The Onset of Multiple Sclerosis in Greece: A Single-Center Study of 1,034 Consecutive Patients

Abstract

Background/Aims: The onset of multiple sclerosis (MS) in Greece has not been systematically studied. We sought to provide data on the onset of MS in Greece with detailed information regarding initial symptoms, and to confirm the prognostic significance of demographic and clinical factors at onset. Methods: We studied 1,034 consecutive patients with MS and independently assessed 265 patients ‘seen at onset’. We used the MS severity score and survival analysis (time to reach an Expanded Disability Status Scale score of 4.0) to evaluate the prognostic significance of factors at onset. Results: Female-to-male ratio was 1.9:1 and mean age at onset was 30.7 ± 9.9 years. MS was primary progressive in 9.6%. Initial symptoms were optic neuritis in 20.1%, brainstem dysfunction in 14.7%, dysfunction of long tracts in 49.3%, cerebral dysfunction in 1% and a combination of symptoms in 14.9%. In ‘seen at onset’ patients, detailed data on initial symptoms are presented. Female gender, earlier age at onset, ‘bout onset’ and onset with optic neuritis were associated with less severe disease and longer time to disability. Conclusion: The onset of MS in Greece is similar to Western populations. Initial symptoms are within the expected spectrum. Prognostic significance of factors at onset is as previously identified.

Sex Differences in Resting-State Functional Connectivity in Multiple Sclerosis

“…[1][2][3] Although sex has a less dramatic effect on disease progression and clinical outcomes, several studies have reported more severe symptoms and faster progression in men. [4][5][6][7] The underlying processes thought to be involved in the development and progression of MS demonstrate significant sex differences. For example, male and female patients with MS have shown differences in the markers of autoimmune function, [8][9][10] and there has been extensive research on the effects of sex hormones on disease progression, particularly during and after pregnancy.…”

Predictive factors and treatment challenges in malignant progression of relapsing-remitting multiple sclerosis

“…In this regard, many researchers have identified female gender as a favorable prognostic factor [ 33 , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] ]. Koutsis et al (2010) [ 48 ] and Koch et al (2010) [ 49 ] concluded that females need a longer time to reach EDSS 4 and to develop secondary progressive types of MS. Although, a smaller number of studies have not detected any significant gender-based prognostic impact [ [50] , [51] , [52] , [53] ].…”

The influence of common infections on clinical course and neurodegeneration in an animal model of multiple sclerosis

“…Although with lower incidence rate of MS in male, they show slower recovery and show more aggressive nature of the disease course than females (Koutsis et al, 2010;Leibowitz and Alter, 1970;Runmarker and Andersen, 1993;Weinshenker et al, 1991).…”