Late onset multiple sclerosis

Arias, Manuel; Dapena, D; Arias-Rivas, Susana; Costa, E.; López, A.; Prieto, José M.; Corredera, E

doi:10.1016/s2173-5808(11)70061-x

Cited by 14 publications

(21 citation statements)

References 21 publications

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confidence: 99%

“…Therefore, an uncommon form of MS is one in which symptoms start at 50 plus years of age, called late onset multiple sclerosis (LOMS) 1,2,3,4,5,6,7,8 . It accounts for 1.4% to 9.9% of the MS population in different countries 2,4,5,7,9,10,11,12 . On average, LOMS represents roughly 4.5% of the MS population 2,4,5,7 , it has a female preponderance 1,2,4,7,12 , its initial presentation is monosymptomatic, with a motor or cerebellar symptom, and the most common clinical course is primary progressive 4,13,14 .…”

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confidence: 99%

“…It accounts for 1.4% to 9.9% of the MS population in different countries 2,4,5,7,9,10,11,12 . On average, LOMS represents roughly 4.5% of the MS population 2,4,5,7 , it has a female preponderance 1,2,4,7,12 , its initial presentation is monosymptomatic, with a motor or cerebellar symptom, and the most common clinical course is primary progressive 4,13,14 . The progression to disability in LOMS has previously been attributed to disease duration time 15 , to clinical form 2 , gender 8 , and older age at the time of the patient's first examination 13 .…”

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confidence: 99%

“…Vascular disease of the central nervous system and cervical spondylotic myelopathy are the main differential diagnoses, due to a higher prevalence at this age and possible similar symptoms 1,4,13,17,18 . Because of previous co-morbid conditions and higher odds of T2-hyperintense lesions on magnetic resonance imaging (MRI) of elderly patients 7,13,19 , there is a delay in diagnosis that can reach three to five years in almost 40% of LOMS patients 7,14,20 . There is scanty literature concerning what influences the presentation and progression to disability in this age group, and few papers compare this population with young MS adults.…”

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Late onset multiple sclerosis: concerns in aging patients

Lotti

Oliveira

Bichuetti

et al. 2017

Arq. Neuro-Psiquiatr.

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Late onset multiple sclerosis (LOMS) is when the first symptom starts after 50 years of age, representing 4.5% of multiple sclerosis (MS) patients. This study describes the clinical characteristics of patients with LOMS followed at a specialized MS center in São Paulo. Data was obtained from medical records of 742 patients with MS. The LOMS frequency was 4.18%, median age at onset was 54 years and the predominant disease course was primary progressive (64.3%). The patients reached the disability landmarks of EDSS grades 3.0, 6.0 and 7.0 in the following proportion and time: EDSS 3.0: 77.42% of patients in 3.7 years; EDSS 6.0: 58.06% in 5.1 years and EDSS 7.0: 32.26% in 5.7 years. The comparative analysis with a matched control group of patients with early onset MS showed that late onset, associated with a progressive course, were predictors of reaching EDSS 3.0 and 6.0 in a shorter time.

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confidence: 99%

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Late onset multiple sclerosis: concerns in aging patients

Lotti

Oliveira

Bichuetti

et al. 2017

Arq. Neuro-Psiquiatr.

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“…When the diagnosis was MS and NMO, we also evaluated the number of patients that presented the first symptom before completing 18 or after 50 years of age, as these are the current literature definitions for pediatric and late onset diseases, respectively 21,22 . All patients were offered regular preventive therapies recommended and available for their diagnosis (MS or NMO) at the time they were seen, which included, but were not restricted to, interferon beta, glatiramer acetate, natalizumab, fingolimod, corticosteroids, cyclophosphamide, methotrexate, azathioprine, plasma exchange and IV immunoglobulin 20,23 .…”

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confidence: 99%

The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis

Bichuetti

Falcão

Boulos

et al. 2015

Arq. Neuro-Psiquiatr.

