Summary
In a search for early prognostic features in multiple sclerosis, the progression rate was calculated in 200 consecutive multiple sclerosis patients who had had a lumbar puncture, and correlated with age at onset, type of disease course, the patient's sex, as well as with indices of blood-brain barrier breakdown and intrathecal IgG synthesis. The present study demonstrates that age at onset plays a role in determining whether the disease will be remitting-relapsing or chronic progressive. Age at onset is also a factor determining the rate of progression of the remitting-relapsing form, but is without influence on the progression of the chronic progressive form. A chronic progressive disease course per se (independent of age at onset) is also associated with a more rapid deterioration. The patient's sex does not appear to be a differentiating factor. Only inconsistent correlations were found between IgG index or number of oligoclonal bands in the CSF and disease progression.
Zusammenfassung
Die vorliegende Arbeit befaßt sich mit der Suche nach frühen prognostischen Parametern der MS. Bei 200 unausgewählten Patienten wurde durch Liquoruntersuchungen die Diagnose bestätigt. Es wurde die Dynamik des Krankheitsverlaufes ermittelt und mit dem Anfangsalter, Verlaufstyp, Geschlecht, intrathekaler IgG-Synthese und Indizien von Bluthirnschrankenstörung korreliert. Der individuelle Krankheitsbeginn bestimmt, ob das Leiden einen Rückfall-Remissionsverlauf nimmt oder chronisch progredient verläuft. Das Anfangsalter bestimmt auch das Tempo der Rückfall-Remissionsform, nicht aber das des progredienten Verlaufes. Generell kommt es bei der chronisch progressiven Form zu einer rascheren Verschlechterung als bei der Rückfall-Remissionsvariante. Das Geschlecht scheint kein differenzierender Faktor zu sein. Eindeutige Zusammenhänge zwischen dem IgG-Index oder der Anzahl oligoklonischer Bänder im Liquor und dem Krankheitsverlauf wurden nicht festgestellt.
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Verjans, E., Theys, P., Delmotte, P. et al. Clinical parameters and intrathecal IgG synthesis as prognostic features in multiple sclerosis. Part I. J Neurol 229, 155–165 (1983). https://doi.org/10.1007/BF00313739
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DOI: https://doi.org/10.1007/BF00313739