The natural history of multiple sclerosis: A geographically based study. I. Clinical course and disability

Brian G Weinshenker, B. Bass, G. P A Rice, J. Noseworthy, W. Carriere, J. Baskerville, G. C. Ebers

Research output: Contribution to journalArticle

1180 Citations (Scopus)

Abstract

The outcome of multiple sclerosis (MS), assessed according to the Kurtzke Disability Status Scale (DSS), was reviewed in 1,099 consecutive patients followed in London, Canada, between 1972 and 1984. A geographically based subgroup of 196 patients representing 90% of Middlesex County MS patients as well as a group of 197 patients seen from onset of disease were separately analysed. The clinical course was progressive from onset in 33% of the total population and in 28% of the Middlesex County subgroup. Of those with duration of 6-10 yrs, 30-40% with initially remitting disease developed progressive MS. The cross-sectional distribution of disability was bimodal with peaks at DSS 1 (no disability) and DSS 6 (assistance required for walking). Actuarial analysis showed that the median time to reach DSS 6 from onset of MS was 14.97 ± 0.31 yrs in the total population and 9.42 ± 0.44 yrs in the 'seen from onset' subgroup. Survival was minimally altered; 87% of patients followed up to 40 yrs were still alive, although ascertainment of cases with this duration of MS was incomplete. Data describing ther ate at which disability develops after the onset of a progressive phase of MS are also presented. The implications of these data in planning and interpretation of clinical therapeutic trials are discussed.

Original languageEnglish (US)
Pages (from-to)133-146
Number of pages14
JournalBrain
Volume112
Issue number1
StatePublished - 1989
Externally publishedYes

Fingerprint

Multiple Sclerosis
Disability
sclerosis
natural history
disease course
Planning
Subgroup
Actuarial Analysis
duration
walking
Bimodal
Population
Walking
Canada
History
Multiple sclerosis
Clinical Trials
planning
Consecutive
therapeutics

ASJC Scopus subject areas

  • Neuroscience(all)
  • Statistics, Probability and Uncertainty
  • Applied Mathematics
  • Mathematics(all)
  • Statistics and Probability
  • Agricultural and Biological Sciences (miscellaneous)
  • Clinical Neurology

Cite this

Weinshenker, B. G., Bass, B., Rice, G. P. A., Noseworthy, J., Carriere, W., Baskerville, J., & Ebers, G. C. (1989). The natural history of multiple sclerosis: A geographically based study. I. Clinical course and disability. Brain, 112(1), 133-146.

The natural history of multiple sclerosis : A geographically based study. I. Clinical course and disability. / Weinshenker, Brian G; Bass, B.; Rice, G. P A; Noseworthy, J.; Carriere, W.; Baskerville, J.; Ebers, G. C.

In: Brain, Vol. 112, No. 1, 1989, p. 133-146.

Research output: Contribution to journalArticle

Weinshenker, BG, Bass, B, Rice, GPA, Noseworthy, J, Carriere, W, Baskerville, J & Ebers, GC 1989, 'The natural history of multiple sclerosis: A geographically based study. I. Clinical course and disability', Brain, vol. 112, no. 1, pp. 133-146.
Weinshenker BG, Bass B, Rice GPA, Noseworthy J, Carriere W, Baskerville J et al. The natural history of multiple sclerosis: A geographically based study. I. Clinical course and disability. Brain. 1989;112(1):133-146.
Weinshenker, Brian G ; Bass, B. ; Rice, G. P A ; Noseworthy, J. ; Carriere, W. ; Baskerville, J. ; Ebers, G. C. / The natural history of multiple sclerosis : A geographically based study. I. Clinical course and disability. In: Brain. 1989 ; Vol. 112, No. 1. pp. 133-146.
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