The work, published in the journal Annals of Neurology, analyzes data from 9,088 people with multiple sclerosis from the multicenter MS PATHS registry. The results indicate that these self-administered measures can identify a significant proportion of patients with worsening disability, associated with greater brain atrophy, increased MRI lesions, and poorer quality of life.
Dr. Carmen Tur, a neurologist at the Vall d'Hebron University Hospital and researcher at the Cemcat, emphasizes that disability in multiple sclerosis is not always a consequence of a relapse. Incorporating the patient's perspective and simple motor and cognitive function tests can help identify changes less visible in a conventional clinical examination.
The study used the Patient-Determined Disease Steps (PDDS), a self-reported disability measure, along with tests for walking speed, manual dexterity, and cognitive processing speed. Over three years of follow-up, 45% of patients showed worsening in at least one measure, and 58% of these met the criteria for PIRA (Progression Independent of Relapse Activity).
Cognitive progression, detected by the processing speed test, was significant, as the PDDS primarily focuses on physical disability. Dr. Mar Tintoré, Head of Clinical Care at the Neurology Service of the Vall d'Hebron University Hospital and Director of the Cemcat, notes that these tests provide additional information to the EDSS, offering a more complete view of disability evolution.
Self-administered measures are associated with changes observed on MRI, such as greater brain volume loss and increased T2 lesion volume. Furthermore, patients with worsening detected by these tools showed poorer quality of life trajectories.
The authors conclude that these tools complement conventional clinical evaluation, providing additional information on different dimensions of disability and contributing to more accessible and efficient monitoring of multiple sclerosis progression.
