Prediction of long-term disability in multiple sclerosis

2011 ◽  
Vol 18 (1) ◽  
pp. 31-38 ◽  
Author(s):  
R Schlaeger ◽  
M D’Souza ◽  
C Schindler ◽  
L Grize ◽  
S Dellas ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Evoked Potentials ◽  
Rank Correlation ◽  
Daily Practice ◽  
Z Score ◽  
Monitoring Methods ◽  
Spearman’S Rank Correlation ◽  
Mri Scans ◽  
Cranial Mri

Background: Little is known about the predictive value of neurophysiological measures for the long-term course of multiple sclerosis (MS). Objective: To prospectively investigate whether combined visual (VEP) and motor evoked potentials (MEP) allow prediction of disability over 14 years. Methods: A total of 30 patients with relapsing–remitting and secondary progressive MS were prospectively investigated with VEPs, MEPs and the Expanded Disability Status Scale (EDSS) at entry (T0) and after 6, 12 and 24 months, and with cranial MRI scans at entry (T2-weighted and gadolinium-enhanced T1-weighted images). EDSS was again assessed at year 14 (T4). The association between evoked potential (EP), magnetic resonance (MR) data and EDSS was measured using Spearman’s rank correlation. Multivariable linear regression was performed to predict EDSST4 as a function of z-transformed EP-latenciesT0. The model was validated using a jack-knife procedure and the potential for improving it by inclusion of additional baseline variables was examined. Results: EDSS valuesT4 correlated with the sum of z-transformed EP-latenciesT0 (rho = 0.68, p < 0.0001), but not with MR-parametersT0. EDSST4 as predicted by the formula EDSST4 = 4.194 + 0.088 * z-score P100T0 + 0.071 * z-score CMCTUE, T0 correlated with the observed values (rho = 0.69, p < 0.0001). Conclusion: Combined EPs allow prediction of long-term disability in small groups of patients with MS. This may have implications for the choice of monitoring methods in clinical trials and for daily practice decisions.

Combined visual and motor evoked potentials predict multiple sclerosis disability after 20 years

2014 ◽  
Vol 20 (10) ◽  
pp. 1348-1354 ◽  
Author(s):  
Regina Schlaeger ◽  
Christian Schindler ◽  
Leticia Grize ◽  
Sophie Dellas ◽  
Ernst W Radue ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Evoked Potentials ◽  
Rank Correlation ◽  
Disease Modifying Therapy ◽  
Disability Status ◽  
Adaptive Processes ◽  
Multivariable Regression ◽  
Predictive Relationships ◽  
Magnetic Resonance Imaging Mri

Background: The development of predictors of multiple sclerosis (MS) disability is difficult due to the complex interplay of pathophysiological and adaptive processes. Objective: The purpose of this study was to investigate whether combined evoked potential (EP)-measures allow prediction of MS disability after 20 years. Methods: We examined 28 patients with clinically definite MS according to Poser’s criteria with Expanded Disability Status Scale (EDSS) scores, combined visual and motor EPs at entry (T0), 6 (T1), 12 (T2) and 24 (T3) months, and a cranial magnetic resonance imaging (MRI) scan at T0 and T2. EDSS testing was repeated at year 14 (T4) and year 20 (T5). Spearman rank correlation was used. We performed a multivariable regression analysis to examine predictive relationships of the sum of z-transformed EP latencies ( s-EPT0) and other baseline variables with EDSST5. Results: We found that s-EPT0 correlated with EDSST5 (rho=0.72, p<0.0001) and ΔEDSST5-T0 (rho=0.50, p=0.006). Backward selection resulted in the prediction model: E (EDSST5)=3.91–2.22×therapy+0.079×age+0.057× s-EPT0 (Model 1, R2=0.58) with therapy as binary variable (1=any disease-modifying therapy between T3 and T5, 0=no therapy). Neither EDSST0 nor T2-lesion or gadolinium (Gd)-enhancing lesion quantities at T0 improved prediction of EDSST5. The area under the receiver operating characteristic (ROC) curve was 0.89 for model 1. Conclusions: These results further support a role for combined EP-measures as predictors of long-term disability in MS.

scholarly journals An Analysis of the Condition of the Tourist Brand and Tourist Attractiveness of the Podkarpackie Region Based on the Brand Asset Valuator Model

