scholarly journals Oligoclonal Immunoglobulin Gamma Bands and Long-Term Disability Progression in Multiple Sclerosis: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Virginija Danylaité Karrenbauer ◽  
Sahl Bedri ◽  
Jan Hillert ◽  
Ali Manochehrinia
Keyword(s):  
Multiple Sclerosis ◽  
Cox Regression ◽  
Brain Mri ◽  
Oligoclonal Bands ◽  
Clinical Aspects ◽  
Positive Group ◽  
Mri Features ◽  
Edss Score ◽  
Immunoglobulin Gamma

Abstract Background Multiple sclerosis (MS) patients without the typical oligoclonal bands (OCB) distribution of immunoglobulin gamma (IgG) in the cerebrospinal fluid (CSF) has a different genetic background and brain MRI features than OCB-positive MS patients. It is less clear if OCB presence indicates differences in clinical aspects of MS. Objective To determine whether CSF OCB status is associated with long-term disability outcomes. Methods We used Swedish MS register data on clinically definite MS patients with known OCB status. Date of birth, MS onset and date at sustained Expanded Disability Status Scale (EDSS) score milestones 3, 4, 6, date at conversion to secondary progressive (SP) MS, sex, and immunomodulatory treatment (IMTs) duration were collected. Multivariate Cox regression models were used to investigate the association between OCB status and risk of reaching each milestone. Results The OCB-positive group reached disability milestones at an earlier time and at younger age. OCB positivity significantly increased the risk of reaching EDSS score 3.0 (HR = 1.29, 95%CI: 1.12 to 1.48, P < 0.001) and 4.0 (HR = 1.38, 95%CI: 1.17 to 1.63, P < 0.001) but non-significantly for EDSS 6. The OCB-positive group had a 20 % higher risk to convert to SPMS. Conclusion Patients with or without CSF OCBs share a risk of long term progression and for conversion to SPMS. Presence of OCBs in the CSF is associated with higher risk to reach EDSS milestones and a higher risk to convert to SPMS. Our findings suggest higher disease modifying effect of OCB presence in the early inflammatory stages of MS.

scholarly journals Cerebrospinal fluid oligoclonal immunoglobulin gamma bands and long-term disability progression in multiple sclerosis: a retrospective cohort study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Virginija Danylaité Karrenbauer ◽  
Sahl Khalid Bedri ◽  
Jan Hillert ◽  
Ali Manouchehrinia
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Cox Regression ◽  
Brain Mri ◽  
Oligoclonal Bands ◽  
Positive Group ◽  
Mri Features ◽  
Modifying Effect ◽  
Immunoglobulin Gamma

AbstractMultiple sclerosis (MS) patients with immunoglobulin gamma (IgG) oligoclonal bands (OCB) in the cerebrospinal fluid (CSF) have different genetic backgrounds and brain MRI features compared to those without. In this study, we aimed to determine whether CSF-OCB status is associated with long-term disability outcomes. We used Swedish MS register data on clinically definite MS patients with known OCB status. Date of birth, age at MS onset, and time to sustained Expanded Disability Status Scale (EDSS) milestones 3, 4, and 6; time to conversion to secondary progressive (SP) MS, sex, and immunomodulatory treatment (IMTs) duration were collected. Multivariate Cox regression models were used to investigate the association between OCB status and risk of reaching each milestone. The OCB-positive group reached disability milestones at an earlier time and younger age. OCB-positivity significantly increased the risk of reaching EDSS 3.0 (HR = 1.29, 95% CI 1.12 to 1.48, P < 0.001) and 4.0 (HR = 1.38, 95% CI 1.17 to 1.63, P < 0.001). The OCB-positive group had a 20% higher risk of conversion to SPMS. CSF-OCB presence is associated with higher risk of reaching EDSS milestones and conversion to SPMS. Our findings suggest higher disease modifying effect of OCB presence in the early inflammatory stages of MS.

scholarly journals Cerebrospinal Fluid Oligoclonal Immunoglobulin Gamma Bands and Long-term Disability Progression in Multiple Sclerosis: a Retrospective Cohort Study

2021 ◽  
Author(s):  
Virginija Karrenbauer ◽  
Sahl Bedri ◽  
Jan Hillert ◽  
Ali Manouchehrinia
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Cox Regression ◽  
Brain Mri ◽  
Positive Group ◽  
Mri Features ◽  
Edss Score ◽  
Different Genetic Background ◽  
Immunoglobulin Gamma

