Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis

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Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis Publisher Pubmed

Le M^{1, 39} ; Malpas C^{1, 39} ; Sharmin S^{1, 39} ; Horakova D² ; Havrdova E² ; Trojano M³ ; Izquierdo G⁴ ; Eichau S⁴ ; Ozakbas S⁵ ; Lugaresi A^{6, 40} ; Prat A⁷ ; Girard M⁷ ; Duquette P⁷ ; Larochelle C⁷ Show All Authors

Le M^{1, 39}
Malpas C^{1, 39}
Sharmin S^{1, 39}
Horakova D²
Havrdova E²
Trojano M³
Izquierdo G⁴
Eichau S⁴
Ozakbas S⁵
Lugaresi A^{6, 40}
Prat A⁷
Girard M⁷
Duquette P⁷
Larochelle C⁷
Alroughani R⁸
Bergamaschi R⁹
Sola P¹⁰
Ferraro D¹⁰
Grammond P¹¹
Grand Maison F¹²
Terzi M¹³
Boz C¹⁴
Hupperts R¹⁵
Butzkueven H¹⁶
Pucci E¹⁷
Granella F¹⁸
Van Pesch V¹⁹
Soysal A²⁰
Yamout BI²¹
Lechnerscott J²²
Spitaleri DLA²³
Ampapa R²⁴
Turkoglu R²⁵
Iuliano G²⁶
Ramotello C²⁷
Sanchezmenoyo JL²⁸
Sidhom Y²⁹
Gouider R²⁹
Shaygannejad V³⁰
Prevost J³¹
Altintas A³²
Fragoso YD³³
Mccombe PA³⁴
Petersen T³⁵
Slee M³⁶
Barnett MH³⁷
Vucic S³⁸
Van Der Walt A¹⁶
Kalincik T^{1, 39}

Show Affiliations

1. CORe, Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
2. Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic
3. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy
4. Hospital Universitario Virgen Macarena, Sevilla, Spain
5. Dokuz Eylul University, Konak/Izmir, Turkey
6. IRCCS Istituto delle Scienze Neurologiche di Bologna, UOSI Riabilitazione Sclerosi Multipla, Bologna, Italy
7. Centre hospitalier de l’Universite de Montreal (CHUM), Montreal, QC, Canada
8. Division of Neurology, Department of Medicine, Amiri Hospital, Sharq, Kuwait
9. IRCCS Mondino Foundation, Pavia, Italy
10. Department of Neuroscience, Azienda Ospedaliera Universitaria, Modena, Italy
11. CISSS de Chaudiere-Appalache, Levis, QC, Canada
12. Neuro Rive-Sud, Quebec, QC, Canada
13. Faculty of Medicine, 19 Mayis University, Samsun, Turkey
14. Farabi Hospital, KTU Faculty of Medicine, Trabzon, Turkey
15. Zuyderland Ziekenhuis, Sittard, Netherlands
16. Department of Neuroscience, Central Clinical School, Monash University, Melbourne, VIC, Australia
17. UOC Neurologia, Azienda Sanitaria Unica Regionale Marche–AV3, Macerata, Italy
18. Department of Medicine and Surgery, University of Parma, Parma, Italy
19. Cliniques Universitaires Saint-Luc, Brussels, Belgium
20. Bakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey
21. Nehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon
22. School of Medicine and Public Health, The University of Newcastle Australia, Newcastle, NSW, Australia
23. Azienda Ospedaliera di Rilievo Nazionale, San Giuseppe Moscati – Avellino, Avellino, Italy
24. Nemocnice Jihlava, Jihlava, Czech Republic
25. Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
26. Ospedali Riuniti di Salerno, Salerno, Italy
27. Hospital Germans Trias i Pujol, Barcelona, Spain
28. Hospital de Galdakao-Usansolo, Galdakao, Spain
29. Department of Neurology, Razi Hospital, Manouba, Tunisia
30. Isfahan University of Medical Sciences, Isfahan, Iran
31. CSSS Saint-Jerome, Saint-Jerome, QC, Canada
32. School of Medicine, Koc University, Istanbul, Turkey
33. Universidade Metropolitana de Santos, Santos, Brazil
34. The University of Queensland, Brisbane, QLD, Australia
35. Kommunehospitalet, Arhus C, Denmark
36. Flinders University, Adelaide, SA, Australia
37. Brain and Mind Centre, The University of Sydney, Camperdown, NSW, Australia
38. Westmead Hospital, Sydney, NSW, Australia
39. Department of Neurology, The Royal Melbourne Hospital, Melbourne, VIC, Australia
40. Dipartimento di Scienze Biomediche e Neuromotorie, Universita di Bologna, Bologna, Italy