2019 ◽  
Vol 26 (2) ◽  
pp. 34-39
Author(s):  
Beata Gierczak-Korzeniowska
Keyword(s):  
Applied Research ◽  
Rank Correlation ◽  
Point Of View ◽  
Chi Square ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Ecological Aspects ◽  
Historical Heritage ◽  
Term Management

AbstractIntroduction. There are many factors which determine the attractiveness of a region for tourists. However, such assessments are, relatively rarely, a result of the analysis of the presence and condition of regional tourist brands and their perception among visitors. The analysis and assessment of the condition of a brand can be carried out using the BAV (Brand Asset Valuator). This is an extremely interesting and useful tool which explains the dynamics of behaviour of brands on the market and diagnoses their “health”, supporting the process of their long-term management.Materials and methods. On the basis of the results of a pilot study, an attempt is made to measure the tourist attractiveness of the Podkarpackie region through the assessment of regional tourist brands and their features which are important from the point of view of the inhabitants of the region. The BAV model was used to analyse 32 tourist products. The applied research methods include the Mann-Whitney test, Spearman’s rank correlation coefficient, and the chi-square independence test.Results. The mapped data analysis based on the BAV model showed that 16 out of 32 products assessed were located in the leadership quadrant. The majority of the remaining products were in the development or decline phases.Conclusions. The presence of branded tourist products and their number have an impact on the tourist attractiveness of the region. The following aspects of the region were considered the most attractive: nature (natural surroundings, natural values, and ecological aspects), heritage (historical heritage and monuments and presentation of important past events), and tourism (tourism and recreation offerings).

scholarly journals Index-based and compliance assessment of water quality for a Brazilian subtropical reservoir

2018 ◽  
Vol 23 (5) ◽  
pp. 841-848 ◽  
Author(s):  
William Bonino Rauen ◽  
Ana Camila Ferraresi ◽  
Leila Maranho ◽  
Edinalva Oliveira ◽  
Rudhy Costa ◽  
...  
Keyword(s):  
Water Quality ◽  
Temporal Trends ◽  
Rank Correlation ◽  
Metropolitan Region ◽  
Biological Assessment ◽  
Trophic State Index ◽  
Reservoir Water ◽  
Spearman’S Rank Correlation ◽  
Physical Chemical

ABSTRACT The Passaúna catchment is part of the Upper Iguaçu watershed and includes a water supply reservoir for over 500,000 inhabitants of Curitiba metropolitan region. The aim of this study was to establish the state of reservoir water quality, and whether it has undergone any recent medium- and long-term variations. A physical-chemical-biological assessment was undertaken using nine indicators and three indexes: Water Quality Index (WQI), Trophic State Index (TSI) and Shannon-Weaver Index (H’) for macroinvertebrate diversity. Compliance with the prescribed quality standards for the water body was verified using frequency curves. Two WQI calculation approaches were contrasted to test for conditions of partial data unavailability. Temporal trends in key parameters were assessed using Spearman’s rank correlation coefficient. WQI results from 1991-2014 indicated that the water quality may be classified as good and improved in the final decade of such period, while most TSI results were in the oligotrophic/mesotrophic range, but with no significant temporal trend. The biodiversity result of H’=1.6 obtained with data acquired in 2014 indicated a moderately degraded ecosystem that is typically associated with flow regulation and a degree of water quality impairment. Such a multi-indicator integrated physical-chemical-biological monitoring approach comprised a robust framework for assessments of medium-long term aquatic health.

scholarly journals Correlation Between Disability Measure and Black Hole (T1 Hypointense Lesion) Lesion Load in Brain Magnetic Resonance Imaging (MRI) of Patients With Multiple Sclerosis (MS): Protocol for a Systematic Review and Meta-analysis

2021 ◽  
Author(s):  
Amir Valizadeh ◽  
Elham Barati ◽  
Mohammad Ali Sahraian ◽  
Mohammad Reza Fattahi ◽  
Mana Moassefi
Keyword(s):  
Multiple Sclerosis ◽  
Meta Analysis ◽  
Rank Correlation ◽  
Brain Magnetic Resonance Imaging ◽  
Lesion Volume ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Disability Status ◽  
Formation And Evolution ◽  
Magnetic Resonance Imaging Mri

