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Poor recovery after the first two attacks of multiple sclerosis is associated with poor outcome five years later
Journal article   Peer reviewed

Poor recovery after the first two attacks of multiple sclerosis is associated with poor outcome five years later

Thomas F Scott and Carol J Schramke
Journal of the neurological sciences, v 292(1-2), pp 52-56
15 May 2010
PMID: 20202650

Abstract

Adult Chi-Square Distribution Disease Progression Female Humans Kaplan-Meier Estimate Longitudinal Studies Male Middle Aged Multiple Sclerosis - diagnosis Multiple Sclerosis - mortality Patient Selection Prognosis Recovery of Function Regression Analysis Risk Assessment Risk Factors Sex Factors
Examine the relative importance of several risk factors for progression, in a large sample of MS patients. Using a retrospective design in a single university-based MS treatment center, we studied 207 patients with relapsing remitting MS diagnosed, treated at our center, evaluated within one year of their second attack, and at least 2 years after their first attack. Risk factors were: 1) age greater than 40 at first attack; 2) more than 2 attacks in the 2 years from onset; 3) EDSS >1.5 after second attack (poor recovery); 4) male gender; and 5) motor symptoms at onset. Groups were defined as having a few (0 to 2) or many (3 to 5) risk factors. Two hundred seven patients were followed for an average of 94 months (SD=44). 30% were over 40 years of age at onset, 38% had more than 2 attacks in 2 years, 28% had an EDSS >1.5 after the second attack (i.e., had poor recovery), 24% were male, and 58% had motor symptoms at onset. Regression analysis and Kaplan-Meier survival curves that suggested poor recovery after the first two attacks were the best individual predictors of progression at 5 years after initial diagnosis. In addition, having many individual risk factors was associated with having a higher risk of progression (p<.001 by Mann Whitney U, sustained final EDSS at an average disease duration of 9.7 years). This study suggests a paramount importance of recovery from early attacks, as well as an additive effect of individual risk factors for progression of MS in the first several years after diagnosis.

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Collaboration types
Domestic collaboration
Web of Science research areas
Clinical Neurology
Neurosciences
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