Usage of Multiple Sclerosis Functional Composite in Multiple Sclerosis

Abstract

Scientific Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system characterized by a relapsing nature and progressive disability. Monitoring the disability in the remission period has a significant importance. The Expanded Disability Status Scale (EDSS) has been used as a primary outcome measure for neurological impairment and disability in clinical trials of MS, despite its well-recognized disadvantages such asa poor cognitive decline and upper limb function, and a poor reproducibility. The Multiple Sclerosis Functional Composite (MSFC) includes quantitative tests of leg function (Timed 25-Foot Walk- T25W), arm function (9-Hole Peg Test-9-HPT), and cognitive function (Paced Auditory Serial Additional Test-PASAT-3 min version).Objectives: In the present study, we purposed to search the correlation between EDSS and every three tests of MSFC and the relationship between demographic features and these two rating scales in patients with MS. Material and Methods: 206 patients (173 female and 33 male) diagnosed with MS were enrolled into the study. 87 % had relapsingremitting course, 10.3 % had secondary progressive course, and 2.3 % had a clinically isolated syndrome. The mean age was 35.4±9.18 (18-54), mean age at onset was 28.44±7.47, mean disease duration was 4.96±2.13 (2-15), and mean EDSS score was 1.90± 1.28 (0.0-6.5). Results: There was not significant correlation between total EDSS scores and age and disease duration of patients. Bladder and bowel functional system was correlated with age. Significant negative correlations between PASAT and age, and PASAT and disease duration were demonstrated. EDSS scores were correlated with pyramidal, sensory, brainstem and bladder-bowel functional systems. Correlationsbetween EDSS and tests of MSFC were demonstrated. Conclusions: It is concluded that because of statistically significant correlation between EDSS and MSFC, and well-recognized disadvantages such as a poor reproducibility anda poor assessment upper limb funetion and cognitive state of EDSS, MSFC might be used for clinical trials instead of EDSS.