Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis
Background: Compared to the adult onset of multiple sclerosis (AOMS), both early-onset (EOMS) and late-onset (LOMS) are much less frequent, but are often under- or misdiagnosed. The aims of the present study were: 1. To compare demographic and clinical features of individuals with EOMS, AOMS and LOM...
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| Format: | Article |
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MDPI AG
2020-05-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/9/5/1326 |
| _version_ | 1797568892435955712 |
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| author | Omid Mirmosayyeb Serge Brand Mahdi Barzegar Alireza Afshari-Safavi Nasim Nehzat Vahid Shaygannejad Dena Sadeghi Bahmani |
| author_facet | Omid Mirmosayyeb Serge Brand Mahdi Barzegar Alireza Afshari-Safavi Nasim Nehzat Vahid Shaygannejad Dena Sadeghi Bahmani |
| author_sort | Omid Mirmosayyeb |
| collection | DOAJ |
| description | Background: Compared to the adult onset of multiple sclerosis (AOMS), both early-onset (EOMS) and late-onset (LOMS) are much less frequent, but are often under- or misdiagnosed. The aims of the present study were: 1. To compare demographic and clinical features of individuals with EOMS, AOMS and LOMS, and 2. To identify predictors for disability progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS). Method: Data were taken from the Isfahan Hakim MS database. Cases were classified as EOMS (MS onset <inline-formula> <math display="inline"> <semantics> <mo>≤</mo> </semantics> </math> </inline-formula>18 years), LOMS (MS onset >50 years) and AOMS (MS >18 and <inline-formula> <math display="inline"> <semantics> <mo>≤</mo> </semantics> </math> </inline-formula>50 years). Patients’ demographic and clinical (initial symptoms; course of disease; disease patterns from MRI; disease progress) information were gathered and assessed. Kaplan–Meier and Cox proportional hazard regressions were conducted to determine differences between the three groups in the time lapse in conversion from relapsing remitting MS to secondary progressive MS. Results: A total of 2627 MS cases were assessed; of these 127 were EOMS, 84 LOMS and 2416 AOMS. The mean age of those with EOMS was 14.5 years; key symptoms were visual impairments, brain stem dysfunction, sensory disturbances and motor dysfunctions. On average, 24.6 years after disease onset, 14.2% with relapsing remitting MS (RRMS) were diagnosed with secondary progressive MS (SPMS). The key predictor variable was a higher Expanded Disability Status Scale (EDSS) score at disease onset. Compared to individuals with AOMS and LOMS, those with EOMS more often had one or two relapses in the first two years, and more often gadolinium-enhancing brain lesions. For individuals with AOMS, mean age was 29.4 years; key symptoms were sensory disturbances, motor dysfunctions and visual impairments. On average, 20.5 years after disease onset, 15.6% with RRMS progressed to SPMS. The key predictors at disease onset were: a higher EDSS score, younger age, a shorter inter-attack interval and spinal lesions. Compared to individuals with EOMS and LOMS, individuals with AOMS more often had either no or three and more relapses in the first two years. For individuals with LOMS, mean age was 53.8 years; key symptoms were motor dysfunctions, sensory disturbances and visual impairments. On average, 14 years after disease onset, 25.3% with RRMS switched to an SPMS. The key predictors at disease onset were: occurrence of spinal lesions and spinal gadolinium-enhancement. Compared to individuals with EOMS and AOMS, individuals with LOMS more often had no relapses in the first two years, and higher EDSS scores at disease onset and at follow-up. Conclusion: Among a large sample of MS sufferers, cases with early onset and late onset are observable. Individuals with early, adult and late onset MS each display distinct features which should be taken in consideration in their treatment. |
| first_indexed | 2024-03-10T20:03:18Z |
| format | Article |
| id | doaj.art-41256ab1dda449769c55db34b940e81c |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T20:03:18Z |
