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Predictors of relapse severity in multiple sclerosis

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Abstract

Background

The severity of relapses is one of the determinants of residual disability in multiple sclerosis (MS), contributing to the final progressive state. However, the factors that predict the severity of relapses are not fully understood.

Aim

To predict relapse severity in MS and investigate the relationship between relapse severity and the degree of improvement in physical, cognitive, and social tests.

Methods

This observational single-center study prospectively assesses relapse severity in patients with MS. Relapses were classified as mild, moderate, and severe. Before relapse treatment and 1 month into remission four physical tests, four cognitive tests, and six surveys were performed. Multinomial regression analyses were applied to predict relapse severity.

Results

A total of 126 relapses were studied prospectively. Twenty-two were lost to follow-up. Multiple sclerosis International Quality of Life (MusiQol) questionnaire (r = 0.28, p = 0.006) and Symbol Digit Modalities Test (SDMT, r = 0.23, p = 0.022) improvement statuses were correlated with the severity of the relapse. Higher cases with improvement were observed in the severe relapse group on both MusiQol and SDMT, but no difference for those with a mild relapse. In the predictive model, only disease duration [Odds Ratio (OR) 0.808 95% confidence ınterval (CI) 0.691 to 0.945; p = 0.008] and Body Mass Index (BMI, OR 1.148 95% CI 1.018 to 1.294; p = 0.024) were associated with relapse severity.

Conclusion

Only disease duration was found to be predictive of relapse severity among disease-related variables. On the other hand, BMI may be a modifiable patient-related factor to consider in the management of exacerbations in MS.

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Data availability

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.

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Funding

No funding was received for conducting this study.

Author information

Authors and Affiliations

  1. Institute of Health Sciences, Dokuz Eylul University, Yenikale Mahallesi Sutculer Caddesi N7 D7 Narlıdere, Izmir, Turkey

    Cavid Baba, Zuhal Abasiyanik, Asiye Tuba Ozdogar & Ozge Sagici

  2. Multiple Sclerosis Research Group, Izmir, Turkey

    Yasemin Simsek

  3. Department of Neurology, Dokuz Eylul University, Izmir, Turkey

    Serkan Ozakbas

Authors
  1. Cavid Baba
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  2. Zuhal Abasiyanik
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  3. Yasemin Simsek
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  4. Asiye Tuba Ozdogar
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  5. Ozge Sagici
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  6. Serkan Ozakbas
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by CB, ZA, ATO and OS. The first draft of the manuscript was written by CB and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Cavid Baba.

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Conflict of ınterest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the Ethics Committee of Dokuz Eylul University (2019/01–188).

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Informed consent was obtained from all individual participants included in the study.

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Baba, C., Abasiyanik, Z., Simsek, Y. et al. Predictors of relapse severity in multiple sclerosis. Acta Neurol Belg 124, 581–589 (2024). https://doi.org/10.1007/s13760-023-02456-y

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