Contributions
Abstract: P328
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: Multiple Sclerosis (MS) is a chronic disease of the central nervous system in which damage resulting from repeated inflammatory insults and neurodegeneration leads to varying types and degrees of symptoms and impairment causing profound adverse impact on quality of life (QOL).
Objective: To study the prevalence of MS symptoms and which symptoms and symptom clusters affect QOL.
Method: This is a cross-sectional study using survey data on patient characteristics, MS symptoms, Patient Determined Disease Steps (PDDS) and Multiple Sclerosis Impact Scale (MSIS) from the Pacific Northwest MS Registry. Maximum Likelihood Exploratory Factor Analysis was used to summarize twenty symptoms into four factor groupings. Multiple linear regression was used to determine the correlation between the factor groups and the physical and psychological dimensions of MSIS, controlling for gender and disease duration.
Results: Data from 2,092 registry participants with mean age of 59.8 (±11.5) years, mean disease duration of 19.4 (±10.4) years, median PDDS of 3, and median MSIS physical and psychological scores (scaled 0-100) of 33.3 [IQR: 13.3, 58.3] and 33.3 [IQR: 14.8, 48.2] respectively were included in the analyses; 81.4% were female and 62.0% had relapsing MS. Among the 20 symptoms studied, fatigue (68.5%), numbness and/or tingling (60.5%), heat sensitivity (59.1%), difficulty walking or maintaining balance (53.7%), and stiffness, spasms, or tremors in limbs (50.9%) were the most prevalent symptoms. Through factor analysis the symptom data were reduced to 4 factors: (a) immobility and bladder/bowel dysfunction, (b) pain and fatigue, (c) dysphasia and speech problem, and (d) cognitive and psychological impairment. Regression results suggested that difficulty walking, often occurring in association with bladder and bowel dysfunction, had the strongest correlation with the physical impact score (Relative Risk (RR) = 10.51, p< .01). In contrast, the pain and fatigue factor had the strongest association with the psychological impact score (RR=7.89, p< .001).
Conclusion: This study identified co-occurring MS symptoms and their differing correlation to the physical and psychological dimensions of QOL as measured by the MSIS. Future studies will investigate the symptoms that are inter-related and seek underlying etiological relationships to assist in development of effective strategies for the detection and management of these complex and clinically significant MS symptoms.
Disclosure:
Chiayi Chen, Tamela Stuchiner, Lindsay Lucas, and Elizabeth Baraban have nothing to disclose.
Stanley Cohan serves on steering committees and advisory boards for Biogen, Novartis, Sanofi-Genzyme, Genentech and Mallinckrodt, receives research support from Biogen, Novartis, Sanofi-Genzyme, Roche, Opexa, and Mallinckrodt, receives speaking honoraria from Biogen, Novartis, Sanofi-Genzyme and Acorda; received support for air travel, lodging and meals from Biogen, Novartis, and Sanofi-Genzyme.
Abstract: P328
Type: Poster
Abstract Category: Clinical aspects of MS - MS symptoms
Background: Multiple Sclerosis (MS) is a chronic disease of the central nervous system in which damage resulting from repeated inflammatory insults and neurodegeneration leads to varying types and degrees of symptoms and impairment causing profound adverse impact on quality of life (QOL).
Objective: To study the prevalence of MS symptoms and which symptoms and symptom clusters affect QOL.
Method: This is a cross-sectional study using survey data on patient characteristics, MS symptoms, Patient Determined Disease Steps (PDDS) and Multiple Sclerosis Impact Scale (MSIS) from the Pacific Northwest MS Registry. Maximum Likelihood Exploratory Factor Analysis was used to summarize twenty symptoms into four factor groupings. Multiple linear regression was used to determine the correlation between the factor groups and the physical and psychological dimensions of MSIS, controlling for gender and disease duration.
Results: Data from 2,092 registry participants with mean age of 59.8 (±11.5) years, mean disease duration of 19.4 (±10.4) years, median PDDS of 3, and median MSIS physical and psychological scores (scaled 0-100) of 33.3 [IQR: 13.3, 58.3] and 33.3 [IQR: 14.8, 48.2] respectively were included in the analyses; 81.4% were female and 62.0% had relapsing MS. Among the 20 symptoms studied, fatigue (68.5%), numbness and/or tingling (60.5%), heat sensitivity (59.1%), difficulty walking or maintaining balance (53.7%), and stiffness, spasms, or tremors in limbs (50.9%) were the most prevalent symptoms. Through factor analysis the symptom data were reduced to 4 factors: (a) immobility and bladder/bowel dysfunction, (b) pain and fatigue, (c) dysphasia and speech problem, and (d) cognitive and psychological impairment. Regression results suggested that difficulty walking, often occurring in association with bladder and bowel dysfunction, had the strongest correlation with the physical impact score (Relative Risk (RR) = 10.51, p< .01). In contrast, the pain and fatigue factor had the strongest association with the psychological impact score (RR=7.89, p< .001).
Conclusion: This study identified co-occurring MS symptoms and their differing correlation to the physical and psychological dimensions of QOL as measured by the MSIS. Future studies will investigate the symptoms that are inter-related and seek underlying etiological relationships to assist in development of effective strategies for the detection and management of these complex and clinically significant MS symptoms.
Disclosure:
Chiayi Chen, Tamela Stuchiner, Lindsay Lucas, and Elizabeth Baraban have nothing to disclose.
Stanley Cohan serves on steering committees and advisory boards for Biogen, Novartis, Sanofi-Genzyme, Genentech and Mallinckrodt, receives research support from Biogen, Novartis, Sanofi-Genzyme, Roche, Opexa, and Mallinckrodt, receives speaking honoraria from Biogen, Novartis, Sanofi-Genzyme and Acorda; received support for air travel, lodging and meals from Biogen, Novartis, and Sanofi-Genzyme.