Abstract Multiple sclerosis (MS) patients with and without the oligoclonal band (OCB) distribution of immunoglobulin gamma (IgG) in the cerebrospinal fluid (CSF) has a different genetic background and brain MRI features. In this study we have aimed to determine whether CSF-OCB status is associated with long-term disability outcomes. We used Swedish MS register data on clinically definite MS patients with known OCB status. Date of birth, MS onset and date at sustained Expanded Disability Status Scale (EDSS) score milestones 3, 4, 6, date at conversion to secondary progressive (SP) MS, sex, and immunomodulatory treatment (IMTs) duration were collected. Multivariate Cox regression models were used to investigate the association between OCB status and risk of reaching each milestone. The OCB-positive group reached disability milestones at earlier time and at younger age. OCB-positivity significantly increased the risk of reaching EDSS score 3.0 (HR=1.29, 95%CI: 1.12 to 1.48, P<0.001) and 4.0 (HR= 1.38, 95%CI: 1.17 to 1.63, P<0.001). The OCB-positive group had a 20 % higher risk to convert to SPMS. CSF-OCBs presence is associated with higher risk to reach EDSS milestones and to convert to SPMS. Our findings suggest higher disease modifying effect of OCB presence in the early inflammatory stages of MS.

scholarly journals Brain MRI in patients with multiple sclerosis with oligoclonal cerebrospinal fluid bands

2003 ◽  
Vol 131 (1-2) ◽  
pp. 31-35 ◽  
Author(s):  
Sarlota Mesaros ◽  
Jelena Drulovic ◽  
Zvonimir Levic ◽  
Vesna Peric
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
The Other ◽  
Mri Findings ◽  
Lesion Load ◽  
Positive Group ◽  
Igg Synthesis ◽  
Intrathecal Igg Synthesis ◽  
Edss Score ◽  
The Brain

Locally produced oligoclonal IgG bands (OCB) are present in the cerebrospinal fluid (CSF) of 95% patients with multiple sclerosis (MS)[2,3]. The most sensitive method for the detection of OCB is isoelectric focusing (IEF) [1]. Occasional patients with clinically definite MS lack evidence for intrathecal IgG synthesis [2,9]. This study was designed to compare brain magnetic resonance imagining (MRI) findings between CSF OCB positive and negative MS patients. The study comprised 22 OB negative patients with clinically definite MS and 22 OCB positive controls matched for age, disease duration, activity and course of MS. In the both groups clinical assessment was performed by using Expanded Disability Status Scale (EDSS) score. T2 weighted MRI of the brain was performed on a Siemens Magnetom (1.0 T). Lesions were countred and sized for 15 anatomically defined locations:7 periventricular (PV) and 8 non-periventricular (NPV) regions. An arbitrary scoring system weighted for lesions size was used to estimate total and regional lesions loads: a)1 point was given for each lesion with a diameter 1-5 mm, b) 2 points for one lesion with a diameter 6-10 mm, c) 3 points for one over 10 mm, and confluent lesions scored one extra point [16]. Atrophy were scored as follows: 0-normal size, 1-mild atrophy, 2-moderate atrophy and 3-severe atrophy. Mean score of total brain MRI loads was lower in OCB negative than in OCB positive MS patients (44 vs. 50) but the difference was not statistically significant. Mean periventricular (32 vs. 23) non-periventricular (26 vs. 19) and infratentorial (11 vs. 9) scores were higher in OCB positive MS group in comparison with OCB negative patients but non-significant (figure 1). There was no correlation between EDSS score and total MRI lesions load in OCB negative MS patients, while in OCB positive group we detected significant correlation between EDSS score and total MRI lesions load (p=0.026) (figure 2). The results of this study demonstrate that by using conventional brain MRI the extent end severity of the pathological process seems to be similar in OCB negative and OCB postive MS patients. On the other hand, we found statistically significant correlation between brain MRI total lesion load and EDSS in the OCB positive MS patients, while this correlation was not detected in OCB negative MS patients. Differences in brain MRI findings between OCB positive nad OCB negative MS patients have been already analyzed [9,12]. In the first, Zeman et al. reported that OCB negative MS patients have lower total MRI brain lesion loads in comparison to OCB positive group, but the differences was not statistically significant [9]. In accordance with these findings Fukazawa et al. also failed to show differences in the distribution, extent shape and number of brain MRI lesions between OCB positive and negative MS patients. [12]. On the other hand, it has been demonstrated that the rate of intrathecal IgG synthesis apparently correlates with plaque volume in the brain, as demonstrated on MRI, in MS patients [17]. However, our results along with those from two above-mentioned previous studies do not support this notion. In conclusion, trend towards lesser MRI lesion load and lack of its correlation with EDSS in OCB negative MS patients, warrants further investigations with new MRI techniques (magnetic resonance spectroscopy and magnetisation transfer), including the thorough exploration of normal-appearing white matter, in OCB negative MS patients.

