Course and prognosis in early-onset MS: Comparison with adult-onset forms
| Autor: | Antonia Ceccarelli, A. Bellacosa, I. Pavone, Maria Liguori, Isabella Laura Simone, Fabio Pellegrini, D. Carrara, Vito Lepore, Carla Tortorella, Paolo Livrea |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Pediatrics Multiple Sclerosis Adolescent genetic structures Pyramidal Tracts Physical examination Cohort Studies Central nervous system disease Disability Evaluation Recurrence otorhinolaryngologic diseases medicine Humans Age of Onset Child Survival analysis Aged Expanded Disability Status Scale medicine.diagnostic_test business.industry Multiple sclerosis Infant Middle Aged Prognosis medicine.disease Magnetic Resonance Imaging Survival Analysis eye diseases Surgery Italy Child Preschool Cohort Disease Progression Female sense organs Neurology (clinical) Age of onset business Cohort study |
| Zdroj: | Neurology (2002). info:cnr-pdr/source/autori:Simone IL, Carrara D, Tortorella C, Liguori M, Lepore V, Pellegrini F, Bellacosa A, Ceccarelli A, Pavone I, Livrea P/titolo:Course and prognosis in early-onset MS: comparison with adult-onset forms./doi:/rivista:Neurology/anno:2002/pagina_da:/pagina_a:/intervallo_pagine:/volume Scopus-Elsevier |
| ISSN: | 1526-632X 0028-3878 |
| DOI: | 10.1212/01.wnl.0000036907.37650.8e |
| Popis: | To establish the prognostic role of clinical and demographic factors in a hospital-based cohort of MS patients categorized by age at clinical onset and clinical course.Eighty-three patients with MS had a clinical onset of the disease in childhood (age16 years; early-onset MS [EOMS]) and 710 in adult age (between 16 and 65 years; adult-onset MS [AOMS]). Patients were followed for a mean period of observation of 5 years. Univariate and multivariate analyses of clinical and demographic predictors for rapid progression and disability were performed using a stepwise Cox regression model with time-dependent covariates.In EOMS, the Expanded Disability Status Scale (EDSS) evaluated at last clinical examination was lower than in AOMS, despite a longer disease duration. The probability to reach growth disability and progression was significantly lower in EOMS than in AOMS. Median times to reach EDSS score of 4 and secondary progression were longer in EOMS than in AOMS, but the age at both endpoints was significantly lower in EOMS. In EOMS and AOMS, an irreversible disability was related to a secondary progressive course, a sphincteric system involvement at onset, and an older age at onset (in EOMS only for the group14 years); in AOMS, other unfavorable factors were a pyramidal involvement at onset and a high relapse frequency in the first 2 years. The risk of entering secondary progression was significantly influenced by a high number of relapses in EOMS and by a higher age at onset and a short interattack interval in AOMS.A slower rate of progression of disease characterized EOMS patients, suggesting more plasticity to recover in developing CNS, but the early clinical manifestation cannot be considered a positive prognostic factor. |
| Databáze: | OpenAIRE |
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