Source: Multiple Sclerosis Journal Published:2021

Abstract

Background: Cerebellar and brainstem symptoms are common in early stages of multiple sclerosis (MS) yet their prognostic values remain unclear. Objective: The aim of this study was to investigate long-term disability outcomes in patients with early cerebellar and brainstem symptoms. Methods: This study used data from MSBase registry. Patients with early cerebellar/brainstem presentations were identified as those with cerebellar/brainstem relapse(s) or functional system score ⩾ 2 in the initial 2 years. Early pyramidal presentation was chosen as a comparator. Andersen-Gill models were used to compare cumulative hazards of (1) disability progression events and (2) relapses between patients with and without early cerebellar/brainstem symptoms. Mixed effect models were used to estimate the associations between early cerebellar/brainstem presentations and expanded disability status scale (EDSS) scores. Results: The study cohort consisted of 10,513 eligible patients, including 2723 and 3915 patients with early cerebellar and brainstem symptoms, respectively. Early cerebellar presentation was associated with greater hazard of progression events (HR = 1.37, p < 0.001) and EDSS (β = 0.16, p < 0.001). Patients with early brainstem symptoms had lower hazard of progression events (HR = 0.89, p = 0.01) and EDSS (β = −0.06, p < 0.001). Neither presentation was associated with changes in relapse risk. Conclusion: Early cerebellar presentation is associated with unfavourable outcomes, while early brainstem presentation is associated with favourable prognosis. These presentations may be used as MS prognostic markers and guide therapeutic approach. © The Author(s), 2020.

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Style	Citing Format
MLA	Le M, et al.. "Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis." Multiple Sclerosis Journal, vol. 27, no. 5, 2021, pp. 755-766.
APA	Le M, Malpas C, Sharmin S, Horakova D, Havrdova E, Trojano M, Izquierdo G, Eichau S, Ozakbas S, Lugaresi A, Prat A, Girard M, Duquette P, Larochelle C, Alroughani R, Bergamaschi R, Sola P, Ferraro D, Grammond P, ... Kalincik T (2021). Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis. Multiple Sclerosis Journal, 27(5), 755-766.
Chicago	Le M, Malpas C, Sharmin S, Horakova D, Havrdova E, Trojano M, Izquierdo G, et al.. "Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis." Multiple Sclerosis Journal 27, no. 5 (2021): 755-766.
Harvard	Le M et al. (2021) 'Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis', Multiple Sclerosis Journal, 27(5), pp. 755-766.
Vancouver	Le M, Malpas C, Sharmin S, Horakova D, Havrdova E, Trojano M, et al.. Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis. Multiple Sclerosis Journal. 2021;27(5):755-766.
BibTex	@article{ author = {Le M and Malpas C and Sharmin S and Horakova D and Havrdova E and Trojano M and Izquierdo G and Eichau S and Ozakbas S and Lugaresi A and Prat A and Girard M and Duquette P and Larochelle C and Alroughani R and Bergamaschi R and Sola P and Ferraro D and Grammond P and Grand Maison F and Terzi M and Boz C and Hupperts R and Butzkueven H and Pucci E and Granella F and Van Pesch V and Soysal A and Yamout BI and Lechnerscott J and Spitaleri DLA and Ampapa R and Turkoglu R and Iuliano G and Ramotello C and Sanchezmenoyo JL and Sidhom Y and Gouider R and Shaygannejad V and Prevost J and Altintas A and Fragoso YD and Mccombe PA and Petersen T and Slee M and Barnett MH and Vucic S and Van Der Walt A and Kalincik T}, title = {Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis}, journal = {Multiple Sclerosis Journal}, volume = {27}, number = {5}, pages = {755-766}, year = {2021} }
RIS	TY - JOUR AU - Le M AU - Malpas C AU - Sharmin S AU - Horakova D AU - Havrdova E AU - Trojano M AU - Izquierdo G AU - Eichau S AU - Ozakbas S AU - Lugaresi A AU - Prat A AU - Girard M AU - Duquette P AU - Larochelle C AU - Alroughani R AU - Bergamaschi R AU - Sola P AU - Ferraro D AU - Grammond P AU - Grand Maison F AU - Terzi M AU - Boz C AU - Hupperts R AU - Butzkueven H AU - Pucci E AU - Granella F AU - Van Pesch V AU - Soysal A AU - Yamout BI AU - Lechnerscott J AU - Spitaleri DLA AU - Ampapa R AU - Turkoglu R AU - Iuliano G AU - Ramotello C AU - Sanchezmenoyo JL AU - Sidhom Y AU - Gouider R AU - Shaygannejad V AU - Prevost J AU - Altintas A AU - Fragoso YD AU - Mccombe PA AU - Petersen T AU - Slee M AU - Barnett MH AU - Vucic S AU - Van Der Walt A AU - Kalincik T TI - Disability Outcomes of Early Cerebellar and Brainstem Symptoms in Multiple Sclerosis JO - Multiple Sclerosis Journal VL - 27 IS - 5 SP - 755 EP - 766 PY - 2021 ER -

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