Contributions
Abstract: P327
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
The existence of benign multiple sclerosis (MS) remains controversial. Uncertainty remains about the frequency and pathological explanation for a favourable outcome in MS. However, identifying and studying individuals with benign MS has considerable implications for patient management and for our understanding of the biology of the disease. Most definitions of benign MS are centred on walking ability after 10-15y despite the far wider impact of MS on ability.
We screened a prevalent population of over 2,000 people with MS and found 275 individuals who had unlimited walking ability after 15 or more years from onset. We undertook detailed assessments in 56 of the individuals within this group (those recorded to have unlimited walking ability after the longest disease durations). Assessment incorporated scores of cognition, fatigue, mood, vision, bladder symptoms and arm and leg function. All patients were defined as having relapsing-remitting MS but they showed a wide range of relapse frequency and severity. In a group of 32 patients who fulfilled a contemporary EDSS-based definition for benign MS, less than 25% were found to be truly benign (defined as normal function in all domains). Patient-reported scores of MS-impact correlated strongly with the outcomes of clinical assessment but patients' own perception of their condition was more benign than clinicians'. MR imaging was used to explore the biology underlying benign MS using both a global and a tract-based approach.
Our study highlights the low prevalence of truly benign MS (estimated here as < 4% of a prevalent population) and provides early insights into its phenotypic and imaging characteristics. This could inform on the biological mechanisms of a favourable outcome in MS.
Disclosure:
EC Tallantyre: This research was conducted while Dr Tallantyre was a Biogen Idec Postdoctoral Fellow.
PC Major: nothing to disclose.
MJ Atherton: nothing to disclose.
WA Davies: nothing to disclose.
TP Pickersgill: nothing to disclose.
KE Harding: nothing to disclose.
M Winter: nothing to disclose.
NP Robertson: has served on the scientific advisory board for Genzyme, Roche, Novartis, and Biogen, received travel funding and/or speaker honoraria from Biogen and Genzyme and has received research support from Genzyme, Novartis, National Institute of Health Wales, Multiple Sclerosis Society of Great Britain, and Northern Ireland Welcome Trust.
Abstract: P327
Type: Poster
Abstract Category: Clinical aspects of MS - 4 Natural course
The existence of benign multiple sclerosis (MS) remains controversial. Uncertainty remains about the frequency and pathological explanation for a favourable outcome in MS. However, identifying and studying individuals with benign MS has considerable implications for patient management and for our understanding of the biology of the disease. Most definitions of benign MS are centred on walking ability after 10-15y despite the far wider impact of MS on ability.
We screened a prevalent population of over 2,000 people with MS and found 275 individuals who had unlimited walking ability after 15 or more years from onset. We undertook detailed assessments in 56 of the individuals within this group (those recorded to have unlimited walking ability after the longest disease durations). Assessment incorporated scores of cognition, fatigue, mood, vision, bladder symptoms and arm and leg function. All patients were defined as having relapsing-remitting MS but they showed a wide range of relapse frequency and severity. In a group of 32 patients who fulfilled a contemporary EDSS-based definition for benign MS, less than 25% were found to be truly benign (defined as normal function in all domains). Patient-reported scores of MS-impact correlated strongly with the outcomes of clinical assessment but patients' own perception of their condition was more benign than clinicians'. MR imaging was used to explore the biology underlying benign MS using both a global and a tract-based approach.
Our study highlights the low prevalence of truly benign MS (estimated here as < 4% of a prevalent population) and provides early insights into its phenotypic and imaging characteristics. This could inform on the biological mechanisms of a favourable outcome in MS.
Disclosure:
EC Tallantyre: This research was conducted while Dr Tallantyre was a Biogen Idec Postdoctoral Fellow.
PC Major: nothing to disclose.
MJ Atherton: nothing to disclose.
WA Davies: nothing to disclose.
TP Pickersgill: nothing to disclose.
KE Harding: nothing to disclose.
M Winter: nothing to disclose.
NP Robertson: has served on the scientific advisory board for Genzyme, Roche, Novartis, and Biogen, received travel funding and/or speaker honoraria from Biogen and Genzyme and has received research support from Genzyme, Novartis, National Institute of Health Wales, Multiple Sclerosis Society of Great Britain, and Northern Ireland Welcome Trust.