Thursday, 12 March 2015

Predicting MS

Tedeholm H, Skoog B, Lisovskaja V, Runmarker B, Nerman O, Andersen O. The outcome spectrum of multiple sclerosis: disability, mortality, and a cluster of predictors from onset. J Neurol. 2015. [Epub ahead of print]

Interest in the long-term natural history of multiple sclerosis (MS) is being revived, as disability endpoints become increasingly important with the advent of highly efficacious long range but potentially harmful drugs. MS had an increasingly benign course, probably due to better assessment and changing diagnostic criteria. Incidence cohorts reduce inclusion bias, capturing both extreme benign and severe cases. We conducted a 50-year follow-up of an incidence cohort of Gothenburg residents with MS onset in 1950-1964 (n = 254; 212 with an initial relapsing-remitting course and 42 with a monophasic course, diagnostic criteria according to Poser). Patients were followed longitudinally until censoring, death, or study termination in 2012. Median time to secondary progression was 15 years. Median time to EDSS6 and EDSS7 was 26 and 48 years (n = 254), respectively. The cumulative risk of reaching EDSS6 was 50 % at 55 years of age and 80 % at 80 years of age (n = 212).  Age at onset predicted the course in men, with 3-6 % yearly increase in the risk of reaching disability milestones. The present incidence cohort provided hard outcome data in untreated patients over several decades


  1. Predicting MS outcomes. I think there are many things that can be done to reduce some progression in MS. These include being aware that infections can trigger potent relapses and potent pseudo replases. Being vigilent to reduce getting infections as much as possible. Be knowledgeable about the way in which we get infections, such as through our mouth, ears, eyes. The over use of central heating, and the body overheating can contribute to getting infections but it is important to keep warm. Anxiety and stress can cause progression. The importance of sleep and rest. A good healthy diet with essential vitamins and minerals. Excercise and keeping mobile as much as possible. I could go on but I have discussed these things a few times now.

    1. I agree it delayed SPMS for me, but it got me in the end. It's not for everyone, although I found the healthy lifestyle easy. However I have been accused of having OCD with my hand washing.


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