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Disability outcomes of early cerebellar and brainstem symptoms in multiple sclerosis
M. Le, C. Malpas, S. Sharmin, D. Horáková, E. Havrdova, M. Trojano, G. Izquierdo, S. Eichau, S. Ozakbas, A. Lugaresi, A. Prat, M. Girard, P. Duquette, C. Larochelle, R. Alroughani, R. Bergamaschi, P. Sola, D. Ferraro, P. Grammond, F. Grand'...
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, práce podpořená grantem
PubMed
32538713
DOI
10.1177/1352458520926955
Knihovny.cz E-zdroje
- MeSH
- kohortové studie MeSH
- lidé MeSH
- mozkový kmen MeSH
- postižení * MeSH
- posuzování pracovní neschopnosti MeSH
- progrese nemoci MeSH
- roztroušená skleróza * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. OBJECTIVE: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. METHODS: This study used data from MSBase registry. Patients with early cerebellar/brainstem presentations were identified as those with cerebellar/brainstem relapse(s) or functional system score ⩾ 2 in the initial 2 years. Early pyramidal presentation was chosen as a comparator. Andersen-Gill models were used to compare cumulative hazards of (1) disability progression events and (2) relapses between patients with and without early cerebellar/brainstem symptoms. Mixed effect models were used to estimate the associations between early cerebellar/brainstem presentations and expanded disability status scale (EDSS) scores. RESULTS: The study cohort consisted of 10,513 eligible patients, including 2723 and 3915 patients with early cerebellar and brainstem symptoms, respectively. Early cerebellar presentation was associated with greater hazard of progression events (HR = 1.37, p < 0.001) and EDSS (β = 0.16, p < 0.001). Patients with early brainstem symptoms had lower hazard of progression events (HR = 0.89, p = 0.01) and EDSS (β = -0.06, p < 0.001). Neither presentation was associated with changes in relapse risk. CONCLUSION: Early cerebellar presentation is associated with unfavourable outcomes, while early brainstem presentation is associated with favourable prognosis. These presentations may be used as MS prognostic markers and guide therapeutic approach.
Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino Avellino Italy
Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases Istanbul Turkey
Brain and Mind Centre The University of Sydney Camperdown NSW Australia
Centre hospitalier de l'Universite de Montreal Montreal QC Canada
CISSS de Chaudière Appalache Levis QC Canada
Cliniques Universitaires Saint Luc Brussels Belgium
CORe Department of Medicine The University of Melbourne Melbourne VIC Australia
CSSS Saint Jérôme Saint Jerome QC Canada
Department of Basic Medical Sciences Neuroscience and Sense Organs University of Bari Bari Italy
Department of Medicine and Surgery University of Parma Parma Italy
Department of Neurology Razi Hospital Manouba Tunisia
Department of Neurology The Royal Melbourne Hospital Melbourne VIC Australia
Department of Neuroscience Azienda Ospedaliera Universitaria Modena Italy
Department of Neuroscience Central Clinical School Monash University Melbourne VIC Australia
Division of Neurology Department of Medicine Amiri Hospital Sharq Kuwait
Dokuz Eylul University Konak Izmir Turkey
Faculty of Medicine 19 Mayis University Samsun Turkey
Farabi Hospital KTU Faculty of Medicine Trabzon Turkey
Flinders University Adelaide SA Australia
Haydarpasa Numune Training and Research Hospital Istanbul Turkey
Hospital de Galdakao Usansolo Galdakao Spain
Hospital Germans Trias i Pujol Barcelona Spain
Hospital Universitario Virgen Macarena Sevilla Spain
IRCCS Mondino Foundation Pavia Italy
Isfahan University of Medical Sciences Isfahan Iran Islamic Republic of
Kommunehospitalet Arhus C Denmark
Nemocnice Jihlava Jihlava Czech Republic
Neuro Rive Sud Quebec QC Canada
Ospedali Riuniti di Salerno Salerno Italy
School of Medicine and Public Health The University of Newcastle Australia Newcastle NSW Australia
School of Medicine Koc University Istanbul Turkey
The University of Queensland Brisbane QLD Australia
Universidade Metropolitana de Santos Santos Brazil
UOC Neurologia Azienda Sanitaria Unica Regionale Marche AV3 Macerata Italy
Citace poskytuje Crossref.org
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- $a Le, Minh $u CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia; Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
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- $a BACKGROUND: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. OBJECTIVE: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. METHODS: This study used data from MSBase registry. Patients with early cerebellar/brainstem presentations were identified as those with cerebellar/brainstem relapse(s) or functional system score ⩾ 2 in the initial 2 years. Early pyramidal presentation was chosen as a comparator. Andersen-Gill models were used to compare cumulative hazards of (1) disability progression events and (2) relapses between patients with and without early cerebellar/brainstem symptoms. Mixed effect models were used to estimate the associations between early cerebellar/brainstem presentations and expanded disability status scale (EDSS) scores. RESULTS: The study cohort consisted of 10,513 eligible patients, including 2723 and 3915 patients with early cerebellar and brainstem symptoms, respectively. Early cerebellar presentation was associated with greater hazard of progression events (HR = 1.37, p < 0.001) and EDSS (β = 0.16, p < 0.001). Patients with early brainstem symptoms had lower hazard of progression events (HR = 0.89, p = 0.01) and EDSS (β = -0.06, p < 0.001). Neither presentation was associated with changes in relapse risk. CONCLUSION: Early cerebellar presentation is associated with unfavourable outcomes, while early brainstem presentation is associated with favourable prognosis. These presentations may be used as MS prognostic markers and guide therapeutic approach.
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