Abstract Introduction: As the role of neurodegeneration in the pathophysiology of multiple sclerosis (MS) has become more prominent, the formation and evolution of chronic or persistent T1-hypointense lesions (Black Holes) have been used as markers of axonal loss and neuronal destruction to measure disease activity. However, findings regarding this subject are controversial. In this study we aim to clarify the level of importance of T1 hypointense lesions for estimating the prognosis of patients.Methods: We will search MEDLINE (through PubMed), Embase and Web of Science for relevant studies. We will extract the Spearman's rank correlation coefficient (SRCC) between the T1 hypointense lesion volume and Extended Disability Status Scale (EDSS) in participants. All included studies will be evaluated for the risk of bias. We will also perform a meta-analysis on the data. The risk of publication bias will be evaluated using Funnel plots. Finally, we will assess the confidence in cumulative evidence using an adapted version of GRADE.

scholarly journals Initial blood pressure is important for long-term outcome after traumatic spinal cord injury

2020 ◽  
Vol 33 (2) ◽  
pp. 256-260 ◽  
Author(s):  
Mette Haldrup ◽  
Stig Dyrskog ◽  
Mathias Møller Thygesen ◽  
Hans Kirkegaard ◽  
Helge Kasch ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Correlation Coefficient ◽  
Chart Review ◽  
Rank Correlation ◽  
Traumatic Spinal Cord Injury ◽  
Spearman’S Rank Correlation ◽  
Spearman’S Rank Correlation Coefficient ◽  
Cord Injury

OBJECTIVEPatients with traumatic spinal cord injury (TSCI) are at risk of developing neurogenic shock that causes hypotension and thereby secondary injury to the spinal cord due to ischemia. Hemodynamic treatment of patients with acute TSCI remains inadequately elucidated. Guidelines for management are divergent and based on limited evidence. To this end, the authors evaluated whether mean arterial blood pressure (MABP) during the prehospital and initial hospital phases of TSCI treatment is correlated with long-term neurological outcome.METHODSThe authors performed a retrospective cohort study based on a chart review of MABP data collected during the prehospital transport, in the operating room (OR), and in the neurointensive care unit (NICU) during the first 7 days after trauma. Data from the NICU were divided into two periods: days 1–2 and days 3–7. Data were analyzed using Spearman’s rank correlation to evaluate for any correlation between MABP and changes in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) score 1 year postinjury. In the analysis, the MABP target value was 80 mm Hg. Hypotension was treated with metaoxedrin or norepinephrine. Statistically significant differences were evaluated using Spearman’s rank correlation coefficient.RESULTSThe chart review yielded 129 patients treated for TSCI. The inclusion period was 2010–2017. For the prehospital transport measurements of MABP, the Spearman’s rank correlation coefficient was a rho of 0.5662 (p < 0.001), for OR measurements it was a rho of 0.6818 (p < 0.001), and for the NICU measurements it was a rho of 0.4611 (p < 0.001); for NICU unit days 1–2 and days 3–7, the Spearman’s rank correlation coefficient was a rho of 0.2209 (p = 0.0681).CONCLUSIONSContinuous MABP levels exceeding 80 mm Hg have a significant impact on neurological outcome—from earliest possible stabilization in the prehospital care, through hospital admission, the surgical phase, and into the first 2 days in the NICU.

scholarly journals Is There Any Relationship between Upper and Lower Limb Impairments in People with Multiple Sclerosis? A Kinematic Quantitative Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Giancarlo Coghe ◽  
Federica Corona ◽  
Giuseppina Pilloni ◽  
Micaela Porta ◽  
Jessica Frau ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Lower Limb ◽  
Rank Correlation ◽  
Correlation Coefficients ◽  
Motor Tasks ◽  
Motor Abilities ◽  
Spearman’S Rank Correlation ◽  
Gait Parameters ◽  
Disability Status ◽  
Spatiotemporal Parameters