scholarly journals Clinical and neurophysiological findings in oligoclonal band negative multiple sclerosis patients

2003 ◽  
Vol 131 (3-4) ◽  
pp. 122-126 ◽  
Author(s):  
Sarlota Mesaros ◽  
Jelena Drulovic ◽  
Zvonimir Levic
Keyword(s):  
Multiple Sclerosis ◽  
Statistical Significance ◽  
Progression Rate ◽  
Positive Group ◽  
Clinical Difference ◽  
Initial Symptoms ◽  
Significant Difference ◽  
Intrathecal Igg Synthesis ◽  
Edss Score ◽  
Multiple Sclerosis Patients

Besides magnetic resonance imaging, the presence of locally produced oligoclonal IgG bands (OCB) in the cerebrospinal fluid (CSF) is the most consistent laboratory abnormality in patients with multiple sclerosis (MS). The most sensitive method for the detection of CSF OCB is isoelectric focusing (IEF) [6]. Occasional patients with clinically definite MS lack evidence for intrathecal IgG synthesis [7, 8]. This study was designed to compare clinical data and evoked potential (EP) findings between CSF OCB positive and OCB negative MS patients. The study comprised 22 OCB negative patients with clinically definite MS [11] and 22 OCB positive controls matched for age, disease duration, activity and course of MS. In both groups clinical assessment was performed by using Expanded Disability Status Scale (EDSS) score [12] and progression rate (PR). All patients underwent multimodal EP: visual (VEPs), brainstem auditory (BAEPs) and median somatosensory (mSEPs). The VEPa were considered abnormal if the P100 latency exceeded 117 ms or inter-ocular difference greater than 8 ms was detected. The BAEPs were considered abnormal if waves III or V were absent or the interpeak latencies I-III, III-V, or I-V were increased. The mSEPs were considerd abnormal when N9, N13 and N20 potentials were absent or when increased interpeak latencies were recorded. The severity of the neurophysiological abnormalities was scored for each modality as follows normal EP score 0; every other EP abnormality except the absence of one of the main waves, score 1; absence of one or more of the main waves, score 2 [13]. Both mean EDSS score (4.0 vs. 3.5) and PR (0.6 vs. 0.5) were similar in OCB positive and OCB negative group, (p>0.05). In the first group males were predominant, but without statistical significance (Table 1). Disease started more often with the brainstem symptoms in the OCB positive than in OCB negative MS group (p=0.028), while there was no differences in other initial symptoms between the groups (Graph 2). The frequency of (multimodal) EP abnormalities was higher in the OCB positive group but the differences were not statistically significant, except for bilateral SEP abnormalities (p=0.012). The severity of the AEPs abnormalities was similar in both groups while for the VEPs and SEPs abnormalities were more pronounced in the OCB positive group but not significantly (Table 2). The male preponderance of OCB negative MS patients in our study is in accordance with previous studies [14, 15]. This finding could be potentially ascribed to the well known gender-related differences in both humoral and cellular immune responses [17]. We found no statistically significant differences in either disability or PR between the two patient groups, although OCB negative MS patients had lower EDSS score and PR than OCB positive cases. In accordance with these findings, Fukazawa et al. also failed to show differences in disability between OCB negative and positive MS patients. On the other hand, few studies reported that OCB negative MS patients have a better prognosis [16 18]. The only clinical difference between two groups of patients that we found was that the disease more often started with brainstem symptoms in OCB positive MS patients (p=0.028). OCB positive MS patients had more often bilateral SEPs abnormalities (p=0.012). There was no statistically significant differences between two groups of patients in the severity of trimodal EPs abnormalities and the frequency of BAEPs and VEPs abnormalities although OCB negative patients had trend towards less pronounced EP disturbancies. In conclusion, our results did not reveal significant difference in clinical and neurophysiological(y) parameters between two groups of patients. However, they indicate a trend towards better prognosis of the disease in OCB negative MS patients.

