Benign multiple sclerosis and long-term outcomes after 30 years.

Area of Science:

• Neurology
• Clinical Research

Background:

• The definition of benign multiple sclerosis (MS) is debated, often relying solely on Expanded Disability Status Scale (EDSS) and disease duration.
• Other factors influencing patient disability are not always considered in benign MS definitions.

Purpose of the Study:

• To determine the prevalence of benign MS in a specific cohort.
• To assess the long-term disease course (20 and 30 years) of patients initially classified as benign MS.
• To identify clinical and demographic factors associated with maintaining a benign MS status.

Main Methods:

• Prospective follow-up of patients meeting benign MS criteria (EDSS < 3.0 and >= 10 years of disease).
• Assessment of EDSS scores at 20 and 30 years post-diagnosis.
• Evaluation of clinical, radiological, fatigue, depression, and cognitive variables.

Main Results:

• Out of 485 patients, 82 initially met benign MS criteria.
• After 20 years, 75% of benign MS patients maintained an EDSS ≤ 3; after 30 years, 60% did.
• No clinical variables predicted sustained benign status. Significant fatigue (50%), depression (22%), and cognitive impairment (83%) were reported by patients at 30 years.

Conclusions:

• The majority of multiple sclerosis patients retain a benign disease status long-term.
• Cognitive impairment is a prevalent issue in patients with long-standing benign MS, warranting attention.