| publishDate | 2020-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-41256ab1dda449769c55db34b940e81c2023-11-19T23:23:04ZengMDPI AGJournal of Clinical Medicine2077-03832020-05-0195132610.3390/jcm9051326Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple SclerosisOmid Mirmosayyeb0Serge Brand1Mahdi Barzegar2Alireza Afshari-Safavi3Nasim Nehzat4Vahid Shaygannejad5Dena Sadeghi Bahmani6Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, IranCenter of Depression, Stress and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, 4002 Basel, SwitzerlandIsfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, IranDepartment of Biostatistics and Epidemiology, Faculty of Health, North Khorasan University of Medical Sciences, Bojnurd 74877-94149, IranIsfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, IranIsfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan 81746-73461, IranCenter of Depression, Stress and Sleep Disorders, Psychiatric Clinics (UPK), University of Basel, 4002 Basel, SwitzerlandBackground: Compared to the adult onset of multiple sclerosis (AOMS), both early-onset (EOMS) and late-onset (LOMS) are much less frequent, but are often under- or misdiagnosed. The aims of the present study were: 1. To compare demographic and clinical features of individuals with EOMS, AOMS and LOMS, and 2. To identify predictors for disability progression from relapsing remitting MS (RRMS) to secondary progressive MS (SPMS). Method: Data were taken from the Isfahan Hakim MS database. Cases were classified as EOMS (MS onset <inline-formula> <math display="inline"> <semantics> <mo>≤</mo> </semantics> </math> </inline-formula>18 years), LOMS (MS onset >50 years) and AOMS (MS >18 and <inline-formula> <math display="inline"> <semantics> <mo>≤</mo> </semantics> </math> </inline-formula>50 years). Patients’ demographic and clinical (initial symptoms; course of disease; disease patterns from MRI; disease progress) information were gathered and assessed. Kaplan–Meier and Cox proportional hazard regressions were conducted to determine differences between the three groups in the time lapse in conversion from relapsing remitting MS to secondary progressive MS. Results: A total of 2627 MS cases were assessed; of these 127 were EOMS, 84 LOMS and 2416 AOMS. The mean age of those with EOMS was 14.5 years; key symptoms were visual impairments, brain stem dysfunction, sensory disturbances and motor dysfunctions. On average, 24.6 years after disease onset, 14.2% with relapsing remitting MS (RRMS) were diagnosed with secondary progressive MS (SPMS). The key predictor variable was a higher Expanded Disability Status Scale (EDSS) score at disease onset. Compared to individuals with AOMS and LOMS, those with EOMS more often had one or two relapses in the first two years, and more often gadolinium-enhancing brain lesions. For individuals with AOMS, mean age was 29.4 years; key symptoms were sensory disturbances, motor dysfunctions and visual impairments. On average, 20.5 years after disease onset, 15.6% with RRMS progressed to SPMS. The key predictors at disease onset were: a higher EDSS score, younger age, a shorter inter-attack interval and spinal lesions. Compared to individuals with EOMS and LOMS, individuals with AOMS more often had either no or three and more relapses in the first two years. For individuals with LOMS, mean age was 53.8 years; key symptoms were motor dysfunctions, sensory disturbances and visual impairments. On average, 14 years after disease onset, 25.3% with RRMS switched to an SPMS. The key predictors at disease onset were: occurrence of spinal lesions and spinal gadolinium-enhancement. Compared to individuals with EOMS and AOMS, individuals with LOMS more often had no relapses in the first two years, and higher EDSS scores at disease onset and at follow-up. Conclusion: Among a large sample of MS sufferers, cases with early onset and late onset are observable. Individuals with early, adult and late onset MS each display distinct features which should be taken in consideration in their treatment.https://www.mdpi.com/2077-0383/9/5/1326multiple sclerosisage of onsetearly onsetlate onsetmagnetic resonance imagingpredictors |
| spellingShingle | Omid Mirmosayyeb Serge Brand Mahdi Barzegar Alireza Afshari-Safavi Nasim Nehzat Vahid Shaygannejad Dena Sadeghi Bahmani Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis Journal of Clinical Medicine multiple sclerosis age of onset early onset late onset magnetic resonance imaging predictors |
| title | Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis |
| title_full | Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis |
| title_fullStr | Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis |
| title_full_unstemmed | Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis |
| title_short | Clinical Characteristics and Disability Progression of Early- and Late-Onset Multiple Sclerosis Compared to Adult-Onset Multiple Sclerosis |
| title_sort | clinical characteristics and disability progression of early and late onset multiple sclerosis compared to adult onset multiple sclerosis |
| topic | multiple sclerosis age of onset early onset late onset magnetic resonance imaging predictors |
| url | https://www.mdpi.com/2077-0383/9/5/1326 |
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