Cerebrospinal fluid levels of chitinase 3-like 1 and neurofilament light chain predict multiple sclerosis development and disability after optic neuritis

2015 ◽  
Vol 21 (14) ◽  
pp. 1761-1770 ◽  
Author(s):  
S Modvig ◽  
M Degn ◽  
H Roed ◽  
TL Sørensen ◽  
HBW Larsson ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cerebrospinal Fluid ◽  
Optic Neuritis ◽  
Light Chain ◽  
Oligoclonal Bands ◽  
Enzyme Linked Immunosorbent Assay ◽  
Csf Biomarkers ◽  
Neurofilament Light Chain ◽  
Neurofilament Light

Background: Cerebrospinal fluid (CSF) biomarkers have been suggested to predict multiple sclerosis (MS) after clinically isolated syndromes, but studies investigating long-term prognosis are needed. Objective: To assess the predictive ability of CSF biomarkers with regard to MS development and long-term disability after optic neuritis (ON). Methods: Eighty-six patients with ON as a first demyelinating event were included retrospectively. Magnetic resonance imaging (MRI), CSF leukocytes, immunoglobulin G index and oligoclonal bands were registered. CSF levels of chitinase-3-like-1, osteopontin, neurofilament light-chain, myelin basic protein, CCL2, CXCL10, CXCL13 and matrix metalloproteinase-9 were measured by enzyme-linked immunosorbent assay. Patients were followed up after 13.6 (range 9.6–19.4) years and 81.4% were examined, including Expanded Disability Status Scale and MS functional composite evaluation. 18.6% were interviewed by phone. Cox regression, multiple regression and Spearman correlation analyses were used. Results: Forty-six (53.5%) developed clinically definite MS (CDMS) during follow-up. In a multivariate model MRI ( p=0.0001), chitinase 3-like 1 ( p=0.0033) and age ( p=0.0194) combined predicted CDMS best. Neurofilament light-chain predicted long-term disability by the multiple sclerosis severity scale ( p=0.0111) and nine-hole-peg-test ( p=0.0202). Chitinase-3-like-1 predicted long-term cognitive impairment by the paced auditory serial addition test ( p=0.0150). Conclusion: Neurofilament light-chain and chitinase-3-like-1 were significant predictors of long-term physical and cognitive disability. Furthermore, chitinase-3-like-1 predicted CDMS development. Thus, these molecules hold promise as clinically valuable biomarkers after ON as a first demyelinating event.

scholarly journals Long-term prognostic value of longitudinal measurements of blood neurofilament levels

2020 ◽  
Vol 7 (5) ◽  
pp. e856 ◽  
Author(s):  
Dieter A. Häring ◽  
Harald Kropshofer ◽  
Ludwig Kappos ◽  
Jeffrey A. Cohen ◽  
Anuja Shah ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Light Chain ◽  
Prognostic Value ◽  
Long Term Outcomes ◽  
Neurofilament Light Chain ◽  
Neurofilament Light ◽  
Longitudinal Measurements ◽  
Relapsing Remitting ◽  
Edss Score

ObjectiveTo assess the long-term prognostic value of an integral of longitudinal measurements of plasma neurofilament light chain levels (NfLlong) over 12 and 24 months vs single neurofilament light chain (NfL) measurements in patients with relapsing-remitting MS (RRMS) and its additional value when combined with clinical and MRI measures.MethodsThis analysis included continuously fingolimod-treated patients with RRMS from the 24-month FTY720 Research Evaluating Effects of Daily Oral therapy in Multiple Sclerosis (FREEDOMS)/12-month Trial Assessing Injectable Interferon vs FTY720 Oral in Relapsing–Remitting Multiple Sclerosis (TRANSFORMS) phase 3 trials and their long-term extension, LONGTERMS. Patients were classified into high (≥30 pg/mL, n = 110) and low (<30 pg/mL, n = 164) NfL categories based on the baseline (BL) NfL value or the geometric mean NfLlong calculated over 12 and 24 months to predict disability-related outcomes and brain volume loss (BVL). The additional prognostic value of NfL was quantified using the area under the receiver operating characteristic (ROC) curve.ResultsA single high (vs low) NfL measure at BL was prognostic of a higher risk of reaching Expanded Disability Status Scale (EDSS) score ≥4 earlier (hazard ratio [HR] = 2.19; 95% CI = 1.21–3.97) and higher BVL over 120 months (difference: −1.12%; 95% CI = −2.07 to −0.17). When NfLlong was measured over 24 months, high NfL was associated with a higher risk of reaching EDSS score ≥4 (HR = 7.91; 95% CI = 2.99–20.92), accelerated 6-month confirmed disability worsening (HR = 3.14; 95% CI = 1.38–7.11), and 20% worsening in the Timed 25-Foot Walk Test (HR = 3.05; 95% CI = 1.38–6.70). Area under the ROC curve was consistently highest in models combining NfL with clinical and MRI measures.ConclusionsNfLlong had a higher prognostic value than single NfL assessments on long-term outcomes in RRMS. Combining it with clinical and MRI measures increased sensitivity and specificity to predict long-term disease outcomes.Classification of evidenceThis study provides Class I evidence that NfLlong was more strongly associated with long-term outcomes than single NfL assessments in patients with RRMS.