Background. In people with multiple sclerosis (pwMS), disability is generally assessed on the basis of ambulation abilities, whereas upper limb motor dysfunctions are less frequently considered. Nevertheless, they can severely affect the quality of life of pwMS. To date, it remains mostly unknown whether a relationship exists between upper and lower limb impairments. Aim. To investigate the existence of a relationship between upper and lower limb impairments in pwMS based on two fundamental motor tasks, namely walking and hand-to-mouth (HTM) movement. Methods. Twenty-eight pwMS with Expanded Disability Status Scale (EDSS) scores in the range of 1–6, and 21 healthy controls (HC) underwent a kinematic analysis of gait and HTM movement performed with a motion capture system. The spatiotemporal parameters for the two tasks were calculated and correlated using Spearman’s rank correlation coefficients. Results. The pwMS performed worse than HC on both tasks. Small to large correlations were found between the total HTM movement duration and most of the gait parameters (rho, 0.35–0.68; p<0.05). Conclusions. Both upper and lower limb motor abilities in pwMS worsen as disability increases. Nevertheless, their relationship is only moderate. This finding emphasizes the need for specific tests to quantify disability considering the overall motor function in pwMS.

Increasing female preponderance of multiple sclerosis in Isfahan, Iran: a population-based study

2010 ◽  
Vol 16 (3) ◽  
pp. 359-361 ◽  
Author(s):  
AH Maghzi ◽  
H. Ghazavi ◽  
M. Ahsan ◽  
M. Etemadifar ◽  
SA Mousavi ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Sex Ratio ◽  
Rank Correlation ◽  
Population Based ◽  
Vitamin D Insufficiency ◽  
Lifestyle Changes ◽  
Isfahan Province ◽  
Male Ratio ◽  
Spearman’S Rank Correlation ◽  
Environmental Interactions

There is an overall increase in the worldwide prevalence and incidence of multiple sclerosis (MS). Studies from several countries also demonstrated an increase of female/male ratio over time denoting an increase in the incidence of MS particularly in women. In this study we sought to assess the trends in MS incidence and prevalence in males and females over recent decades in Isfahan, Iran, which differs from other regions in terms of environmental and lifestyle changes. We determined female/male ratio by year of birth (YOB) in 1584 patients with MS registered with Isfahan Multiple Sclerosis Society (IMSS) from April 2003 to August 2007. A comparison of sex ratio of MS patients by YOB showed a significant, progressive, gradual increase, with an apparent interruption in the late 1960s. In this study year of birth is a significant predictor for sex ratio ( p < 0.001, χ2 = 17.130, Spearman’s rank correlation r = 0.893). Our findings show that there is a significant increase in the incidence of MS among females for the the last decades in the Isfahan province of Iran. This rapid increase may be related to changes in environmental interactions rather than genetic factors, and among them vitamin D insufficiency, enhanced diagnosis, and lifestyle changes appear to be more plausible causative factors.

scholarly journals Bone Mineral Content in Patients with Anaphylactic Reactions, Signs of Mastocytosis and Elevated Basal Serum Tryptase Levels

2010 ◽  
Vol 3 (1) ◽  
pp. 7-15 ◽  
Author(s):  
Christoph Bucher ◽  
Daniel Uebelhart ◽  
Brunello Wüthrich ◽  
Jaap Swanenburg ◽  
Gerhard W. Goerres
Keyword(s):  
Bone Mineral ◽  
Characteristic Curve ◽  
Cell Mass ◽  
Rank Correlation ◽  
Z Score ◽  
Serum Tryptase ◽  
Mineral Density ◽  
Spearman’S Rank Correlation ◽  
Basal Serum ◽  
Increased Risk

Introduction: To examine the relationship between elevated basal serum tryptase levels (BST), a marker of total mast cell mass, and bone mineral density (BMD) in patients with anaphylactic reactions and signs of mastocytosis. Methods: Retrospective evaluation of patient charts at an allergy unit. Patients with BST levels above 20 ng/ml were eligible if clinical and follow-up data and results of dual X-ray absorptiometry (DXA) were available. Patients with previous use of anti-osteoporotic medications and with osteoporosis not caused by mastocytosis were excluded. Spearman’s rank correlation, Mann-Whitney test and receiver operating characteristic curve (ROC) was used for analysis. Results: 24 patients were included. The main presenting symptom (17 of 24 patients) was anaphylactic reactions to insect stings. BST levels ranged between 21 and 158 ng/ml (median 48 ng/ml). Study participants with Z-score values below - 1.0 had a median BST level of 46 ng/ml, the patients with Z-score values above or equal to -1.0 had a median BST level of 27 ng/ml. ROC analysis of the patient group with BST values between 30 and 100 ng/ml revealed a best cut-off value of BST to detect a low BMD when BST level would be at least 27 ng/ml resulting in a sensitivity of 92% and a specificity of 70%. Conclusion: Patients with moderately elevated BST levels seem to be at increased risk for low BMD.

