Work

Factors associated with the progression of disability (EDSS) among MS patients

Year: 2025

Type: article

Abstract: Multiple sclerosis is a chronic, inflammatory, autoimmune disease of the central nervous system. Accumulating neurological disability has a substantial impact on the lives of patients with MS. The Expanded Disability Status Scale is a method of quantifying disability in MS. The aim of this study was to analyze the disability trajectory across years of patients living with MS seen at the Neurological Institute and to explore factors associated with the rate of change per year. A single-center study was conducted at the Neurological Institute located in the city of Medellin based on medical records obtained from 2013 to 2021. The clinical and demographic characteristics were analyzed using descriptive statistics. To recognize changes in the rate of increase in disability measured by the EDSS with increasing time lived with the disease, a polynomial model was used. Disability measured by the EDSS was not linear over time, there were times when disability progressed more rapidly and other times when it was slower. The bivariate model showed that variables such as gait medications and botulinum toxin had the highest beta values; however, the multivariate model showed that clinical and sociodemographic variables such as initial cerebellar symptoms and sex had the highest significant beta values. This type of study facilitates predictions of natural history within the risk scheme. Prognostic models for chronic diseases are needed to guide management decisions and counseling of patients and their families. Such models can consider outcomes ranging from response to treatment to changes in disability. • Long-term EDSS trajectories were modeled in a retrospective cohort of MS patients. • Several clinical factors were significantly associated with increased EDSS scores. • Higher disability was linked to age at diagnosis, male sex, and multiple symptom domains. • Antidepressants, relaxants, analgesics, botulinum toxin, and other drugs were associated with higher EDSS. • Initial cerebellar, pyramidal, sensory, gait, bladder–bowel, and vision complications predicted EDSS increase. • A longer interval from symptom onset to diagnosis was associated with greater disability progression. • Disease-modifying treatment was associated with a decrease in mean EDSS scores.

Source: eNeurologicalSci

DOI: 10.1016/j.ensci.2025.100602

Authors: Anibal Arteaga-Noriega, Jose Zapata-Berruecos, Johanna Gutiérrez-Vargas, John Camilo Garcia, Diego Rojas-Gualdron, Manuela Restrepo-Botero

Institutions: Universidad CES, Corporación Universitaria Remington, Instituto Neurológico de Colombia, Universidad de Antioquia

Language: English

Topic: Multiple Sclerosis Research Studies

Subfield: Pathology and Forensic Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,260