| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
, MD
aolu, MDlu, MDrul, MD
From the Department of Neurology (Drs. Kantarci and Siva), Istanbul University, Cerrahpasa School of Medicine; the Department of Neurology(Dr. Eraksoy), Istanbul University, Istanbul Medical School; the Department of Neurology (Dr. Karabudak), Hacettepe University Medical School, Ankara; the Department of Neurology (Dr. Sütla), Bakirköy State Hospital for Mental and Neurological Illnesses, Istanbul; the Department of Neurology(Dr. Aaolu), Okmeydani Social Security Hospital, Istanbul; the Department of Neurology (Dr. Turan), Uluda University Medical School, Bursa; the Department of Neurology (Dr. Özmenolu), Karadeniz Technical University Medical School, Trabzon; the Department of Neurology (Dr. Torul), Gülhane Military Academy of Medicine, Istanbul; and the Department of Neurology (Dr. Demirkiran), Çukurova University Medical School, Adana.
Address correspondence and reprint requests to Dr. Aksel Siva, Hac1 Emin Sok. 20/7 Nianta1, 80200, Istanbul, Turkey.
Objective: To examine the natural history, survival, and prognostic factors in a sample of Turkish MS patients.
Method: This multicenter study included 1,259 definite MS patients diagnosed according to the criteria of Poser et al. Actuarial analysis of selected disability levels of 3, 6, 8, and 10 achieved with the Expanded Disability Status Scale (EDSS); a multivariate Cox regression analysis for prognostic factors related to time to reach EDSS 
6; and Pearson's correlation coefficient for individual factors were performed.
Results: The survival (±SE) at 15 years from onset was 94.6 ± 2.9%, and at 25 years was 89.0 ± 5.8%. The disability reached by 15 years was EDSS 3 in 66.4%, EDSS 6 in 41.2%, EDSS 8 in 10.5%, and EDSS = 10 in 5.4%. The most significant unfavorable prognostic factors were progressive course (relative risk [RR], 3.73; CI, 2.71 to 5.13) and sphincter symptoms at onset (RR, 1.86; CI, 1.23 to 2.82), followed by male sex, motor symptoms at onset, and a high attack frequency within the first 5 years. Primary progressive disease was correlated positively with male sex (r = 0.0895, p = 0.001), older age (r = 0.1807, p = 0.000), and motor (r = 0.1433, p = 0.000) or sphincter symptoms (r = 0.1001, p = 0.000) at onset, unlike relapsing-remitting and secondary progressive disease.
Conclusions: Although a slightly better prognosis is observed in the Turkish MS population, early prognostic factors are similar to most of the previous Western series. Primary progressive disease, mostly seen in older men with motor and sphincter involvement at onset, has a worse prognosis and may represent a distinct behavioral variant of MS.
*See the Appendix on page 772 for a listing of the investigators of the Turkish Multiple Sclerosis Study Group and their affiliations.
Supported in part by the Turkish Multiple Sclerosis Society.
Presented in part at the 13th ECTRIMS (European Committee for Treatment and Research in Multiple Sclerosis) Congress; Istanbul, Turkey; November 1997; and awarded as one of the two best presentations by the scientific committee of ECTRIMS.
Received January 28, 1998. Accepted in final form May 15, 1998.
