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.