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Long-Term Disability Trajectories in Primary Progressive Ms Patients: A Latent Class Growth Analysis Publisher



Signori A1 ; Izquierdo G2 ; Lugaresi A3, 4 ; Hupperts R5 ; Grandmaison F6 ; Sola P7 ; Horakova D8 ; Havrdova E8 ; Prat A9 ; Girard M9 ; Duquette P9 ; Boz C10 ; Grammond P11 ; Terzi M12 Show All Authors
Authors
  1. Signori A1
  2. Izquierdo G2
  3. Lugaresi A3, 4
  4. Hupperts R5
  5. Grandmaison F6
  6. Sola P7
  7. Horakova D8
  8. Havrdova E8
  9. Prat A9
  10. Girard M9
  11. Duquette P9
  12. Boz C10
  13. Grammond P11
  14. Terzi M12
  15. Singhal B13
  16. Alroughani R14
  17. Petersen T15
  18. Ramo C16
  19. Orejaguevara C17
  20. Spitaleri D18
  21. Shaygannejad V19
  22. Butzkueven H20, 21
  23. Kalincik T21
  24. Jokubaitis V21
  25. Slee M22
  26. Fernandez Bolanos R23
  27. Sanchezmenoyo JL24
  28. Pucci E25
  29. Granella F26
  30. Lechnerscott J27
  31. Iuliano G28
  32. Hughes S29
  33. Bergamaschi R30
  34. Taylor B31
  35. Verheul F32
  36. Edite Rio M33
  37. Amato MP34
  38. Sajedi SA35
  39. Majdinasab N36
  40. Van Pesch V37
  41. Sormani MP1
  42. Trojano M38
Show Affiliations
Authors Affiliations
  1. 1. Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa, Genova, Italy
  2. 2. Hospital Universitario Virgen Macarena, Sevilla, Spain
  3. 3. Department of Biomedical and Neuromotor Sciences(DIBINEM), Alma Mater Studiorum, University of Bologna, Italy
  4. 4. IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
  5. 5. Zuyderland Ziekenhuis, Sittard, Netherlands
  6. 6. Clinique Neuro Rive-Sud, Greenfield Park, QC, Canada
  7. 7. Nuovo Ospedale Civile S. Agostino-Estense, Modena, Italy
  8. 8. Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
  9. 9. Hopital Notre-Dame, Montreal, QC, Canada
  10. 10. KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
  11. 11. Centre de Readaptation En Deficience Physique Chaudiere-Appalache, Levis, QC, Canada
  12. 12. Medical Faculty, Ondokuz Mayis University, Samsun, Turkey
  13. 13. Bombay Hospital Institute of Medical Sciences (BHIMS), Mumbai, India
  14. 14. Amiri Hospital, Kuwait City, Kuwait
  15. 15. Kommunehospitalet, Aarhus, Denmark
  16. 16. Hospital Germans Trias i Pujol, Badalona, Spain
  17. 17. Hospital Clinico San Carlos, Madrid, Spain
  18. 18. Azienda Ospedaliera di Rilievo Nazionale, San Giuseppe Moscati, Avellino, Italy
  19. 19. Isfahan University of Medical Sciences, Isfahan, Iran
  20. 20. Box Hill Hospital, Melbourne, VIC, Australia
  21. 21. Department of Medicine, The University of Melbourne, Melbourne, VIC, Australia
  22. 22. Flinders University and Medical Centre, Adelaide, SA, Australia
  23. 23. Hospital Universitario Virgen de Valme, Seville, Spain
  24. 24. Hospital de Galdakao-Usansolo, Galdakao, Spain
  25. 25. UOC Neurologia, Azienda Sanitaria Unica Regionale Marche, Macerata, Italy
  26. 26. University of Parma, Parma, Italy
  27. 27. Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
  28. 28. Ospedali Riuniti di Salerno, Salerno, Italy
  29. 29. Craigavon Area Hospital, Craigavon, United Kingdom
  30. 30. C. Mondino National Neurological Institute, Pavia, Italy
  31. 31. Royal Hobart Hospital, Hobart, TAS, Australia
  32. 32. Groene Hart Ziekenhuis, Gouda, Netherlands
  33. 33. Hospital Sao Joao, Porto, Portugal
  34. 34. Department NEUROFARBA, Section Neuroscience, University of Florence, Florence, Italy
  35. 35. Department of Neurology, Golestan University of Medical Sciences, Gorgan, Iran/Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  36. 36. Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
  37. 37. Cliniques Universitaires Saint-Luc, Brussels, Belgium
  38. 38. Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari, Bari, Italy

Source: Multiple Sclerosis Journal Published:2018


Abstract

Background: Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation. Objectives: To identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time. Methods: All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics. Results: A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5–5.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild (n = 143; 16.8%), moderate (n = 378; 44.3%), or severe (n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively. Conclusion: Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis. © 2017, © The Author(s), 2017.
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