This article has been cited by other articles:
|
|
 |
|
  R Antulov, B Weinstock-Guttman, J. Cox, S Hussein, J Durfee, C Caiola, M. Dwyer, N Bergsland, N Abdelrahman, M Stosic, et al. Gender-related differences in MS: a study of conventional and nonconventional MRI measures Multiple Sclerosis, March 1, 2009; 15(3): 345 - 354. [Abstract] [PDF]
|
|
|
|
|
|
M Debouverie, L Laforest, E Van Ganse, F Guillemin, and for the LORSEP Group Earlier disability of the patients followed in Multiple Sclerosis centers compared to outpatients Multiple Sclerosis, February 1, 2009; 15(2): 251 - 257. [Abstract] [PDF]
|
|
|
|
 |
|
 C Hirst, G Ingram, R Swingler, D A S Compston, T Pickersgill, and N P Robertson Change in disability in patients with multiple sclerosis: a 20-year prospective population-based analysis J. Neurol. Neurosurg. Psychiatry, October 1, 2008; 79(10): 1137 - 1143. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C Hirst, R Swingler, D A S Compston, Y Ben-Shlomo, and N P Robertson Survival and cause of death in multiple sclerosis: a prospective population-based study J. Neurol. Neurosurg. Psychiatry, September 1, 2008; 79(9): 1016 - 1021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Leray, S. Morrissey, J. Yaouanq, M. Coustans, E. Le Page, J. Chaperon, and G. Edan Long-term survival of patients with multiple sclerosis in West France Multiple Sclerosis, August 1, 2007; 13(7): 865 - 874. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Langer-Gould, R. A. Popat, S. M. Huang, K. Cobb, P. Fontoura, M. K. Gould, and L. M. Nelson Clinical and Demographic Predictors of Long-term Disability in Patients With Relapsing-Remitting Multiple Sclerosis: A Systematic Review Arch Neurol, December 1, 2006; 63(12): 1686 - 1691. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O. H. Kantarci, L. F. Barcellos, E. J. Atkinson, P. P. Ramsay, R. Lincoln, S. J. Achenbach, M. De Andrade, S. L. Hauser, and B. G. Weinshenker Men transmit MS more often to their children vs women: the Carter effect. Neurology, July 25, 2006; 67(2): 305 - 310. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Confavreux and S. Vukusic Age at disability milestones in multiple sclerosis Brain, March 1, 2006; 129(3): 595 - 605. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Bronnum-Hansen, N. Koch-Henriksen, and E. Stenager Trends in survival and cause of death in Danish patients with multiple sclerosis Brain, April 1, 2004; 127(4): 844 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Tuzun, A. AltWntas, I. Karacan, S. Tangurek, S. Saip, and A. Siva Bone status in multiple sclerosis: beyond corticosteroids Multiple Sclerosis, December 1, 2003; 9(6): 600 - 604. [Abstract] [PDF]
|
|
|
|
|
|
M. Eriksson, O. Andersen, and B. Runmarker Long-term follow up of patients with clinically isolated syndromes, relapsing-remitting and secondary progressive multiple sclerosis Multiple Sclerosis, June 1, 2003; 9(3): 260 - 274. [Abstract] [PDF]
|
|
|
|
|
|
C. Confavreux, S. Vukusic, and P. Adeleine Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process Brain, April 1, 2003; 126(4): 770 - 782. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. L. Simone, D. Carrara, C. Tortorella, M. Liguori, V. Lepore, F. Pellegrini, A. Bellacosa, A. Ceccarelli, I. Pavone, and P. Livrea Course and prognosis in early-onset MS: Comparison with adult-onset forms Neurology, December 24, 2002; 59(12): 1922 - 1928. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. S. Burks, B. G. Arnason, P. K. Coyle, C. C. Ford, A. Noronha, and K. W. Rammohan Issues and Practices in Multiple Sclerosis Neurorehabil Neural Repair, December 1, 2002; 16(4): 307 - 320. [Abstract] [PDF]
|
|
|
|
|
|
J. Chapman, S. Vinokurov, A. Achiron, D. M. Karussis, K. Mitosek-Szewczyk, M. Birnbaum, D. M. Michaelson, and A. D. Korczyn APOE genotype is a major predictor of long-term progression of disability in MS Neurology, February 13, 2001; 56(3): 312 - 316. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K M Myhr, T Riise, C Vedeler, M W Nortvedt, M Gronning, R Midgard, and H I Nyland Disability and prognosis in multiple sclerosis: demographic and clinical variables important for the ability to walk and awarding of disability pension Multiple Sclerosis, February 1, 2001; 7(1): 59 - 65. [Abstract] [PDF]
|
|
|
|
|
|
M. T. Wallin, W. F. Page, and J. F. Kurtzke Epidemiology of multiple sclerosis in US veterans VIII. Long-term survival after onset of multiple sclerosis Brain, August 1, 2000; 123(8): 1677 - 1687. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. G Weinshenker Databases in MS research: pitfalls and promises Multiple Sclerosis, August 1, 1999; 5(4): 206 - 211. [Abstract] [PDF]
|
|
|
|
|
|
Z M Levic, I Dujmovic, T Pekmezovic, M Jarebinski, J Marinkovic, N Stojsavljevic, and J Drulovic Prognostic factors for survival in multiple sclerosis Multiple Sclerosis, June 1, 1999; 5(3): 171 - 178. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