scholarly journals Prognostic factors for long-term outcomes in relapsing–remitting multiple sclerosis

2016 ◽  
Vol 2 ◽  
pp. 205521731666640 ◽  
Author(s):  
Anthony L Traboulsee ◽  
Peter Cornelisseª ◽  
Magnhild Sandberg-Wollheim ◽  
Bernard MJ Uitdehaag ◽  
Ludwig Kappos ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Prognostic Factors ◽  
Regression Models ◽  
Brain Volume ◽  
Univariate Analysis ◽  
Medication Possession Ratio ◽  
Stepwise Multiple Regression ◽  
Long Term Outcomes ◽  
Edss Score

Objective The objective of this article is to investigate potential clinical and MRI predictors of long-term outcomes in multiple sclerosis (MS). Methods This was a post hoc analysis using data from all 382 patients in the PRISMS long-term follow-up (LTFU) study collected up to eight years after randomisation. An additional analysis was performed including only those patients originally randomised to receive early subcutaneous interferon (IFN) β-1a ( n = 259). Baseline/prestudy variables, indicators of early clinical and MRI activity (baseline to month 24), and indicators of IFN β-1a treatment exposure (including medication possession ratio (MPR)) were investigated as candidate prognostic factors for outcomes measured from baseline and from month 24 to LTFU. Explanatory variables identified from univariate regression models ( p ≤ 0.15) were selected for inclusion in stepwise multiple regression models. Results Candidate prognostic factors selected by the univariate analysis ( p ≤ 0.15) included age, MS duration, baseline brain volume, EDSS score, and log(T2 burden of disease (BOD)). In most of the multivariate regression models applied, higher baseline brain volume and MPR predicted better long-term clinical outcomes, while higher baseline and greater early increase in EDSS score predicted worse outcomes. Conclusion Identification of markers that may be prognostic for long-term disability could help identify MS patients at higher risk of disability progression.

Relevance of hypointense brain MRI lesions for long-term worsening of clinical disability in relapsing multiple sclerosis

2013 ◽  
Vol 20 (2) ◽  
pp. 214-219 ◽  
Author(s):  
Antonio Giorgio ◽  
Maria Laura Stromillo ◽  
Maria Letizia Bartolozzi ◽  
Francesca Rossi ◽  
Marco Battaglini ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Univariate Analysis ◽  
Brain Lesion ◽  
Brain Magnetic Resonance Imaging ◽  
Stepwise Multiple Regression ◽  
Lesion Volume ◽  
Magnetic Resonance Imaging Mri ◽  
Relapsing Remitting Multiple Sclerosis

Background: The accrual of brain focal pathology is considered a good substrate of disability in relapsing–remitting multiple sclerosis (RRMS). However, knowledge on long-term lesion evolution and its relationship with disability progression is poor. Objective: The objective of this paper is to evaluate in RRMS the long-term clinical relevance of brain lesion evolution. Methods: In 58 RRMS patients we acquired, using the same scanner and protocol, brain magnetic resonance imaging (MRI) at baseline and 10±0.5 years later. MRI data were correlated with disability changes as measured by the Expanded Disability Status Scale (EDSS). Results: The annualized 10-year lesion volume (LV) growth was +0.25±0.5 cm3 (+6.7±8.7%) for T2-weighted (T2-W) lesions and +0.20±0.31 cm3 (+11.5±12.3%) for T1-weighted (T1-W) lesions. The univariate analysis showed moderate correlations between baseline MRI measures and EDSS at 10 years ( p < 0.001). Also, 10-year EDSS worsening correlated with LV growth and the number of new/enlarging lesions measured over the same period ( p < 0.005). In the stepwise multiple regression analysis, EDSS worsening over 10 years was best correlated with the combination of baseline T1-W lesion count and increasing T1-W LV ( R = 0.61, p < 0.001). Conclusion: In RRMS patients, long-term brain lesion accrual is associated with worsening in clinical disability. This is particularly true for hypointense, destructive lesions.

