Brain, Vol. 112, No. 1, 133-146, 1989
© 1989 Oxford University Press
research-article |
THE NATURAL HISTORY OF MULTIPLE SCLEROSIS: A GEOGRAPHICALLY BASED STUDY
I. CLINICAL COURSE AND DISABILITY
Department of Clinical Neurological Sciences, University of Western Ontario London, Ontario, Canada
Correspondence to:
Correspondence to: Dr G. C. Ebers, Department of Clinical Neurological Sciences, University Hospital, PO Box 5339, London, Ontario N6A 5A5, Canada
The outcome of multiple sclerosis (MS), assessed according to the Kurtzke Disability Status Scale (DSS), was reviewed in 1,099 consecutive patients followed in London, Canada, between 1972 and 1984. A geographically based subgroup of 196 patients representing 90% of Middlesex County MS patients as well as a group of 197 patients seen from onset of disease were separately analysed. The clinical course was progressive from onset in 33% of the total population and in 28% of the Middlesex County subgroup Of those with duration of 6–10 yrs, 30–40% with initially remitting disease developed progressive MS. The cross-sectional distribution of disability was bimodal with peaks at DSS 1 (no disability) and DSS 6 (assistance required for walking). Actuarial analysis showed that the median time to reach DSS 6 from onset of MS was 14.97±0.31 yrs in the total population and 9.42±0.44 yrs in the ‘seen from onset’ subgroup Survival was minimally altered; 87% of patients followed up to 40 yrs were still alive, although ascertainment of cases with this duration of MS was incomplete Data describing the rate at which disability develops after the onset of a progressive phase of MS are also presented. The implications of these data in planning and interpretation of clinical therapeutic trials are discussed.
Received January 12, 1988. Revised May 10, 1988. Accepted June 1, 1988.
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G. C Ebers Natural history of primary progressive multiple sclerosis Multiple Sclerosis, June 1, 2004; 10(1_suppl): S8 - S15. [Abstract] [PDF]
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O. Stuve, M. Kita, D. Pelletier, R. J Fox, J. Stone, D. E Goodkin, and S. S Zamvil Mitoxantrone as a potential therapy for primary progressive multiple sclerosis Multiple Sclerosis, June 1, 2004; 10(1_suppl): S58 - S61. [Abstract] [PDF]
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P Sundstrom, A Svenningsson, L Nystrom, and L Forsgren Clinical characteristics of multiple sclerosis in Vasterbotten County in northern Sweden J. Neurol. Neurosurg. Psychiatry, May 1, 2004; 75(5): 711 - 716. [Abstract] [Full Text] [PDF]
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S. J. Pittock, W. T. Mayr, R. L. McClelland, N. W. Jorgensen, S. D. Weigand, J. H. Noseworthy, and M. Rodriguez Quality of Life Is Favorable for Most Patients With Multiple Sclerosis: A Population-based Cohort Study Arch Neurol, May 1, 2004; 61(5): 679 - 686. [Abstract] [Full Text] [PDF]
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G. C Ebers Natural history of primary progressive multiple sclerosis Multiple Sclerosis, May 1, 2004; 10(3_suppl): S8 - S15. [Abstract] [PDF]
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O. Stuve, M. Kita, D. Pelletier, R. J Fox, J. Stone, D. E Goodkin, and S. S Zamvil Mitoxantrone as a potential therapy for primary progressive multiple sclerosis Multiple Sclerosis, May 1, 2004; 10(3_suppl): S58 - S61. [Abstract] [PDF]
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A Romberg, A Virtanen, S Aunola, S-L Karppi, H Karanko, and J Ruutiainen Exercise capacity, disability and leisure physical activity of subjects with multiple sclerosis Multiple Sclerosis, April 1, 2004; 10(2): 212 - 218. [Abstract] [PDF]
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H. Bronnum-Hansen, N. Koch-Henriksen, and E. Stenager Trends in survival and cause of death in Danish patients with multiple sclerosis Brain, April 1, 2004; 127(4): 844 - 850. [Abstract] [Full Text] [PDF]
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S. J. Pittock, W. T. Mayr, R. L. McClelland, N. W. Jorgensen, S. D. Weigand, J. H. Noseworthy, and M. Rodriguez Disability profile of MS did not change over 10 years in a population-based prevalence cohort Neurology, February 24, 2004; 62(4): 601 - 606. [Abstract] [Full Text] [PDF]
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J de Seze, C Lebrun, T Stojkovic, D Ferriby, M Chatel, and P Vermersch Is Devic's neuromyelitis optica a separate disease? A comparative study with multiple sclerosis Multiple Sclerosis, October 1, 2003; 9(5): 521 - 525. [Abstract] [PDF]
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R. K. Burt, B. A. Cohen, E. Russell, K. Spero, A. Joshi, Y. Oyama, W. J. Karpus, K. Luo, B. Jovanovic, A. Traynor, et al. Hematopoietic stem cell transplantation for progressive multiple sclerosis: failure of a total body irradiation-based conditioning regimen to prevent disease progression in patients with high disability scores Blood, October 1, 2003; 102(7): 2373 - 2378. [Abstract] [Full Text] [PDF]
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 I A F van der Mei, A-L Ponsonby, T Dwyer, L Blizzard, R Simmons, B V Taylor, H Butzkueven, and T Kilpatrick Past exposure to sun, skin phenotype, and risk of multiple sclerosis: case-control study BMJ, August 9, 2003; 327(7410): 316. [Abstract] [Full Text] [PDF]
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 F. Giuliani, C. G. Goodyer, J. P. Antel, and V. W. Yong Vulnerability of Human Neurons to T Cell-Mediated Cytotoxicity J. Immunol., July 1, 2003; 171(1): 368 - 379. [Abstract] [Full Text] [PDF]
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J Lechner-Scott, L Kappos, M Hofman, C H Polman, H Ronner, X Montalban, M Tintore, M Frontoni, C Buttinelli, M P Amato, et al. Can the Expanded Disability Status Scale be assessed by telephone? Multiple Sclerosis, April 1, 2003; 9(2): 154 - 159. [Abstract] [PDF]
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R. Rudick Mechanisms of disability progression in primary progressive multiple sclerosis: are they different from secondary progressive multiple sclerosis? Multiple Sclerosis, April 1, 2003; 9(2): 210 - 212. [PDF]
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C. Confavreux, S. Vukusic, and P. Adeleine Early clinical predictors and progression of irreversible disability in multiple sclerosis: an amnesic process Brain, April 1, 2003; 126(4): 770 - 782. [Abstract] [Full Text] [PDF]
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J. Chilcott, C. McCabe, P. Tappenden, A. O'Hagan, N. J Cooper, K. Abrams, K. Claxton, and D. H Miller Modelling the cost effectiveness of interferon beta and glatiramer acetate in the management of multiple sclerosis * Commentary: Evaluating disease modifying treatments in multiple sclerosis BMJ, March 8, 2003; 326(7388): 522 - 522. [Abstract] [Full Text] [PDF]
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B. Turner, X. Lin, G. Calmon, N. Roberts, and L. D Blumhardt C erebral atrophy and disability in relapsing-remitting and secondary progressive multiple sclerosis over four years Multiple Sclerosis, February 1, 2003; 9(1): 21 - 27. [Abstract] [PDF]
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J. R Avasarala, A. H Cross, D. B Clifford, B. A Singer, B. A Siegel, and E. E Abbey Rapid onset Mitoxantrone-induced cardiotoxicity in secondary progressive multiple sclerosis Multiple Sclerosis, February 1, 2003; 9(1): 59 - 62. [Abstract] [PDF]
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