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Onset of progressive phase is an age-dependent clinical milestone in multiple sclerosis

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dc.contributor.author Tutuncu M.
dc.contributor.author Tang J.
dc.contributor.author Zeid N.A.
dc.contributor.author Kale N.
dc.contributor.author Crusan D.J.
dc.contributor.author Atkinson E.J.
dc.contributor.author Siva A.
dc.contributor.author Pittock S.J.
dc.contributor.author Pirko I.
dc.contributor.author Keegan B.M.
dc.contributor.author Lucchinetti C.F.
dc.contributor.author Noseworthy J.H.
dc.contributor.author Rodriguez M.
dc.contributor.author Weinshenker B.G.
dc.contributor.author Kantarci O.H.
dc.contributor.editor
dc.date 2013
dc.date.accessioned 2017-10-05T15:38:17Z
dc.date.available 2017-10-05T15:38:17Z
dc.date.issued 2013
dc.identifier 10.1177/1352458512451510
dc.identifier.isbn
dc.identifier.issn 13524585
dc.identifier.uri http://hdl.handle.net/10938/16252
dc.description.abstract Background: It is unclear if all patients with relapsing-remitting multiple sclerosis (RRMS) ultimately develop progressive MS. Onset of progressive disease course seems to be age- rather than disease duration-dependent. Some forms of progressive MS (e.g. primary progressive MS (PPMS)) are uncommon in population-based studies. Ascertainment of patients with PPMS from clinic-based populations can facilitate a powerful comparison of age at progression onset between secondary progressive MS (SPMS) and PPMS but may introduce unclear biases. Objective: Our aim is to confirm that onset of progressive disease course is more relevant to the patient's age than the presence or duration of a pre-progression relapsing disease course in MS. Methods: We studied a population-based MS cohort (n=210, RRMS n=109, progressive MS n=101) and a clinic-based progressive MS cohort (n=754). Progressive course was classified as primary (PPMS; n=322), single attack (SAPMS; n=112) and secondary progressive (SPMS; n=421). We studied demographics (chi2 or t-test), age-of-progression- onset (t-test) and time to Expanded Disability Status Scale of 6 (EDSS6) (Kaplan-Meier analyses). Results: Sex ratio (p=0.58), age at progression onset (p=0.37) and time to EDSS6 (p=0.16) did not differ between the cohorts. Progression had developed before age 75 in 99percent of patients with known progressive disease course; 38percent with RRMS did not develop progression by age 75. Age at progression onset did not differ between SPMS (44.9±9.6), SAPMS (45.5±9.6) and PPMS (45.7±10.8). In either cohort, only 2percent of patients had reached EDSS6 before onset of progression. Conclusions: Patients with RRMS do not inevitably develop a progressive disease course. Onset of progression is more dependent on age than the presence or duration of a pre-progression symptomatic disease course. Moderate disability is sustained predominantly after the onset of a progressive disease course in MS. © The Author(s) 2012.
dc.format.extent
dc.format.extent Pages: (188-198)
dc.language English
dc.publisher LONDON
dc.relation.ispartof Publication Name: Multiple Sclerosis; Publication Year: 2013; Volume: 19; no. 2; Pages: (188-198);
dc.relation.ispartofseries
dc.relation.uri
dc.source Scopus
dc.subject.other
dc.title Onset of progressive phase is an age-dependent clinical milestone in multiple sclerosis
dc.type Article
dc.contributor.affiliation Tutuncu, M., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Tang, J., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Zeid, N.A., Department of Neurology, American University of Beirut Medical Center, Lebanon, Department of Neurology, Mayo Clinic College of Medicine, United States
dc.contributor.affiliation Kale, N., Department of Neurology, Bakirkoy State Hospital, Istanbul, Turkey, Department of Neurology, Mayo Clinic College of Medicine, United States
dc.contributor.affiliation Crusan, D.J., Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, United States
dc.contributor.affiliation Atkinson, E.J., Division of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Rochester, United States
dc.contributor.affiliation Siva, A., Department of Neurology, Cerrahpasa School of Medicine, Istanbul University, Turkey
dc.contributor.affiliation Pittock, S.J., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Pirko, I., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Keegan, B.M., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Lucchinetti, C.F., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Noseworthy, J.H., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Rodriguez, M., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Weinshenker, B.G., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.affiliation Kantarci, O.H., Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States
dc.contributor.authorAddress Kantarci, O.H.; Mayo Clinic Center for Multiple Sclerosis and CNS Demyelinating Diseases, Department of Neurology, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN 55905, United States; email: kantarci.orhun@mayo.edu
dc.contributor.authorCorporate University: American University of Beirut Medical Center; Faculty: Faculty of Medicine; Department: Internal Medicine; Division: Neurology;
dc.contributor.authorDepartment Internal Medicine
dc.contributor.authorDivision Neurology
dc.contributor.authorEmail kantarci.orhun@mayo.edu
dc.contributor.authorFaculty Faculty of Medicine
dc.contributor.authorInitials Tutuncu, M
dc.contributor.authorInitials Tang, J
dc.contributor.authorInitials Abou Zeid, N
dc.contributor.authorInitials Kale, N
dc.contributor.authorInitials Crusan, DJ
dc.contributor.authorInitials Atkinson, EJ
dc.contributor.authorInitials Siva, A
dc.contributor.authorInitials Pittock, SJ
dc.contributor.authorInitials Pirko, I
dc.contributor.authorInitials Keegan, BM
dc.contributor.authorInitials Lucchinetti, CF
dc.contributor.authorInitials Noseworthy, JH
dc.contributor.authorInitials Rodriguez, M
dc.contributor.authorInitials Weinshenker, BG
dc.contributor.authorInitials Kantarci, OH
dc.contributor.authorOrcidID
dc.contributor.authorReprintAddress Kantarci, OH (reprint author), Mayo Clin and Mayo Fdn, Dept Neurol, 200 1st St SW, Rochester, MN 55905 USA.
