AAN 2016 – What MS symptoms matter the most?
American Academy of Neurology (AAN) annual meeting, Vancouver, B.C., April 15-21, 2016 – The disabling physical symptoms that can occur in multiple sclerosis, such as difficulty walking, poor vision and bowel/bladder problems, are the focus of attention from neurologists and researchers. But they are not the symptoms that have the greatest impact on a person’s daily life, according to a survey of people with MS in New York (Green & Kister. AAN 2016; abstract P2.175).
The researchers asked 439 people with MS (average age 47 years) to rate their overall health. On average, people in the group said their health was somewhere between “moderate” and “good”. About 15% said it was Very Good, 39% said it was Good, 36% said it was Moderate, and 10% said it was Bad or Very Bad. People’s perception of their health was directly related to the severity of their MS symptoms.
The MS symptoms that had the greatest impact were fatigue, difficulty thinking, dexterity, anxiety, sensory symptoms (e.g. tingling, numbness), and pain.
The researchers noted that mental symptoms, such as fatigue, difficulty thinking and anxiety, had a greater impact on how people perceived their health compared to physical symptoms, such as difficulty getting around, bladder symptoms or vision problems. They added that clinical trials, which tend to emphasize the effects of medications on physical parameters, need to pay more attention to mental health issues, which may be more important to people.
Few studies have prospectively looked at the impact of MS treatments on mental health. One such study was COGIMUS, which examined the effect of Rebif on cognition (thinking, planning, attention, etc.) (Patti and colleagues. PLoS One 2013;8:e74111). The study found that the proportion of people experiencing cognitive difficulties remained stable over a 5-year period with the higher dose of Rebif (44 mcg three times a week). Cognitive difficulties were almost twice as common in men compared to women, which may be because MS is generally worse in men, or because women may have a somewhat better response to Rebif.
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