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Can we predict benign multiple sclerosis? Results of a 20-year long-term follow-up study

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Abstract

Benign multiple sclerosis (MS) is a discussed clinical entity, with variable reported prevalence (6–64%) requiring at least 5–10 years of clinical observation. Moreover, many benign patients progress with time becoming no longer benign (NLB). The objective of this study is to compare benign MS patients (EDSS ≤3, 10 years from disease onset) who still fulfilled the definition at 20 years to those NLB. In our retrospective study based on Ottawa Hospital MS Clinic database, 175 benign patients fulfilled the inclusion criteria (clinically definite MS, EDSS ≤3 at 10 years, disease onset from 1983 to 1993, and clinical assessments performed at 10 ± 1 and 20 ± 1 years from onset). Out of the identified patients, 66.3% remained benign at 20 years; however, by changing the definition for benign to EDSS ≤2 or ≤1 at 10 years, they increased to 71.9 and 81.6%, respectively. Female sex, EDSS ≤1 at 10 years, and a pure sensory onset were associated with a benign course, while a pure motor onset with an NLB condition. According to multivariate analysis, an EDSS ≤2 at 10 years predicted a long-term benign course. Our study questions the current definition of “benign” MS, suggesting a more stringent EDSS cutoff at 10 years to predict long-term benign prognosis.

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Authors and Affiliations

  1. Neurology Unit, Department of Medical, Surgical, and Health Sciences, University of Trieste, ASUITs, Cattinara Hospital, Strada di Fiume 447, 34149, Trieste, Italy

    Arianna Sartori

  2. Multiple Sclerosis Research Clinic, Division of Neurology, Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa Hospital MS Clinic, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada

    Mohammad Abdoli & Mark S. Freedman

Authors
  1. Arianna Sartori
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  2. Mohammad Abdoli
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  3. Mark S. Freedman
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Correspondence to Arianna Sartori.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical standards

This study has been performed in accordance with the Declaration of Helsinki and with the ethical standards of the institution.

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Sartori, A., Abdoli, M. & Freedman, M.S. Can we predict benign multiple sclerosis? Results of a 20-year long-term follow-up study. J Neurol 264, 1068–1075 (2017). https://doi.org/10.1007/s00415-017-8487-y

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  • DOI: https://doi.org/10.1007/s00415-017-8487-y

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