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.

Cerrahpaşa Faculty of Medicine Istanbul University Istanbul Turkey

Department of Health Sciences Research Mayo Clinic College of Medicine and Science Rochester MN USA

Department of Neurology Mayo Clinic College of Medicine and Science Rochester MN USA Polyclinic Medicina Plus Prague Czech Republic

Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology and Department of Neurology Mayo Clinic College of Medicine Rochester MN USA

Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology and Department of Neurology Mayo Clinic College of Medicine Rochester MN USA Cerrahpaşa Faculty of Medicine Istanbul University Istanbul Turkey

Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology and Department of Neurology Mayo Clinic College of Medicine Rochester MN USA Department of Radiology Mayo Clinic College of Medicine Rochester MN USA

Mayo Clinic Center for Multiple Sclerosis and Autoimmune Neurology and Department of Neurology Mayo Clinic College of Medicine Rochester MN USA HealthPartners Neuroscience Center Saint Paul MN USA

Citace poskytuje Crossref.org

Using personalized prognosis in the treatment of relapsing multiple sclerosis: A practical guide

Clinical Parameters to Predict Future Clinical Disease Activity After Treatment Change to Higher-Dose Subcutaneous Interferon Beta-1a From Other Platform Injectables in Patients With Relapsing-Remitting Multiple Sclerosis