Prognostic information for people with MS: Impossible or inevitable?

Heesen, Christoph; Scalfari, Antonio; Galea, Ian

doi:10.1177/1352458518807101

Cited by 6 publications

(5 citation statements)

References 12 publications

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“…Patient preferences are likely to be important in this context. While it has been suggested that delivery of prognostic information may lead to nocebo effects (Heesen et al, 2018), we found no studies in our review to support this assumption, at least in terms of QOL impacts.…”

Section: Negative Focscontrasting

confidence: 55%

The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review

Maguire

McKeague

Kóka

et al. 2021

Multiple Sclerosis and Related Disorders

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Multiple Sclerosis (MS) is a highly variable condition characterised by uncertainty of disease course which can make formation of expectations about the future difficult. This systematic review aimed to examine associations between expectations, or Future Oriented Cognitions (FOCs), and Quality of Life (QOL) in people with MS (PwMS). Methods: Following PRISMA guidelines, literature up to October 2019 was searched using Medline, EMBASE, PsycINFO and Web of Science. Quantitative studies that investigated relationships between FOCs and QOL in PwMS (assessed using a standardised QOL assessment) were considered for inclusion. After data extraction, results were analysed using narrative synthesis, focusing on the valence of FOCs (positive, negative, unvalenced). Quality appraisal was conducted using the Mixed Methods Appraisal Tool (MMAT). All stages of the review were patient-led by a person with MS. Results: A total of 13 studies met the review inclusion criteria, with a combined sample size of 4,179. Of these studies, 11 involved measures of positive FOCs, most commonly self-efficacy, one measured a negative FOC, with one FOC unclassified. Nine studies found significant associations between QOL and self-efficacy. Although other positively valenced constructs were less frequently reported, significant associations with higher QOL were also evidenced. Conclusions: Identifying ways to foster positive FOCs, particularly self-efficacy, may have beneficial effects on QOL. More research is needed to understand the impacts of negative FOCs on QOL to determine whether these processes could be meaningfully targeted in interventions.

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Section: Negative Focscontrasting

confidence: 55%

The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review

Maguire

McKeague

Kóka

et al. 2021

Multiple Sclerosis and Related Disorders

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“…Multiple sclerosis (MS) is a highly heterogeneous disease, with a wide spectrum of disability outcomes and immunological endophenotypes. 1 It is therefore important to identify biomarkers in the cerebrospinal fluid (CSF) and blood to better predict disability outcomes, and to help select the most appropriate therapy for an individual person with MS. Reliable biomarkers would be helpful to identify those higher risk MS patients for whom highly efficacious (but higher risk) treatments might be prescribed, as well as to identify patients with low risk of disability for whom safer, but lower efficacy treatments would be sufficient.…”

Section: Introductionmentioning

confidence: 99%

Can CSF biomarkers predict future MS disease activity and severity?

Magliozzi

Cross

2020

Mult Scler

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Multiple sclerosis (MS) is a heterogeneous disease. With several disease modifying treatments of different mechanisms of action in use now and in development, it is important to identify reliable biomarkers to identify those higher risk MS patients in whom stronger but riskier treatments might be used, as well as to identify those for whom safer treatments of lower efficacy would be sufficient. Here we review cerebrospinal fluid (CSF) and blood biomarkers that show promise for differentiating people with MS who are at risk for severe disease and disability from those with more benign disease. We reviewed published literature for studies reporting biomarkers with predictive value in MS. Most studies of MS CSF found the presence of oligoclonal bands (both IgG and IgM), high IgG index and high levels of kappa light chains to each be associated with worse prognosis. Neurofilament light chain (NfL) and two markers of glial activation, glial fibrillary acidic protein (GFAP) and YKL-40, were higher in CSF of people with subsequent clinical progression or imaging evidence for neurodegeneration. Few reports have been made yet on the prognostic significance of blood NfL, but in one early report baseline, serum NfL (sNfL) predicted subsequent brain volume loss.

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“…2 Given its highly heterogeneous clinical presentations and disease course, it is critical to identify biomarkers to monitor disease progression and therapeutic efficacy. 3,4 Although brain magnetic resonance image (MRI) is routinely used to monitor disease progression, the clinical relevance of the changes in the MRI activity is uncertain. 5 As the extension of the brain, the retina of the patients with MS displays inflammatory and neurodegenerative changes.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Study of Retinal Structure, Vascular, and Neuronal Function in Patients With Relapsing-Remitting Multiple Sclerosis: 1-Year Follow-Up

Chen

Jiang

Delgado

et al. 2021

Trans. Vis. Sci. Tech.

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The purpose of this study was to quantify retinal structural, vascular, and functional changes in patients with relapsing-remitting multiple sclerosis (RRMS) over 1 year.Methods: Eighty-eight eyes of 44 patients with RRMS underwent assessments of low contrast letter acuity (LCLA), retinal ganglion cell function detected by the steady-state pattern electroretinogram (PERG), axonal microstructural integrity measured as birefringence, intraretinal layer thicknesses by ultra-high-resolution optical coherence tomography (OCT), volumetric vessel density (VVD) by OCT angiography, and retinal tissue perfusion (RTP) by the Retinal Function Imager (RFI). All measurements were performed at baseline and 1-year follow-up. The impacts of disease activities and a history of optic neuritis (ON) were analyzed.Results: Compared to baseline, there were no significant differences in all variables (P > 0.05), except for the axonal birefringence and RTP. The birefringence's of the retinal fiber layer at the temporal and superior quadrants was significantly decreased (P < 0.05), whereas RTP was significantly increased (P < 0.05). In the subgroup with ON, significantly longer PERG latency and decreased VVD were observed at follow-up (P < 0.05). In patients with improved LCLA, significantly increased RTP and decreased VVD (P < 0.05) were also observed.Conclusions: This is the first longitudinal study that assessed the RTP and VVD, along with other retinal structural and functional parameters in MS. The recovery of retinal vascular function occurred with the improved LCLA, suggesting that these measurements may be associated with disease progression.Translational Relevance: The retinal microvascular changes could be potential biomarkers for monitoring therapeutic efficacy in MS.

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Prognostic information for people with MS: Impossible or inevitable?

Cited by 6 publications

References 12 publications

The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review

The role of expectations and future-oriented cognitions in quality of life of people with multiple sclerosis: A systematic review

Can CSF biomarkers predict future MS disease activity and severity?

Longitudinal Study of Retinal Structure, Vascular, and Neuronal Function in Patients With Relapsing-Remitting Multiple Sclerosis: 1-Year Follow-Up

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