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Abstract Details

Age and relapse location: Critical determinants in recovery from multiple sclerosis relapses
Multiple Sclerosis
S6 - MS and CNS Inflammatory Disease: Clinical Considerations I (2:28 PM-2:39 PM)
009
Incomplete relapse recovery may result in increasing disability in multiple sclerosis. We have previously shown that recovery from early relapses seems to be similar within an individual patient.

To investigate the impact of age on recovery from relapses in multiple sclerosis when controlled for an individual's inherent factors.

The first and last-ever relapse data (168 relapses in 193 patients) from a population-based cohort of multiple sclerosis were studied using paired analyses for age at the time of relapse and maximum recovery from the peak deficit attained during that relapse. Two relapse-outcome measures were used: 1) change from peak deficit to maximum recovery in raw functional system score related to the relapse (ΔFSS), 2) change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. 

The first relapse (age, mean±SD= 30.2±8.8) and last-ever relapse (age, mean±SD= 45.0±10.0) were separated by 15 years. Older age was associated with worse recovery in the ΔFSS outcome (= 0.002) and ΔEDSS outcome (< 0.001) in a given individual. A multivariate analysis of the ΔFSS outcome identified previously suspected variables; having spinal cord/brainstem/cerebellar syndrome (as opposed to optic neuritis) (p<0.001) or relapse fulminance (p=0.004) as additional co-variates impacting recovery. An increase in the brainstem/cerebellar location relapses was observed with aging (1st relapse 19%; last relapse 31.5%, p=0.005).

When relapses from the same individual are studied through paired analyses; recovery from relapses in multiple sclerosis declines with increased age, independent of relapse location, while a concomitant increase in the preponderance for brainstem/cerebellar relapses with increased age is observed. Understanding biological mechanisms underlying these observations could help future targeted drug development in multiple sclerosis.

Authors/Disclosures
Burcu Zeydan, MD (Mayo Clinic)
PRESENTER
The institution of Dr. Zeydan has received research support from National Institutes of Health.
Brittani L. Conway, MD (University of Minnesota) No disclosure on file
Ugur Uygunoglu (Cerrahpasa) Ugur Uygunoglu has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche Turkey . The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Biogen Idec/Gen Pharma of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck-Serono of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Sanovel of Turkey. The institution of Ugur Uygunoglu has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Genveon of Turkey.
Martina Novotna (Mayo Clinic) No disclosure on file
Aksel Siva, MD (Istanbul University Cerrahpasa School of Medicine) Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi-Genzyme. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Alexion. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Ali Raif Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanovel Pharmaceuticals, Turkiye. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Abdi Ibrahim Ilac - TR. Dr. Siva has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Merck Serono . The institution of Dr. Siva has received research support from Turkish MS Society. The institution of Dr. Siva has received research support from The Scientific and Technological Research Council Of Turkey - Health Sciences Research Grants.
Sean J. Pittock, MD, FAAN (Mayo Clinic Dept of Neurology) Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UCB. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Arialys Therapeutics. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Alexion. Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Arialys. The institution of Dr. Pittock has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for UCB. The institution of Dr. Pittock has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche/Genentech. The institution of Dr. Pittock has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from NIH. The institution of Dr. Pittock has received research support from Alexion/AstraZeneka. The institution of Dr. Pittock has received research support from F. Hoffman/LaRoche/Genentech. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received intellectual property interests from a discovery or technology relating to health care. Dr. Pittock has received publishing royalties from a publication relating to health care.
No disclosure on file
Moses Rodriguez, MD, FAAN (Mayo Clinic Department Of Neurology) Dr. Rodriguez has received intellectual property interests from a discovery or technology relating to health care.
Orhun H. Kantarci, MD Dr. Kantarci has nothing to disclose.