Clinical, MRI, and CSF Markers of Disability Progression in Multiple Sclerosis

Table 1

Clinical markers of MS disability progression reported in longitudinal natural history studies.

Marker	Findings	References
Male gender	Shorter time to walking assistance need (i.e., EDSS score 6) and/or transition to the SP phase	[24–29]
Older age	Older age at onset associated with shorter time to EDSS 6 and/or to SP phase	[24–28, 30, 31]
Progressive course	PP MS patients reach relevant disability milestones in a significantly shorter time compared to RR MS cases	[24–27, 30]
Multifocal presentation	Symptoms/signs of multiple CNS sites involvement at onset are associated with shorter time to EDSS 6 and/or SP phase compared to monofocal presentation	[27, 30]
Motor symptoms	MS patients with pyramidal and/or cerebellar involvement at onset reach EDSS 6 more rapidly compared to patients with optic nerve or sensory symptoms (no influence on time to SP MS)	[24, 25]
Incomplete recovery	Shorter time to EDSS 6 and/or transition to the SP phase	[25, 27, 30]
Relapse rate	Shorter time to second attack and higher relapse number in first 2–5 years after onset are associated with more rapid progression to EDSS 6 and transition to the SP phase	[24, 25, 27, 29, 32]

EDSS: expanded disability status scale; PP: primary progressive; RR: relapsing remitting; SP: secondary progressive.