Early Phase Multiple Sclerosis Patients Present Substantial Deficits in Physical-,Cognitive-,and Patient-reported Outcomes Compared to Matched Healthy Controls

Abstract

Background

Early identification of potential deficits is of utmost importance as early diagnosis and early treatment has been shown to be crucial to reduce disease activity and disease impact—leading to the notion of “Time matters” in multiple sclerosis (MS).

Objective

The aim of the present study was to compare physical-, cognitive-, and patient-reported outcomes in early phase MS patients with matched healthy controls (HC).

Methods

This cross-sectional study included 84 patients early in the disease course of MS (≤2 years from diagnosis) and 84 age- and sex-matched HC. All participants underwent a comprehensive test battery including physical-, cognitive-, and patient-reported outcomes.

Results

Relative deficits for patients with MS compared to HC corresponded to 7% to 35% in walking capacity (Timed 25-Foot Walk Test, 6 Spot Step Test, 6 Minute Walk Test), 5% for upper limb function (9 Hole Peg Test), 27% for aerobic capacity (maximal oxygen uptake), 17% to 38% for physical activity level (Baecke Sport Index and accelerometer counts/minute), 68% for fatigability (Walking Fatigability Index), 150% for fatigue (Modified Fatigue Impact Scale), 4% to 20% for cognitive function (Symbol Digit Modalities Test, Paced Auditory Serial Addition Test, and Selective Reminding Test), and lastly, 7% to 8% for quality of life (Short Form-36 health survey). Only the Symbol Digit Modalities Test and Selective Reminding Test Delayed did not differ between groups, statistically.

Conclusion

Early phase MS patients present substantial deficits in physical-, cognitive-, and patient-reported outcomes compared to HC. These early impairments highlight the importance of early initiatives aimed at preserving and/or building of reserve capacity.