Trajectories of cognitive processing speed and physical disability over 11 years following initiation of a first multiple sclerosis disease-modulating therapy

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Trajectories of cognitive processing speed and physical disability over 11 years following initiation of a first multiple sclerosis disease-modulating therapy

Longinetti, Elisa (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, S-17177 Stockholm, Sweden.;Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.

Englund, Simon (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Burman, Joachim, 1974- (author): Uppsala universitet,Uppsala University,Institutionen för medicinska vetenskaper,Translationell neurologi

Fink, Katharina (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Fogdell-Hahn, Anna (author): Karolinska Institute,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Gunnarsson, Martin, 1973- (author): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Neurology, Örebro University, Örebro, Sweden,Örebro Univ, Dept Neurol, Örebro, Sweden.

Hillert, Jan (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Langer-Gould, Annette Magdalene (author): Clinical and Translational Neuroscience, Kaiser Permanente Southern California, CA, Pasadena, United States,Kaiser Permanente Southern Calif, Clin & Translat Neurosci, Pasadena, CA USA.

Lycke, Jan, 1956 (author): Gothenburg University,Göteborgs universitet,University of Gothenburg,Univ Gothenburg, Dept Clin Neurosci, Gothenburg, Sweden.,Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap,Institute of Neuroscience and Physiology, Department of Clinical Neuroscience

Nilsson, Petra (author): Lund University,Lunds universitet,Neurologi, Lund,Sektion IV,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Neurology, Lund,Section IV,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund Univ, Dept Clin Sci, Div Neurol, Lund, Sweden.

Salzer, Jonatan (author): Umeå University,Umeå universitet,Neurovetenskaper,Umeå Univ, Dept Clin Sci, Neurosci, Umeå, Sweden.

Svenningsson, Anders (author): Karolinska Institutet,Karolinska Inst, Danderyd Hosp, Dept Clin Sci, Stockholm, Sweden.,Danderyd Hospital

Mellergård, Johan (author): Linköping University,Linköpings universitet,Avdelningen för neurobiologi,Medicinska fakulteten,Region Östergötland, Neurologiska kliniken i Linköping,Linköping Univ, Dept Neurol, Linköping, Ostergotland, Sweden. Linköping Univ, Dept Biomed & Clin Sci, Linköping, Sweden.

Olsson, Tomas (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Piehl, Fredrik (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden.

Frisell, Thomas (author): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.

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Karolinska Institutet Karolinska Inst, Dept Med Solna, S-17177 Stockholm, Sweden;Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden. (creator_code:org_t)

BMJ Publishing Group Ltd, 2024
2024
English.
In: Journal of Neurology, Neurosurgery and Psychiatry. - : BMJ Publishing Group Ltd. - 0022-3050 .- 1468-330X. ; 95:2, s. 134-141

Related links:: https://doi.org/10.1...; show more...; https://umu.diva-por... (primary) (Raw object); https://liu.diva-por... (primary) (Raw object); http://dx.doi.org/10... (free); https://uu.diva-port... (primary) (Raw object); https://urn.kb.se/re...; https://doi.org/10.1...; https://urn.kb.se/re...; http://kipublication...; https://urn.kb.se/re...; https://lup.lub.lu.s...; https://urn.kb.se/re...; https://gup.ub.gu.se...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BACKGROUND: We analysed the COMparison Between All immunoTherapies for Multiple Sclerosis (NCT03193866), a Swedish nationwide observational study in relapsing-remitting multiple sclerosis (RRMS), to identify trajectories of processing speed and physical disability after disease-modulating therapy (DMT) start.METHODS: Using a group-modelling approach, we assessed trajectories of processing speed with oral Symbol Digit Modalities Test (SDMT) and physical disability with Expanded Disability Status Scale, from first DMT start among 1645 patients with RRMS followed during 2011-2022. We investigated predictors of trajectories using group membership as a multinomial outcome and calculated conditional probabilities linking membership across the trajectories.RESULTS: We identified 5 stable trajectories of processing speed: low SDMT scores (mean starting values=29.9; 5.4% of population), low/medium (44.3; 25.3%), medium (52.6; 37.9%), medium/high (63.1; 25.8%) and high (72.4; 5.6%). We identified 3 physical disability trajectories: no disability/stable (0.8; 26.8%), minimal disability/stable (1.6; 58.1%) and moderate disability (3.2; 15.1%), which increased to severe disability. Older patients starting interferons were more likely than younger patients starting rituximab to be on low processing speed trajectories. Older patients starting teriflunomide, with more than one comorbidity, and a history of pain treatment were more likely to belong to the moderate/severe physical disability trajectory, relative to the no disability one. There was a strong association between processing speed and physical disability trajectories.CONCLUSIONS: In this cohort of actively treated RRMS, patients' processing speed remained stable over the years following DMT start, whereas patients with moderate physical disability deteriorated in physical function. Nevertheless, there was a strong link between processing speed and disability after DMT start.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Neurologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Neurology (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Annan medicin och hälsovetenskap -- Övrig annan medicin och hälsovetenskap (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Other Medical and Health Sciences -- Other Medical and Health Sciences not elsewhere specified (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP -- Medicinska och farmaceutiska grundvetenskaper -- Neurovetenskaper (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Basic Medicine -- Neurosciences (hsv//eng)

Keyword

Cognition
epidemiology
multiple sclerosis
cognition
epidemiology
multiple sclerosis

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ref (subject category)
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By the author/editor: Longinetti, Elis ...; Englund, Simon; Burman, Joachim, ...; Fink, Katharina; Fogdell-Hahn, An ...; Gunnarsson, Mart ...; show more...; Hillert, Jan; Langer-Gould, An ...; Lycke, Jan, 1956; Nilsson, Petra; Salzer, Jonatan; Svenningsson, An ...; Mellergård, Joha ...; Olsson, Tomas; Piehl, Fredrik; Frisell, Thomas; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Neurology

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Other Medical an ...; and Other Medical an ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Basic Medicine; and Neurosciences

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By the university: Örebro University; Umeå University; Karolinska Institutet; Linköping University; Lund University; Uppsala University; show more...; University of Gothenburg; show less...

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