Age is a critical determinant in recovery from multiple sclerosis relapses

Brittani L. Conway, Burcu Zeydan, Uğur Uygunoğlu, Martina Novotna, Aksel Siva, Sean J Pittock, Elizabeth J. Atkinson, Moses Rodriguez, Orhun H Kantarci

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

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 (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. Results: Older age was linearly associated with worse recovery in the ΔFSS outcome (p = 0.002), ΔEDSS outcome (p < 0.001), and the FSS-based relapse-impact model (p < 0.001). A multivariate analysis of ΔFSS 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.

Original languageEnglish (US)
JournalMultiple Sclerosis Journal
DOIs
StateAccepted/In press - Jan 1 2018

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Multiple Sclerosis
Recurrence
Brain Stem
Transverse Myelitis
Cerebellar Diseases
Optic Nerve
Spinal Cord
Decision Making
Multivariate Analysis
Outcome Assessment (Health Care)

Keywords

  • age
  • extended disability status score
  • fulminance
  • Multiple sclerosis
  • population-based cohort
  • recovery
  • relapse

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Age is a critical determinant in recovery from multiple sclerosis relapses. / Conway, Brittani L.; Zeydan, Burcu; Uygunoğlu, Uğur; Novotna, Martina; Siva, Aksel; Pittock, Sean J; Atkinson, Elizabeth J.; Rodriguez, Moses; Kantarci, Orhun H.

In: Multiple Sclerosis Journal, 01.01.2018.

Research output: Contribution to journalArticle

Conway, Brittani L. ; Zeydan, Burcu ; Uygunoğlu, Uğur ; Novotna, Martina ; Siva, Aksel ; Pittock, Sean J ; Atkinson, Elizabeth J. ; Rodriguez, Moses ; Kantarci, Orhun H. / Age is a critical determinant in recovery from multiple sclerosis relapses. In: Multiple Sclerosis Journal. 2018.
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abstract = "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 (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. Results: Older age was linearly associated with worse recovery in the ΔFSS outcome (p = 0.002), ΔEDSS outcome (p < 0.001), and the FSS-based relapse-impact model (p < 0.001). A multivariate analysis of ΔFSS 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.",
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AU - Atkinson, Elizabeth J.

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