scholarly journals DIAGNOSIS OF THE LEVEL OF FORMATION OF CONSCIOUS PARENTHOOD OF STUDENT YOUTH AS A CONDITION FOR THE PREVENTION OF SOCIAL ORPHANHOOD

2020 ◽  
Vol 1 ◽  
pp. 287
Author(s):  
Larysa Kalchenko ◽  
Nataliya Ostrovska ◽  
Galyna Kuzmenko
Keyword(s):  
Higher Education ◽  
Survey Methods ◽  
Rank Correlation ◽  
Monitoring Methods ◽  
Social Phenomena ◽  
Spearman’S Rank Correlation ◽  
Formative Stage ◽  
Spearman’S Rank Correlation Coefficient ◽  
Main Components ◽  
The City

The article reveals the problem of the dependence of social phenomena – conscious parenthood and social orphanhood. The aim of the article is to present the results of experimental research in diagnosis of the level of creation of conscious parenting of student youth as a condition of prevention of social orphanhood in the territorial community of the city. The characteristic of the main components of the process of the formation of conscious parenthood of student youth is given, the essence of the phenomenon of social orphanhood is revealed. The main methods of this study are: methods of theoretical knowledge - analysis, synthesis, systematization, classification, generalization, focus groups, ranking method, survey methods - questioning, testing, socio-pedagogical experiment, monitoring, methods of mathematical statistics (Pearson's criterion χ2, Fisher criterion *F-test, Spearman's rank correlation coefficient). The results of the ascertaining and control stages of the experimental study on the diagnosis of the level of formation of the conscious parenthood of student youth in institutions of higher education in the cities of Lviv, Kyiv and Khmelnytsky (Ukraine) are presented.Diagnostic results of the ascertaining stage of the experiment has shown that the majority of modern Ukrainian students has a low level of knowledge and skills about conscious parenthood and they are practically not aware of the possibilities of the subjects of the territorial community of the city towards forming the youth conscious parenthood and preventing of the social orphanhood. At the formative stage of the experiment the strategy of involving and activating young students into the process of forming conscious parenthood through development and realization of social and pedagogical technology, aimed to popularization of the idea of conscious parenting among youth, is determined as a condition for precluding the Kalchenko et al., 2020.Диагностика уровня сформированности осознанного родительства студенческой молодёжи как условие превенции социального сиротства 288 phenomenon of social orphanhood, abandonment and homelessness of children. The results of the control phase of the experiment have confirmed the effectiveness of the developed and tested social-pedagogical technology and have shown a positive dynamics of changes in the level of formation of the conscious parenthood of students of the higher education institutions experimental groups for all indicators of cognitive and value-based behavioural criteria. 

The predictive value of gadolinium enhancement for long term disability in relapsing-remitting multiple sclerosis-preliminary results

2001 ◽  
Vol 7 (1) ◽  
pp. 23-25 ◽  
Author(s):  
N A Losseff ◽  
D H Miller ◽  
D Kidd ◽  
A J Thompson
Keyword(s):  
Multiple Sclerosis ◽  
Median Number ◽  
Short Term ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Relapsing Remitting ◽  
Mri Scans ◽  
Relapsing Remitting Multiple Sclerosis

As short-term MRI studies are increasingly being used to monitor disease activity in multiple sclerosis (MS) it is vital to establish if short-term MRI activity is predictive of long term clinical outcome. We followed up after 5 years a group of 10 benign (relapsing-remitting MS with a disease duration 410 years and EDSS 43) and 10 early relapsing-remitting patients who previously had monthly serial MRI scans for 6 months. In the early relapsing-remitting group median EDSS at entry to the initial serial study was three and in the benign group 2.5. At 5-year follow up, five of these 20 patients had developed a definite deterioration in EDSS. The median number of new enhancing lesions detected originally in the group that had deteriorated was 11 (7-17) compared to 0 (0-5) new enhancing lesions, for those who had not deteriorated (P50.05). There was a trend towards a higher baseline T2 lesion load in the group with a definite change in EDSS but this was not significant. This study suggests that short-term measurement of the number of gadolinium enhancing lesions may predict long term outcome in relapsing-remitting MS.

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