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Multiple sclerosis (MS) and neuromyelitis optica (NMO) are the most important and common inflammatory autoimmune diseases that affect the central nervous system (CNS) and can lead to sustained neurologic disability and financial burden for the society 1,2 . Both diseases can cause visual impairment, pyramidal deficits, sensation loss, neuropathic pain, coordination problems, gait impairment and cognitive problems (more MS than NMO). While MS has a Conclusion:We identified that 15% of patients seen have NMO. As patients with NMO have a more severe disease than MS, this data may be important for planning local health care policies.Keywords: multiple sclerosis, neuromyelitis optica, epidemiology, Sao Paulo. RESUMOObjetivo: Descrever a casuística de pacientes atendidos no setor de Neuroimunologia da Universidade Federal de São Paulo (UNIFESP) de 1994 a 2013. Método: Analisamos o diagnóstico final de todos os pacientes atendidos de 1999 a 2013, sendo o diagnóstico revisado na última consulta e estabelecido de acordo com os critérios específicos para cada doença. O volume de atendimentos clínicos e não clínicos (relatórios e receitas) foram contabilizados para avaliar a carga de trabalho da equipe. Resultados: 1.599 pacientes foram avaliados: 816 com esclerose múltipla (EM), 172 com síndromes clínicas isoladas, 178 com neuromielite óptica (NMO), 216 com outras doenças desmielinizantes, 20 com doenças metabólicas, 42 com doenças vasculares e 155 com outros diagnósticos ou diagnósticos indefinidos. Identificamos uma média de 219 consultas e 65 solicitações de relatórios por mês. Conclusão: Identificamos que 15% dos pacientes atendidos tem NMO. Por ser uma doença mais incapacitante que a EM estes dados podem ser importantes para o planejamento de políticas de saúde locais.Palavras-chave: esclerose múltipla, neuromielite óptica, epidemiologia, São Paulo.

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Diagnosis of coexistent neurodegenerative dementias in multiple sclerosis

Londoño

Arumaithurai

Constantopoulos

et al. 2022

Brain Communications

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Among people with multiple sclerosis, cognitive impairment occurs commonly and is a potent predictor of disability. Some multiple sclerosis patients present with severe cognitive impairment, and distinguishing multiple sclerosis-related cognitive impairment from co-existent progressive neurodegenerative diseases such as Alzheimer disease poses a diagnostic challenge. The use of biomarkers such as PET and CSF proteins may facilitate this distinction. The study was a retrospective, descriptive study on convenience samples of separate cohorts, one of cognitively impaired multiple sclerosis patients evaluated on autopsy to demonstrate coincidence of both multiple sclerosis and neurodegenerative cognitive diseases. The second cohort were cognitively impaired multiple sclerosis patients evaluated by biomarker to investigate possible additional neurodegenerative cognitive disorders contributing to the cognitive impairment. We investigated selected biomarkers among 31 severely impaired patients (biomarker cohort) and 12 severely impaired patients assessed at autopsy and selected 24 (23 biomarker cohort, 1 autopsy cohort) had comprehensive neurocognitive testing. Biomarker cohort investigations included 18F-Fluorodeoxyglucose PET and/or CSF amyloid Aβ1-42, phospho-tau, and total tau levels. The autopsy cohort was evaluated with comprehensive neuropathological assessment for etiology of cognitive impairment. The cohorts shared similar sex, age at multiple sclerosis onset and multiple sclerosis clinical course. The autopsy-cohort patients were older at diagnosis (69.5 vs 57 years, p = .006), had longer disease duration (median [range] 20 years [3-59] vs 9[1-32], p = 0.001) and had more impaired bedside mental status scores at last followup (Kokmen median [range] 23 [1-38] vs 31 [9-34] p = 0.01). Autopsy-cohort patients confirmed, or excluded, coexistent neurogenerative disease by neuropathology gold standard. Most biomarker-cohort patients had informative results evaluating coexistent neurogenerative disease. Biomarkers may be useful in indicating a coexistent neurodegenerative disease earlier, and in life, in patients with multiple sclerosis and significant cognitive impairment.

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Late onset multiple sclerosis

Cited by 14 publications

References 21 publications

Late onset multiple sclerosis: concerns in aging patients

Late onset multiple sclerosis: concerns in aging patients

The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis

Diagnosis of coexistent neurodegenerative dementias in multiple sclerosis

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