الفهرس 
OVERVIEW ON MULTIPLE SCLEROSISOnly 14 pages are availabe for public view
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Abstract
MS is an autoimmune-mediated disorder that affects the central nervous system (CNS) and often leads to severe physical or cognitive incapacitation as well as neurological problems in young adults.
Subtypes of MS are considered important for treatment decisions and include: RRMS, PPMS, and SPMS. RRMS is the most common subtype (approximately 87%) being characterized by acute attacks (exacerbated by inflammatory attacks on myelin and nerve fibers) followed by periods of remission.
MS patients have considerable divergence concerning the brain reserve, modifiable cognitive reserve, and neuroplasticity, representing one of the main obstacles in early progression diagnosis.
Clinical diagnosis of SPMS tends to be retrospective, based on the patient’s history of symptoms worsening after an initial relapsing disease course. There is no definitive imaging or laboratory test indicative of progressive disease; however, measures of disability progression widely used in clinical practice include the EDSS, Timed 25-foot Walk test (T25FW), and 9-hole Peg Test (9HPT).
Our study focused on analyzing the possible risk factors and markers for disease progression in MS patients and assessed the use of serum neurofilament light chain sNFL as a potential biomarker for disability progression.
This hospital based retrospective study analyzed the demographic, clinical and imaging data of 196 patients who were diagnosed as SPMS and found that Females represented 67.35% of the study population, the mean age at the onset of the disease was 26.75 years. While the mean duration of illness was 16.11 years.
Correlations between the last EDSS score and different studied parameters revealed that disease progression is influenced by male gender, age at the onset of the disease, multi system affection and the number of relapses in the first 2 years.
Also, the presence of periventricular and spinal cord lesions and brain atrophy at baseline were significantly correlated to high EDSS scores (P< 0.001, P= 0.038 and P = 0.002) respectively. Also, the number of T2 lesions more than 10 was significantly correlated to the progression of the EDSS scores (P=0.007) after linear regression analysis.
This study assessed serum neurofilament levels for 76 patients who were newly diagnosed with MS and before receiving any DMDs and correlated them with baseline and 1-year follow-up EDSS, highlighting a significant correlation with p 0.012, it was also positively correlated with the onset of pyramidal symptoms and high number of T2 lesions in the initial MRI p 0.002, <0.001 respectively.
This study concluded that; male gender, older age at disease onset, multifunctional system affection, higher T2 lesion load, presence of early brain atrophy and spinal cord lesions along with elevated sNFL are considered the parameters for disease progression and to be taken into consideration when tailoring the appropriate treatment plans for these patients to delay disease progression and disability accumulation.