Yuan Zhou1, Suzi B Claflin1, Jim Stankovich2, Ingrid van der Mei1, Steve Simpson3, Richard H Roxburgh4, Tomas Kalincik5, Leigh Blizzard1, Alessandra Lugaresi6, Raed Alroughani7, Seyed Aidin Sajedi8, Helmut Butzkueven2, Eugenio Pucci9, Daniele LA Spitaleri10, Franco Granella11, Edgardo Cristiano12, Bassem Yamout13, Stella Hughes14, Riadh Gouider15, José Luis Sánchez Menoyo16, Javier Olascoaga17, Chris McGuigan18, Cameron Shaw19, Allan G Kermode20, Krisztian Kasa21, Talal Al-Harbi22, Ayse Altintas23, Guy Laureys24, Yara Fragoso25, Todd A Hardy26, Tunde Csepany27, Carmen-Adella Sirbu28, Danny Decoo29, Attila Sas30, Jose C Alvarez-Cermeño31, Karim Kotkata32, Jorge Millán-Pascual33, Bruce V Taylor1. 1. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia. 2. Department of Neuroscience, Monash University, Melbourne, VIC, Australia. 3. Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia/Royal Melbourne Hospital, The University of Melbourne, Melbourne, VIC, Australia. 4. Centre for Brain Research Neurogenetics Clinic, The University of Auckland, Auckland, New Zealand. 5. CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia/Department of Neurology, The University of Melbourne, Melbourne, VIC, Australia. 6. IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Riabilitazione Sclerosi Multipla, Bologna, Italy/Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy. 7. Amiri Hospital, Kuwait City, Kuwait. 8. Neuroscience Research Center, Golestan University of Medical Sciences, Gorgan, Iran. 9. Generale Provinciale Macerata, Macerata, Italy. 10. Azienda Ospedaliera di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy. 11. University of Parma, Parma, Italy. 12. Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. 13. American University of Beirut Medical Center, Beirut, Lebanon. 14. Craigavon Area Hospital, Craigavon, UK. 15. Razi Hospital, Tunis, Tunisia. 16. Hospital de Galdakao-Usansolo, Bizkaia, Spain. 17. Hospital Donostia, Gipuzkoa, Spain. 18. St. Vincent's University Hospital, Dublin, Ireland. 19. Geelong Hospital, Geelong, VIC, Australia. 20. Perron Institute for Neurological and Translational Sciences, Nedlands, WA, Australia. 21. Jahn Ferenc Teaching Hospital, Budapest, Hungary. 22. King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia. 23. Department of Neurology, School of Medicine, Koç University, Istanbul, Turkey. 24. University Hospital Ghent, Gent, Belgium. 25. Universidade Metropolitana de Santos, Santos, Brazil. 26. University of Parma, Parma, Italy/Concord Repatriation General Hospital, Sydney, NSW, Australia. 27. Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary. 28. Central University Emergency Military Hospital, Bucharest, Romania. 29. AZ Alma, Eeklo, Belgium. 30. Borsod-Abaúj-Zemplén County Hospital, Miskolc, Hungary. 31. Ramon y Cajal University Hospital, Madrid, Spain. 32. Alexandria University Student Hospital, Alexandria, Egypt. 33. Hospital Mancha Centro, Real, Spain.
Abstract
BACKGROUND: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. OBJECTIVE: We evaluated sex-specific and onset phenotype-specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. METHODS: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype-specific MSSS matrices. We compared matrices using permutation analysis. RESULTS: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. CONCLUSION: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
BACKGROUND: The Multiple Sclerosis Severity Score (MSSS) is a widely used measure of the disability progression rate. However, the global MSSS may not be the best basis for comparison between all patient groups. OBJECTIVE: We evaluated sex-specific and onset phenotype-specific MSSS matrices to determine if they were more effective than the global MSSS as a basis for comparison within these subsets. METHODS: Using a large international dataset of multiple sclerosis (MS) patient records and the original MSSS algorithm, we constructed global, sex-specific and onset phenotype-specific MSSS matrices. We compared matrices using permutation analysis. RESULTS: Our final dataset included 30,203 MS cases, with 28.9% males and 6.5% progressive-onset cases. Our global MSSS matrix did not differ from previously published data (p > 0.05). The progressive-onset-specific matrix differed significantly from the relapsing-onset-specific matrix (p < 0.001), with lower MSSS attributed to cases with the same Expanded Disability Status Score (EDSS) and disease duration. When evaluated with a simulation, using an onset-specific MSSS improved statistical power in mixed cohorts. There were no significant differences by sex. CONCLUSION: The differences in the disability accrual rate between progressive- and relapsing-onset MS have a significant effect on MSSS. An onset-specific MSSS should be used when comparing the rate of disability progression among progressive-onset cases and for mixed cohorts.
Authors: Marianna Vitkova; Ibrahima Diouf; Charles Malpas; Dana Horakova; Eva Kubala Havrdova; Francesco Patti; Serkan Ozakbas; Guillermo Izquierdo; Sara Eichau; Vahid Shaygannejad; Marco Onofrj; Alessandra Lugaresi; Raed Alroughani; Alexandre Prat; Catherine Larochelle; Marc Girard; Pierre Duquette; Murat Terzi; Cavit Boz; Francois Grand'Maison; Patrizia Sola; Diana Ferraro; Pierre Grammond; Helmut Butzkueven; Katherine Buzzard; Olga Skibina; Bassem I Yamout; Rana Karabudak; Oliver Gerlach; Jeannette Lechner-Scott; Davide Maimone; Roberto Bergamaschi; Vincent Van Pesch; Gerardo Iuliano; Elisabetta Cartechini; Maria José Sà; Radek Ampapa; Michael Barnett; Stella E Hughes; Cristina M Ramo-Tello; Suzanne Hodgkinson; Daniele L A Spitaleri; Thor Petersen; Ernest Gerard Butler; Mark Slee; Chris McGuigan; Pamela Ann McCombe; Franco Granella; Edgardo Cristiano; Julie Prevost; Bruce V Taylor; Josã Luis Sãnchez-Menoyo; Guy Laureys; Liesbeth Van Hijfte; Steve Vucic; Richard A Macdonell; Orla Gray; Javier Olascoaga; Norma Deri; Yara Dadalti Fragoso; Cameron Shaw; Tomas Kalincik Journal: Neurology Date: 2022-04-11 Impact factor: 11.800
Authors: Patrick Altmann; Fritz Leutmezer; Katharina Leithner; Tobias Monschein; Markus Ponleitner; Miranda Stattmann; Paulus Stefan Rommer; Tobias Zrzavy; Gudrun Zulehner; Klaus Berek; Thomas Berger; Gabriel Bsteh Journal: Front Neurol Date: 2021-02-09 Impact factor: 4.003