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MS research update - People with non-progressive MS up to 60 years after onset - 8 March 2012

MS is different for each person. For some, MS does not progress for many years, sometimes not at all.

This study in Sweden followed 307 people for up to 60 years after their first symptoms of MS. For the 202 people whose MS began as the relapsing remitting form, there was 22% probability of non- progressive disease after 40 years and 14% probability after 50 years.

At the last follow up, 37-59 years after onset, 13 people remained non-progressive. Their annual relapse rate had decreased significantly over time but MRI scans showed that they should still have a diagnosis of MS. Nine of the 13 had an EDSS score of 0-2.5 and the other four were in the range 3 or 3.5 reflecting the consequences of relapses experienced many years in the past.

Looking back, it was possible to see who was most likely to be non-progressive: these people were more likely to have experienced complete remission after the first attack and to have had low or moderate relapse rates in the early stages.

Skoog B, Runmarker B, Winblad S, et al.
A representative cohort of patients with non-progressive multiple sclerosis at the age of normal life expectancy.
Brain. 2012 Mar;135(Pt 3):900-11.

Behavioural symptoms can be part of MS

MS can attack different parts of the central nervous system (the brain and spinal cord) giving rise to lesions that are seen on an MRI scan as white patches. The particular place where a lesion occurs corresponds to the symptoms experienced by the person with MS and may include both physical and cognitive problems.

Most research has focussed on cognitive symptoms, such as attention and memory, depression and anxiety which are common in MS. Behavioural symptoms have received less attention and are not often included in health assessments for people with MS.

This review re-examined 23 previously published research studies which included over 1100 people with MS, 437 healthy controls and 277 people with other diagnoses. The results of the individual studies were combined (a meta-analysis) as this can be a more effective way to analyse the results of smaller research studies.

Just under half of the participants had relapsing remitting MS; they were generally not severely affected by their MS as the average EDSS score was 3.2 (range from 1.5 to 5.1); the average age was 40.

The meta-analysis showed that MS can include behavioural symptoms and impairments. Many of these are common in the general population but, when this is taken into account, people with MS were found to be more susceptible to aggression (23%), apathy (22%), euphoria (12%) and lack of insight (11%). Some of these difficulties may be caused by dealing with a chronic disease rather than MS in particular.

Rosti-Otajärvi E, Hämäläinen P.
Behavioural symptoms and impairments in multiple sclerosis: a systematic review and meta-analysis.
Mult Scler. 2012 Mar 1. [Epub ahead of print]


Research by topic areas...

Symptoms and symptom management

Lugaresi A, Ziemssen T, Oreja-Guevara C, et al.
Improving patient-physician dialog: commentary on the results of the MS Choices survey.
Patient Prefer Adherence. 2012;6:143-52.

Disease modifying treatments

Jain N, Bhatti MT.
Fingolimod-associated macular edema: incidence, detection, and management.
Neurology. 2012 Feb 28;78(9):672-80.

Balak DM, Hengstman GJ, Cakmak A, et al.
Cutaneous adverse events associated with disease-modifying treatment in multiple sclerosis: a systematic review.
Mult Scler. 2012 Feb 27. [Epub ahead of print]


Finlayson M, Preissner K, Cho C.
Outcome moderators of a program for people with multiple sclerosis.
Am J Occup Ther. 2012 Mar;66(2):187-197.

Heremans E, D'hooge AM, De Bondt S, et al.
The relation between cognitive and motor dysfunction and motor imagery ability in patients with multiple sclerosis.
Mult Scler. 2012 Mar 2. [Epub ahead of print]

Assessment tools

Motl RW, Suh Y, Balantrapu S, et al.
Evidence for the different physiological significance of the 6- and 2-minute walk tests in multiple sclerosis.
BMC Neurol. 2012 Mar 1;12(1):6. [Epub ahead of print]

Wetzel JL, Fry DK, Pfalzer LA, et al.
Six-minute walk test for persons with mild or moderate disability from multiple sclerosis: performance and explanatory factors.
Physiother Can. 2011 Spring;63(2):166-80.

Quality of life

Pakenham KI, Tilling J, Cretchley J.
Parenting difficulties and resources: The perspectives of parents with multiple sclerosis and their partners.
Rehabil Psychol. 2012 Feb;57(1):52-60.

Dlugonski D, Motl RW.
Possible antecedents and consequences of self-esteem in persons with multiple sclerosis: Preliminary evidence from a cross-sectional analysis.
Rehabil Psychol. 2012 Feb;57(1):35-42.

Hadgkiss EJ, Jelinek GA, Weiland TJ, et al.
Health-related quality of life outcomes at 1 and 5 years after a residential retreat promoting lifestyle modification for people with multiple sclerosis.
Neurol Sci. 2012 Feb 25. [Epub ahead of print]

Vitamin D

Wood H.
Multiple sclerosis: Sunlight and vitamin D influence multiple sclerosis risk independently of HLA-DRB1(*)15 status.
Nat Rev Neurol. 2012 Feb 28. doi: 10.1038/nrneurol.2012.29. [Epub ahead of print]

Soilu-Hänninen M, Aivo J, Lindström BM, et al.
A randomised, double blind, placebo controlled trial with vitamin D3 as an add on treatment to interferon β-1b in patients with multiple sclerosis.
J Neurol Neurosurg Psychiatry. 2012 Feb 22. [Epub ahead of print]

Paediatric MS

Macallister WS, Christodoulou C, Milazzo M, et al.
Pediatric multiple sclerosis: What we know and where are we headed?
Child Neuropsychol. 2012 Mar 1. [Epub ahead of print]

Yeh EA.
Multiple sclerosis: Which MRI findings predict MS development in children?
Nat Rev Neurol. 2012 Feb 28. doi: 10.1038/nrneurol.2012.25. [Epub ahead of print]

Psychological aspects

Sumowski JF, Chiaravalloti N, Leavitt VM, et al.
Cognitive reserve in secondary progressive multiple sclerosis.
Mult Scler. 2012 Mar 2. [Epub ahead of print]

Physical activity

Neamţu MC, Rusu L, Marin M, et al.
Morphofunctional aspects of lower limb in multiple sclerosis.
Rom J Morphol Embryol. 2012;53(1):117-20.

Bregman DJ, van der Krogt MM, de Groot V, et al.
The effect of ankle foot orthosis stiffness on the energy cost of walking: a simulation study.
Clin Biomech (Bristol, Avon). 2011 Nov;26(9):955-61.


Bove RM, Healy B, Augustine A, et al.
Effect of gender on late-onset multiple sclerosis.
Mult Scler. 2012 Mar 1. [Epub ahead of print]

Newland PK, Fearing A, Riley M, et al.
Symptom clusters in women with relapsing-remitting multiple sclerosis.
J Neurosci Nurs. 2012 Apr;44(2):66-71.


Albrecht P, Ringelstein M, Mueller A, et al.
Degeneration of retinal layers in multiple sclerosis subtypes quantified by optical coherence tomography.
Mult Scler. 2012 Mar 2. [Epub ahead of print]


Simka M, Latacz P, Ludyga T, et al.
Prevalence of extracranial venous abnormalities: results from a sample of 586 multiple sclerosis patients.
Funct Neurol. 2011 Oct-Dec;26(4):197-203.

Dake MD, Zivadinov R, Haacke EM.
Chronic cerebrospinal venous insufficiency in multiple sclerosis: a historical perspective.
Funct Neurol. 2011 Oct-Dec;26(4):181-95.

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