Factors predicting incomplete recovery from relapses in multiple sclerosis: a prospective study

2008 ◽  
Vol 14 (4) ◽  
pp. 485-493 ◽  
Author(s):  
MA Leone ◽  
S. Bonissoni ◽  
L. Collimedaglia ◽  
F. Tesser ◽  
S. Calzoni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Brain Mri ◽  
Total Duration ◽  
Oligoclonal Bands ◽  
Relapsing Remitting ◽  
Environmental Background ◽  
Maximum Improvement ◽  
A Prospective Study ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Speed Of Onset

Objective To prospectively evaluate predictors of incomplete recovery after the first attacks in a cohort of patients with clinically isolated syndrome or relapsing—remitting multiple sclerosis. Methods Seventy-two consecutive patients recruited from January 2001 to December 2003, evaluated every six months or at any relapse up to 31 July 2005. Relapse intervals were calculated from the date of onset, nadir, onset of improvement and maximum improvement. Predictive factors analysed were relapse-related (age at relapse onset, season and severity of the relapse, type of symptoms, speed of onset, plateau and total duration, number of affected Functional systems, preceding infections) and individual-related (gender, age at first attack, season of birth and first attack, characteristics of first brain MRI and cerebrospinal fluid oligoclonal bands, Link Index, IgG). Results We counted 209 attacks: 44 (21%) left mild sequelae, and 27 (13%) severe. The highest probability of sequelae was associated with sphincteric symptoms (9/20; 45%), followed by sensitive (38/113; 34%), motor (20/84; 24%), visual (13/61; 21%), cerebellar (4/24; 17%), brainstem (5/44; 11%) and others (0/6) ( P 0.005). Four variables were still relevant to predict sequelae after multivariate analysis: mild, moderate or severe relapses versus very mild (Odds ratio = 17.2, 95% confidence limits = 2.2—136.4), intermediate or long relapses versus short (3.2, 1.5—6.9), age ≥ 30 at relapse onset (2.9, 1.5—5.7) and bi-polysymptomatic versus monosymptomatic (2.2, 1.1—4.3). Conclusions Factors predicting incomplete recovery are more closely linked to the characteristics of the single relapse (extension and duration of tissue damage) than to the patient's genetic and environmental background. Multiple Sclerosis 2008; 14: 485—493. http://msj.sagepub.com

scholarly journals Disability and progression in Afro-descendant patients with multiple sclerosis

2016 ◽  
Vol 74 (10) ◽  
pp. 836-841 ◽  
Author(s):  
Juliana Calvet Kallenbach Aurenção ◽  
Claudia Cristina Ferreira Vasconcelos ◽  
Luiz Claudio Santos Thuler ◽  
Regina Maria Papais Alvarenga
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
African Ancestry ◽  
Clinical Aspects ◽  
Published Data ◽  
Therapeutic Decision ◽  
Disease Outcomes ◽  
The Impact ◽  
Clinical Characteristic

ABSTRACT Multiple sclerosis (MS) prevalence is higher in Caucasian (CA) populations, narrowing the analysis of the impact of Afro-descendant (AD) populations in disease outcomes. Even so, recent studies observed that AD patients have a more severe course. The main objective of this study is to confirm and discuss, through a systematic review, that being AD is a risk factor for disability accumulation and/or severe progression in patients with MS. A systematic review of published data in the last eleven years was performed, which evaluated clinical aspects and long term disability in patients with MS. Fourteen studies were included. Of these fourteen articles, thirteen observed a relationship between ancestry and poorer outcome of MS. African ancestry is a condition inherent in the patient and should be considered as an initial clinical characteristic affecting prognosis, and influencing which therapeutic decision to make in initial phases.

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