Age is a critical determinant in recovery from multiple sclerosis relapses
MULTIPLE SCLEROSIS JOURNAL, cilt.25, sa.13, ss.1754-1763, 2019 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 25 Sayı: 13
- Basım Tarihi: 2019
- Doi Numarası: 10.1177/1352458518800815
- Dergi Adı: MULTIPLE SCLEROSIS JOURNAL
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.1754-1763
- Anahtar Kelimeler: Multiple sclerosis, relapse, recovery, age, population-based cohort, extended disability status score, fulminance, PLASMA-EXCHANGE, NATURAL-HISTORY, OLMSTED COUNTY, DISABILITY, IMPAIRMENT, PREVALENCE, SEVERITY, ONSET, PHASE
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Hayır
Özet
Objective: To evaluate the impact of age on recovery from multiple sclerosis relapses. Background: Increasing disability in multiple sclerosis is a consequence of progressive disease and incomplete relapse recovery. Methods: The first and last-ever relapse data (357 relapses in 193 patients) from the Olmsted County population-based multiple sclerosis cohort were systematically reviewed for age, fulminance, location (optic nerve, brainstem/cerebellar, spinal cord), peak deficit, and maximum recovery. Three different relapse-outcome measures were studied both as paired analyses and as an overall group effect: change from peak deficit to maximum recovery in raw functional system score related to the relapse (Delta FSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (Delta EDSS) score. Results: Older age was linearly associated with worse recovery in the Delta FSS outcome (p = 0.002), Delta EDSS outcome (p < 0.001), and the FSS-based relapse-impact model (p < 0.001). A multivariate analysis of Delta FSS outcome linked poor recovery to older age (p = 0.015), relapse location (transverse myelitis or brainstem/cerebellar syndrome; p < 0.001), and relapse fulminance (p = 0.004). Conclusion: Multiple sclerosis-relapse recovery declines in a linear fashion with increased age, which should be considered when making treatment decisions.