related variables. On the other hand, BMI may be a modifiable patient-related factor to consider in the management of exacerbations in MS.
Insights
Disease duration and Body Mass Index (BMI) predict multiple sclerosis (MS) relapse severity. BMI is a modifiable factor that may aid in managing MS exacerbations.
Area of Science:
- Neurology
- Clinical Research
- Epidemiology
Background:
- Relapse severity in multiple sclerosis (MS) influences residual disability and progression.
- Predictors of MS relapse severity remain incompletely understood.
Purpose of the Study:
- To predict relapse severity in MS patients.
- To examine the link between relapse severity and recovery in physical, cognitive, and social functions.
Main Methods:
- Prospective observational study of MS relapses.
- Classification of relapses as mild, moderate, or severe.
- Assessment of physical, cognitive, and quality-of-life measures before treatment and one month post-remission.
- Multinomial regression analysis for predicting relapse severity.
Main Results:
- Disease duration and Body Mass Index (BMI) were significantly associated with MS relapse severity.
- Improvements in the Multiple Sclerosis International Quality of Life (MusiQol) questionnaire and Symbol Digit Modalities Test (SDMT) correlated with relapse severity.
- Higher improvement rates were noted in severe relapse groups for MusiQol and SDMT.
Conclusions:
- Disease duration is a key predictor of MS relapse severity among disease-related factors.
- BMI presents as a potentially modifiable patient factor for managing MS exacerbations.
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