Systematic Literature Review and Validity Evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in Patients with Multiple Sclerosis

Meyer-Moock, S.; Feng, You-Shan; Dippel, FW; Kohlmann, Thomas

doi:10.1016/j.jval.2013.08.1560

Cited by 87 publications

(107 citation statements)

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“…Even though patients with older age, longer disease duration, or higher EDSS also showed more pronounced correlations between MRI and cognitive metrics, the majority of interactions between age, disease duration, or EDSS and MRI measures in multivariable models predicting cognitive performance were not significant after correction for false discovery rate. We hypothesize this may be explained by the fact that associations between age or disease duration and cumulative disease burden are only indirect and that EDSS (as a measure of clinical disease burden) is less objective and a relatively inaccurate measure of disease burden, 32 as compared to volumetric MRI measures. 33 Taken together, the strong associations between MRI and cognitive metrics in more advanced disease imply there is a greater sensitivity of cognitive performance to structural changes in patients with already greater cumulative structural brain damage.…”

Section: Discussionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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ObjectiveTo investigate whether the strength of the association between magnetic resonance imaging (MRI) metrics and cognitive outcomes differs between various multiple sclerosis subpopulations.MethodsA total of 1052 patients were included in this large cross‐sectional study. Brain MRI (T1 and T2 lesion volume and brain parenchymal fraction) and neuropsychological assessment (Brief International Cognitive Assessment for Multiple Sclerosis and Paced Auditory Serial Addition Test) were performed.ResultsWeak correlations between cognitive domains and MRI measures were observed in younger patients (age≤30 years; absolute Spearman's rho = 0.05–0.21), with short disease duration (<2 years; rho = 0.01–0.21), low Expanded Disability Status Scale [EDSS] (≤1.5; rho = 0.08–0.18), low T2 lesion volume (lowest quartile; <0.59 mL; rho = 0.01–0.20), and high brain parenchymal fraction (highest quartile; >86.66; rho = 0.01–0.16). Stronger correlations between cognitive domains and MRI measures were observed in older patients (age>50 years; rho = 0.24–0.50), with longer disease duration (>15 years; rho = 0.26–0.53), higher EDSS (≥5.0; rho = 0.23–0.39), greater T2 lesion volume (highest quartile; >5.33 mL; rho = 0.16–0.32), and lower brain parenchymal fraction (lowest quartile; <83.71; rho = 0.13–0.46). The majority of these observed results were confirmed by significant interactions (P ≤ 0.01) using continuous variables.InterpretationThe association between structural brain damage and functional cognitive impairment is substantially weaker in multiple sclerosis patients with a low disease burden. Therefore, disease stage should be taken into consideration when interpreting associations between structural and cognitive measures in clinical trials, research studies, and clinical practice.

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Section: Discussionmentioning

confidence: 99%

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Uher

Krásenský

Sobíšek

et al. 2017

Ann Clin Transl Neurol

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“…The most popular and widely used instrument as an endpoint in clinical trials to assess the effectiveness of therapeutic interventions is the Expanded Disability Status Scale (EDSS) of Kurtzke. It is a clinicianadministered assessment scale evaluating the functional systems of the CNS (17) . The EDSS is a 20-step scale of disease severity ranging from 0 (normal) to 10 (death due to MS) in 0.5 increments interval l. This scale includes two parts: one (from 0 to 3.5) taking into account functional parameters and EDSS measure impairments based on the neurological examination, the other (from 4 to 10) estimating degrees of mobility in patients.…”

Section: Expanded Disability Satus Scale (Edss)mentioning

confidence: 99%

Comparing the Quality of Life among Patients with Relapsing Remitting Multiple Sclerosis in Iraq Using Different Disease Modifying Therapies

Yahya

Kasim²,

Gawwam³

2018

IJPS

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Multiple sclerosis (MS) is a chronic, inflammatory, immune mediated disease of the central nervous system, mostly affecting young adults with mean age of 30 years, twice as high in women compared to men. The etiology of MS is not fully elucidated. MS symptoms are directly related to demyelination and axonal loss, along with other psychological symptoms, can result in functional limitations, disability and reduced quality of life (QoL). The QoL assessments in patients with a chronic disease may contribute to improving treatment and could even be of prognostic value. The goals of this study were to compare the QoL of Iraqi patients with relapsing remitting multiple sclerosis (RRMS), using three different diseases modifying therapies(DMTs) administered orally, subcutaneously, and by slow infusion; namely, fingolimod, interferonβ-1b, and natalizumab, respectively. And to assess the role of disability status, educational status, occupational status, MS duration, and treatment duration as a predictor for the QoL. Functional Assessment of Multiple Sclerosis (FAMS) questionnaire version 4 was used to assess QoL. Sociodemographic and clinical characteristics were tested by univariate and multivariate regression analyses to assess the contribution of these predictors to QoL. No significant differences were found in symptoms, thinking/fatigue subscales and FAMS total scores among the three DMTs. In conclusion: Iraqi MS patients using Interferonβ-1b, fingolimod or natalizumab have a comparable low level of QoL. The expanded disability status scale (EDSS) is negatively associated with QoL of MS patients in all of the three therapies, while other predictors such as occupational status, educational status, smoking habit and MS duration have different impact in different treatments.

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“…From the clinical point, the degree of neurologic impairment and the level of disability in MS patients are assessed by the Expanded Disability Status Scale (EDSS) which is the most widely used scale nowadays [7]. EDSS is a 20-step scale of disease severity ranging from 0 (normal) to 10 (death due to MS).…”

Section: Introductionmentioning

confidence: 99%

Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system

Hamed

Fathi

Mahmoud

et al. 2019

Egypt J Radiol Nucl Med

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Background: The aim of our work was to assess the diagnostic accuracy of a double inversion recovery (DIR) sequence in the detection of brain and spinal cord MS lesions. In addition, we aimed to evaluate the reliability of the correlation between GM affection and high Expanded Disability Status Scale (EDSS) to enhance the role of DIR as a practical test for clinical disability. Ninety MS patients were prospectively included in this study. Imaging was performed using Philips Intera 1.5 Tesla device. T2W-TSE, FLAIR, and DIR sequences were performed and compared to each other. Each patient was clinically assessed at the time of the MRI examination with EDSS. Results: DIR showed significantly higher total lesion load in comparison to T2 and FLAIR with increased sensitivity for cortical lesion detection by DIR. There was a positive association between patients with cortical lesions and male gender, clinical disability, cognitive changes, and higher EDSS score. Conclusion: The increased rate of cortical lesion detection by DIR does not affect its accuracy in white matter lesions count. Moreover, DIR provided a better morphological characterization and delineation of white matter lesion with good differentiation between juxtacortical and mixed white matter-gray matter lesions; thus, we recommend adding DIR sequence in routine MR protocols for MS patients.

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Systematic Literature Review and Validity Evaluation of the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) in Patients with Multiple Sclerosis

Cited by 87 publications

References 0 publications

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Cognitive clinico‐radiological paradox in early stages of multiple sclerosis

Comparing the Quality of Life among Patients with Relapsing Remitting Multiple Sclerosis in Iraq Using Different Disease Modifying Therapies

Diagnostic accuracy of double inversion recovery in delineation of multiple sclerosis lesions and its clinical correlation with expanded disability scoring system

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