Hospital Universitari de Bellvitge-IDIBELL
MS Unit, "EMxarxa"

Author Of 3 Presentations

Clinical Outcome Measures Poster Presentation

P0029 - Assessment of Multiple Sclerosis Severity Score and Age-Related Multiple Sclerosis Severity Score as health indicators in a population-based cohort (ID 447)

Speakers
Presentation Number
P0029
Presentation Topic
Clinical Outcome Measures

Abstract

Background

Persons with multiple sclerosis (MS) present varying degrees of disability throughout the course of the disease. The Multiple Sclerosis Severity Score (MSSS) and the Age-Related Multiple Sclerosis Severity Score (ARMSSS) adjust the score obtained in the Expanded Disability Status Scale (EDSS) according to disease duration and age, respectively. These measures could be useful as health outcome indicators.

Objectives

The aim of this study was to describe the severity of MS in our health district and assess MSSS and ARMSSS consistency over time.

Methods

Patients diagnosed with MS according to 2010 McDonald criteria, with at least one year of disease duration and followed up in our MS unit within the previous 18 months were selected. Sex, age at onset, disease duration, clinical course, age and irreversible EDSS at last follow-up visit were collected. MSSS and ARMSSS were calculated. Our cohort was studied twice, in 2017 and 2020 to assess the consistency of both instruments.

Results

One hundred and seventy-seven patients were included in 2017, and 208 in 2020. Prevalence of MS in our health district was 90 and 105 per 100,000 inhabitants, respectively, in line with the expected prevalence. Median MSSS and ARMSSS were similar in both study years. In 2017, median MSSS was 1.77 (IQR 0.76-4.28) and ARMSSS was 2.9 (IQR 1.47-5.72). In 2020, median MSSS was 2.03 (IQR 0.82-4.36) and ARMSSS was 2.93 (IQR 1.51-5.56).

Conclusions

According to MSSS and ARMSSS, our cohort presented mild disease, and the results were consistent at both time points. MSSS and ARMSSS may be reliable health outcome measures.

Collapse
Biomarkers and Bioinformatics Poster Presentation

P0087 - Identification of proteins associated with ageing in patients with progressive multiple sclerosis (ID 1589)

Abstract

Background

Similar to other neurodegenerative disorders, the onset of progressive MS is related to age, a factor known to amplify neurodegeneration. Recent studies have shown that exposure of aged mice to a young blood circulation through parabiosis or administration of young blood plasma (plasma from 3-month-old mice) reverses cognitive deficits observed with normal ageing.

Objectives

We aimed to search for soluble factors in the serum of patients with progressive MS that are affected by age and are differentially decreased in patients compared to healthy controls (HC) of similar age.

Methods

Protein levels were determined in serum samples from a cohort of 30 untreated MS patients (15 patients with secondary progressive MS - SPMS - and 15 with primary progressive MS - PPMS) and 25 HC. Progressive MS patients were classified according to age and clinical characteristics into the following three groups (each group containing 10 patients, 5 with SPMS and 5 with PPMS): (i) 40 ± 3 years old, disease duration <10 years, EDSS <4.5; (ii) 50 ± 3 years old, disease duration between 10-20 years, EDSS between 4.5-6; and (iii) 60 ± 3 years old, disease duration >20 years, EDSS >6.5. HC were classified based on age into the following groups (each group containing 5 individuals): 20, 30, 40, 50, and 60 ± 3 years old. To maximize the breadth and depth of serum proteome coverage, the top 70 abundant proteins in serum were depleted. Afterwards, samples were subjected to mass spectrometry.

Results

After depletion of the most abundant proteins in serum, a total of 2,059 molecules were detected in all 55 samples. The maSigPro package (R Bioconductor) was used to identify proteins with significantly divergent expression profiles as a function of time. A quadratic regression model was fit for each molecule and 823 proteins, among the 2059 analyzed, were found differentially expressed (FDR < 0.05) between the MS group and HC. The serum levels of the following proteins were significantly decreased by ageing in progressive MS patients compared with HC and were selected for further studies: PLXDC2, Neudesin, Myostatin, Myocilin, and EMMPRIN.

Conclusions

Protein expression profiling associated with ageing in progressive MS patients and HC lead to the identification of number of promising candidates associated with neurotrophic functions, myelination, and nervous system development. Results obtained by mass spectrometry need to be validated by targeted immunoassays.

Collapse
Observational Studies Poster Presentation

P0840 - Benign Multiple Sclerosis: Is the EDSS scale enough to define it?  (ID 436)

Speakers
Presentation Number
P0840
Presentation Topic
Observational Studies

Abstract

Background

Benign multiple sclerosis (BMS) is a controversial concept. Most definitions only consider the Expanded Disability Status Scale (EDSS) and disease duration to define it, although other factors may influence patient’s disability.

Objectives

The aim of this study was to assess symptoms not evaluated or underestimated in the EDSS scale in patients with BMS defined as EDSS≤3 after 10 years of disease.

Methods

Patients were selected from a hospital-based series of 485 multiple sclerosis (MS) patients assessed in 1996.  Those fulfilling the definition of BMS were selected. Patients were followed up in a prospective basis and EDSS were obtained after 20 and 30 years. At 30 years, the following test were completed: Patient Health Questionnaire (PHQ-9), Modified Fatigue Impact Scale (MFIS), Symbol Digit Modalities Test (SDMT) and Visual Analogue Scale (VAS) to evaluate severity of MS.

Results

82 from 485 patients evaluated in 1996 were selected. In 51 out of 68 (75%) patients evaluated in 2006 and in 35 out of 58 (60.3%) in 2016, the EDSS remained ≤3. Eighteen from the 35 BMS patients completed the questionnaire. 9/18 (50%) showed fatigue in the MFIS, 4/18 (22%) depression in the PHQ-9 and 15/18 (83%) cognitive impairment in the SDMT. 11/18 (61%) perceived their illness as more severe than estimated by the Multiple Sclerosis Severity Scale (MSSS). Fatigue and depression results were similar to those obtained in the rest of our MS patients (47.3% fatigue, 31% depression).

Conclusions

In patients with BMS, fatigue and depression frequency is similar to that of our MS cohort. A high percentage of patients present cognitive impairment, although it could be influenced by the older age of the patients.

Collapse