PLoS ONE (Jan 2023)

Prospective outcome analysis of multiple sclerosis cases reveals candidate prognostic cerebrospinal fluid markers.

  • Elif Everest,
  • Ugur Uygunoglu,
  • Melih Tutuncu,
  • Alper Bulbul,
  • Umut Inci Onat,
  • Mehmetcan Unal,
  • Timucin Avsar,
  • Sabahattin Saip,
  • Ugur Bilge,
  • Eda Tahir Turanli,
  • Aksel Siva

DOI
https://doi.org/10.1371/journal.pone.0287463
Journal volume & issue
Vol. 18, no. 6
p. e0287463

Abstract

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BackgroundPredicting the long-term disability outcomes of multiple sclerosis (MS) cases is challenging.ObjectiveWe prospectively analysed our previous MS cohort with initial cerebrospinal fluid (CSF) proteomics data to reveal disability markers after 8.2±2.2 years of follow-up.MethodsPatients with regular follow-up visits were assigned into two groups: those with an age-related MS severity (ARMSS) score ≥5 (unfavourable course group, N = 27) and ARMSS score ResultsCSF alpha-2-macroglobulin (P = 0.0015), apo-A1 (P = 0.0016), and haptoglobin (P = 0.0003) protein levels, as well as cerebral lesion load (>9 lesions) on magnetic resonance imaging, gait disturbance (P = 0.04), and bladder/bowel symptoms (P = 0.01) were significantly higher in the unfavourable course group than in the favourable course group. Optic nerve involvement evident on initial magnetic resonance imaging (P = 0.002) and optic neuritis (P = 0.01) were more frequent in the favourable course group.ConclusionThe herein identified initial CSF protein levels, in addition to the clinical and radiological parameters at disease onset, have predictive value for long-term disability in MS cases.