Physical and cognitive functioning after 3 years can be predicted using information from the diagnostic process in recently diagnosed multiple sclerosis.
OBJECTIVE
To predict functioning after 3 years in patients with recently diagnosed multiple sclerosis (MS).


METHODS
Inception cohort with 3 years of follow-up. At baseline, predictors were obtained from medical history taking, neurologic examination, and magnetic resonance imaging (MRI).


METHODS
Neurology outpatient clinic.


METHODS
Patients with MS (N=156); 146 with complete follow-up.


METHODS
Not applicable.


METHODS
Inability to walk at least 500 m, impaired dexterity, cognitive impairments, incontinence, inability to drive a car or use public transportation, social dysfunction, and reliance on a disability pension.


RESULTS
Clinical prediction rules were constructed for the models that were well calibrated (sufficient agreement between predicted and observed outcomes, based on visual inspection of calibration curves) and that showed sufficient discrimination (area under the receiver operation characteristic curve >.70) after internal bootstrap validation. The models for the inability to walk at least 500 m, impaired dexterity, and cognitive impairments were well calibrated. Discrimination was sufficient for all 7 models, except the one predicting social dysfunction (.67). The inability to walk at least 500 m was predicted by the perceived ability to walk, impairment of the cerebellar tract, and the number of MRI lesions in the spinal cord. Impaired dexterity was predicted by the perceived ability to use the hands, impairments of the pyramidal, cerebellar, and sensory tracts, and the T2-weighted infratentorial lesion load. Cognitive impairment was predicted by age, gender, the perceived ability to concentrate, and the T2-weighted supratentorial lesion load.


CONCLUSIONS
Inability to walk at least 500 m, impaired dexterity, and cognitive impairments can be predicted with predictors that are derived from medical history taking, neurologic examination, and MRI shortly after a definite diagnosis of MS has been made.
de Groot
Vincent
V
Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands. v.degroot@vumc.nl
Beckerman
Heleen
H
Uitdehaag
Bernard M
BM
Hintzen
Rogier Q
RQ
Minneboo
Arjan
A
Heymans
Martijn W
MW
Lankhorst
Gustaaf J
GJ
Polman
Chris H
CH
Bouter
Lex M
LM
D000293:Adolescent; D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000503:physiopathology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000503:physiopathology*; D055815:Young Adult