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dc.contributor.authorRodriguez, Moses
dc.contributor.authorTutuncu, Melih
dc.contributor.authorNoseworthy, John H.
dc.contributor.authorWeinshenker, Brian G.
dc.contributor.authorKantarci, Orhun H.
dc.contributor.authorSiva, Aksel
dc.contributor.authorNovotna, Martina
dc.contributor.authorSoldan, M. Mateo Paz
dc.contributor.authorAbou Zeid, Nuhad
dc.contributor.authorKale, Nilufer
dc.contributor.authorCrusan, Daniel J.
dc.contributor.authorAtkinson, Elizabeth J.
dc.contributor.authorKeegan, B. Mark
dc.contributor.authorPirko, Istvan
dc.contributor.authorPittock, Sean J.
dc.contributor.authorLucchinetti, Claudia F.
dc.date.accessioned2021-03-05T08:11:56Z
dc.date.available2021-03-05T08:11:56Z
dc.date.issued2015
dc.identifier.citationNovotna M., Soldan M. M. P. , Abou Zeid N., Kale N., Tutuncu M., Crusan D. J. , Atkinson E. J. , Siva A., Keegan B. M. , Pirko I., et al., "Poor early relapse recovery affects onset of progressive disease course in multiple sclerosis", NEUROLOGY, cilt.85, ss.722-729, 2015
dc.identifier.issn0028-3878
dc.identifier.othervv_1032021
dc.identifier.otherav_97a12e02-3904-4a44-affb-69d8ad12ee03
dc.identifier.urihttp://hdl.handle.net/20.500.12627/102079
dc.identifier.urihttps://doi.org/10.1212/wnl.0000000000001856
dc.description.abstractObjective:To evaluate the relationship between early relapse recovery and onset of progressive multiple sclerosis (MS).Methods:We studied a population-based cohort (105 patients with relapsing-remitting MS, 86 with bout-onset progressive MS) and a clinic-based cohort (415 patients with bout-onset progressive MS), excluding patients with primary progressive MS. Bout-onset progressive MS includes patients with single-attack progressive and secondary progressive MS. Good recovery (as opposed to poor recovery) was assigned if the peak deficit of the relapse improved completely or almost completely (patient-reported and examination-confirmed outcome measured 6 months post relapse). Impact of initial relapse recovery and first 5-year average relapse recovery on cumulative incidence of progressive MS was studied accounting for patients yet to develop progressive MS in the population-based cohort (Kaplan-Meier analyses). Impact of initial relapse recovery on time to progressive MS onset was also studied in the clinic-based cohort with already-established progressive MS (t test).Results:In the population-based cohort, 153 patients (80.1%) had on average good recovery from first 5-year relapses, whereas 30 patients (15.7%) had on average poor recovery. Half of the good recoverers developed progressive MS by 30.2 years after MS onset, whereas half of the poor recoverers developed progressive MS by 8.3 years after MS onset (p = 0.001). In the clinic-based cohort, good recovery from the first relapse alone was also associated with a delay in progressive disease onset (p < 0.001). A brainstem, cerebellar, or spinal cord syndrome (p = 0.001) or a fulminant relapse (p < 0.0001) was associated with a poor recovery from the initial relapse.Conclusions:Patients with MS with poor recovery from early relapses will develop progressive disease course earlier than those with good recovery.
dc.language.isoeng
dc.subjectSağlık Bilimleri
dc.subjectDahili Tıp Bilimleri
dc.subjectNöroloji
dc.subjectTıp
dc.subjectKlinik Tıp (MED)
dc.subjectKlinik Tıp
dc.subjectKLİNİK NEUROLOJİ
dc.titlePoor early relapse recovery affects onset of progressive disease course in multiple sclerosis
dc.typeMakale
dc.relation.journalNEUROLOGY
dc.contributor.departmentMayo Clinic , ,
dc.identifier.volume85
dc.identifier.issue8
dc.identifier.startpage722
dc.identifier.endpage729
dc.contributor.firstauthorID223858


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