dc.contributor.authorResearcherID
dc.contributor.authorUniversity American University of Beirut Medical Center
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dc.description.citedCount 8
dc.description.citedTotWOSCount 10
dc.description.citedWOSCount 10
dc.format.extentCount 11
dc.identifier.articleNo
dc.identifier.coden MUSCF
dc.identifier.pubmedID 22736750
dc.identifier.scopusID 84873694378
dc.identifier.url
dc.publisher.address 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND
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dc.relation.ispartofConferenceCode
dc.relation.ispartofConferenceDate
dc.relation.ispartofConferenceHosting
dc.relation.ispartofConferenceLoc
dc.relation.ispartofConferenceSponsor
dc.relation.ispartofConferenceTitle
dc.relation.ispartofFundingAgency
dc.relation.ispartOfISOAbbr Mult. Scler. J.
dc.relation.ispartOfIssue 2
dc.relation.ispartOfPart
dc.relation.ispartofPubTitle Multiple Sclerosis
dc.relation.ispartofPubTitleAbbr Mult. Scler.
dc.relation.ispartOfSpecialIssue
dc.relation.ispartOfSuppl
dc.relation.ispartOfVolume 19
dc.source.ID WOS:000315607100011
dc.type.publication Journal
dc.subject.otherAuthKeyword disability
dc.subject.otherAuthKeyword EDSS
dc.subject.otherAuthKeyword Multiple sclerosis
dc.subject.otherAuthKeyword outcome measurement
dc.subject.otherAuthKeyword progressive
dc.subject.otherAuthKeyword relapsing remitting
dc.subject.otherChemCAS
dc.subject.otherIndex adult
dc.subject.otherIndex aged
dc.subject.otherIndex article
dc.subject.otherIndex disease classification
dc.subject.otherIndex disease course
dc.subject.otherIndex disease duration
dc.subject.otherIndex Expanded Disability Status Scale
dc.subject.otherIndex female
dc.subject.otherIndex human
dc.subject.otherIndex major clinical study
dc.subject.otherIndex male
dc.subject.otherIndex multiple sclerosis
dc.subject.otherIndex onset age
dc.subject.otherIndex outcome assessment
dc.subject.otherIndex patient referral
dc.subject.otherIndex sex ratio
dc.subject.otherIndex Adult
dc.subject.otherIndex Age of Onset
dc.subject.otherIndex Aged
dc.subject.otherIndex Aging
dc.subject.otherIndex Brain
dc.subject.otherIndex Brain Stem
dc.subject.otherIndex Data Interpretation, Statistical
dc.subject.otherIndex Disease Progression
dc.subject.otherIndex Female
dc.subject.otherIndex Humans
dc.subject.otherIndex Kaplan-Meier Estimate
dc.subject.otherIndex Longitudinal Studies
dc.subject.otherIndex Male
dc.subject.otherIndex Middle Aged
dc.subject.otherIndex Multiple Sclerosis
dc.subject.otherIndex Multiple Sclerosis, Chronic Progressive
dc.subject.otherIndex Multiple Sclerosis, Relapsing-Remitting
dc.subject.otherIndex Population
dc.subject.otherIndex Sex Ratio
dc.subject.otherIndex Spinal Cord
dc.subject.otherIndex Treatment Outcome
dc.subject.otherKeywordPlus NATURAL-HISTORY
dc.subject.otherKeywordPlus FOLLOW-UP
dc.subject.otherKeywordPlus DIAGNOSTIC-CRITERIA
dc.subject.otherKeywordPlus DISABILITY
dc.subject.otherKeywordPlus MS
dc.subject.otherKeywordPlus DISEASE
dc.subject.otherKeywordPlus IMPAIRMENT
dc.subject.otherKeywordPlus RELAPSE
dc.subject.otherKeywordPlus COHORT
dc.subject.otherKeywordPlus RISK
dc.subject.otherWOS Clinical Neurology


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