Do prodrome symptoms influence multiple sclerosis disease course and severity?

Vienažindytė, I.; Cesarskaja, J.; Vaičiulytė, D.; Balnytė, Renata; Matijošaitis, Vaidas

doi:10.1016/j.mehy.2022.110888

Cited by 2 publications

(2 citation statements)

References 25 publications

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“…These psychiatric prodromal symptoms could affect the severity of relapses. This is in line with the study done by Vienažindytė and colleagues, which hypothesized that detecting prodromal symptoms as early as possible could play an important role in identifying the course of the MS and predicting disability progression [36].…”

Section: Discussionsupporting

confidence: 90%

Predictors of severity and outcome of multiple sclerosis relapses

et al. 2023

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Background Multiple Sclerosis (MS) is a demyelinating disease of the central nervous system (CNS). The most common type of MS is the relapsing–remitting MS (RRMS) where relapses are the main component of the disease course. However, the relationship between the characteristics of the relapses on one hand and their severity and outcome on the other hand has not been fully characterized. Objectives To explore the characteristics of relapses among a cohort of Egyptian MS patients and their relation to the severity and outcome of the disease. Subjects and methods We analyzed 300 attacks from 223 patients in a retrospective study to identify demographic, clinical and paraclinical (laboratory and radiological) factors affecting: 1- Severity of relapses (the difference between the EDSS at the day of maximum worsening and the EDSS before the onset of the attack). 2- Outcome of relapses (the difference between the EDSS at the day of maximum improvement and the EDSS before the onset of the relapse). Results Severe attacks were most likely to occur in patients who are males, single, presenting with poly-symptomatic presentation, slower tempo of evolution of attack symptoms, longer duration of the attack, absence of DMTs at the time of the attack. The risk of having a severe relapse is more than 3 times when the patient is single. Regarding attack outcome, poorly recovered attacks were more common in patients with older age at disease onset and at attack onset, male sex, higher number of relapses, longer duration of illness prior to the attack, severe relapses, polysymptomatic presentation, associated cognitive symptoms, slower tempo of symptom evolution, longer duration of the attack, patients on OCPs, smoking, and presence of black holes in brain MRI. The risk of having relapses with partial or no recovery is more than five times when the patient has black holes in brain MRI and more than 4 times when the patient is a smoker. Conclusion Bearing in mind the demographic characteristics as well as the clinical and paraclinical characteristics of each attack and their relation to attack severity and outcome are a key to understanding the individual disease course of every patient and hence tailoring the best therapeutic plan suitable for his individual needs. In other words, prompt, rapid intervention in male patients, polysymptomatic attacks, slower tempo of evolution of attack symptoms and longer duration of the attack should be adopted since these factors are predictive of severe relapses as well as poor relapse outcome.

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Section: Discussionsupporting

confidence: 90%

Predictors of severity and outcome of multiple sclerosis relapses

et al. 2023

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“…Neuropsychiatric disorders, while common among age-associated neurodegenerative diseases (NDDs), can be a harbinger of the disease and emerge during the prodromal phase of Alzheimer’s disease (AD) ( 1 – 3 ), Parkinson’s disease (PD) ( 4 , 5 ), Multiple Sclerosis (MS) ( 6 , 7 ) and Amyotrophic Lateral Sclerosis (ALS) ( 8 ). Their emergence during the prodromal phase is suggestive of shared pathological drivers of neuropsychiatric and neurodegenerative diseases.…”

Section: Introductionmentioning

confidence: 99%

Association between CNS-active drugs and risk of Alzheimer’s and age-related neurodegenerative diseases

Cortes-Flores,

Torrandell-Haro,

Brinton

2024

Front. Psychiatry

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ObjectiveAs neuropsychiatric conditions can increase the risk of age-related neurodegenerative diseases (NDDs), the impact of CNS-active drugs on the risk of developing Alzheimer’s Disease (AD), non-AD dementia, Multiple Sclerosis (MS), Parkinson’s Disease (PD) and Amyotrophic Lateral Sclerosis (ALS) was investigated.Research design and methodsA retrospective cohort analysis of a medical claims dataset over a 10 year span was conducted in patients aged 60 years or older. Participants were propensity score matched for comorbidity severity and demographic parameters. Relative risk (RR) ratios and 95% confidence intervals (CI) were determined for age-related NDDs. Cumulative hazard ratios and treatment duration were determined to assess the association between CNS-active drugs and NDDs at different ages and treatment duration intervals.ResultsIn 309,128 patients who met inclusion criteria, exposure to CNS-active drugs was associated with a decreased risk of AD (0.86% vs 1.73%, RR: 0.50; 95% CI: 0.47-0.53; p <.0001) and all NDDs (3.13% vs 5.76%, RR: 0.54; 95% CI: 0.53-0.56; p <.0001). Analysis of impact of drug class on risk of AD indicated that antidepressant, sedative, anticonvulsant, and stimulant medications were associated with significantly reduced risk of AD whereas atypical antipsychotics were associated with increased AD risk. The greatest risk reduction for AD and NDDs occurred in patients aged 70 years or older with a protective effect only in patients with long-term therapy (>3 years). Furthermore, responders to these therapeutics were characterized by diagnosed obesity and higher prescriptions of anti-inflammatory drugs and menopausal hormonal therapy, compared to patients with a diagnosis of AD (non-responders). Addition of a second CNS-active drug was associated with greater reduction in AD risk compared to monotherapy, with the combination of a Z-drug and an SNRI associated with greatest AD risk reduction.ConclusionCollectively, these findings indicate that CNS-active drugs were associated with reduced risk of developing AD and other age-related NDDs. The exception was atypical antipsychotics, which increased risk. Potential use of combination therapy with atypical antipsychotics could mitigate the risk conferred by these drugs. Evidence from these analyses advance precision prevention strategies to reduce the risk of age-related NDDs in persons with neuropsychiatric disorders.

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Do prodrome symptoms influence multiple sclerosis disease course and severity?

Cited by 2 publications

References 25 publications

Predictors of severity and outcome of multiple sclerosis relapses

Predictors of severity and outcome of multiple sclerosis relapses

Association between CNS-active drugs and risk of Alzheimer’s and age-related neurodegenerative diseases

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