Contributions
Abstract: P681
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Late onset Multiple sclerosis (LOMS) with a diagnosis made after the age of 50 has a number of differences to young onset MS (YOMS), including faster rate of disability accumulation in LOMS. Some studies and clinicians suggest that LOMS is actually late presentation due to delays in diagnosis or misdiagnosis. Disease monitoring is currently affected by the perceived onset of MS so establishing whether LOMS is late diagnosis or true late onset might have management implications for individual patients. Clinical symptoms at onset might be affected by recall bias and a more objective measure is needed to assess disease chronicity. As brain white matter lesions accumulate over the course of MS, they may be a more appropriate marker.
Aims: To assess the patient reported duration of the MS course before presentation to MS services (time between the reported clinically isolated syndrome (CIS) and diagnosis), and the objectively quantified MRI total white matter lesion volumes at presentation in YOMS and LOMS patients.
Methods: Clinical 2D FLAIR scans from the UK Nottingham MS Register cohort from 139 participants, 21 with LOMS and 118 with YOMS, were assessed for this study. Information on the time of CIS, diagnosis dates and lesion volumes at the time of diagnosis were extracted for each patient and assessed against age at diagnosis.
Results: In the whole cohort, the mean time between CIS and diagnosis was 61.42 months. In the age range 50-59, the mean time was 95.24 months. COX regression showed that time between CIS and actual diagnosis increased by 2.5% for each year older at diagnosis (P = 0.003). On the contrary, when MRI were assessed, multiple linear regression showed that there was no correlation between age at diagnosis and lesion volume at presentation (P = 0.747).
Conclusion: This study found that brain lesion volume detected at the first scan is not affected by the age at diagnosis. The MRI results do not support the findings that LOMS may be a delayed diagnosis and suggests that LOMS is indeed late onset. However, further research into lesion accumulation rate at different ages of untreated patients is needed to fully understand whether LOMS is indeed really late onset or not.
Disclosure: S. Quraishi: nothing to disclose; H. Lyle: nothing to disclose; M. Clarke: nothing to disclose; J. Paul: nothing to disclose; P. Morgan: nothing to disclose; C.Tench: nothing to disclose; N. Evangelou has received funding and support from PCORI, MS society, Biogen, Novartis, Roche,Teva
Abstract: P681
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Epidemiology
Background: Late onset Multiple sclerosis (LOMS) with a diagnosis made after the age of 50 has a number of differences to young onset MS (YOMS), including faster rate of disability accumulation in LOMS. Some studies and clinicians suggest that LOMS is actually late presentation due to delays in diagnosis or misdiagnosis. Disease monitoring is currently affected by the perceived onset of MS so establishing whether LOMS is late diagnosis or true late onset might have management implications for individual patients. Clinical symptoms at onset might be affected by recall bias and a more objective measure is needed to assess disease chronicity. As brain white matter lesions accumulate over the course of MS, they may be a more appropriate marker.
Aims: To assess the patient reported duration of the MS course before presentation to MS services (time between the reported clinically isolated syndrome (CIS) and diagnosis), and the objectively quantified MRI total white matter lesion volumes at presentation in YOMS and LOMS patients.
Methods: Clinical 2D FLAIR scans from the UK Nottingham MS Register cohort from 139 participants, 21 with LOMS and 118 with YOMS, were assessed for this study. Information on the time of CIS, diagnosis dates and lesion volumes at the time of diagnosis were extracted for each patient and assessed against age at diagnosis.
Results: In the whole cohort, the mean time between CIS and diagnosis was 61.42 months. In the age range 50-59, the mean time was 95.24 months. COX regression showed that time between CIS and actual diagnosis increased by 2.5% for each year older at diagnosis (P = 0.003). On the contrary, when MRI were assessed, multiple linear regression showed that there was no correlation between age at diagnosis and lesion volume at presentation (P = 0.747).
Conclusion: This study found that brain lesion volume detected at the first scan is not affected by the age at diagnosis. The MRI results do not support the findings that LOMS may be a delayed diagnosis and suggests that LOMS is indeed late onset. However, further research into lesion accumulation rate at different ages of untreated patients is needed to fully understand whether LOMS is indeed really late onset or not.
Disclosure: S. Quraishi: nothing to disclose; H. Lyle: nothing to disclose; M. Clarke: nothing to disclose; J. Paul: nothing to disclose; P. Morgan: nothing to disclose; C.Tench: nothing to disclose; N. Evangelou has received funding and support from PCORI, MS society, Biogen, Novartis, Roche,Teva