Study Identifies Factors Influencing the Degree of Disability in MS

Drug use, serum albumin, and total number of lesions may serve as independent factors influencing the degree of disability in patients with multiple sclerosis (MS), investigators of a retrospective analysis concluded.

A recent study identified several independent factors, including serum albumin, total number of lesions, and drug use, that influence the degree of disability in patients with multiple sclerosis (MS).

The investigators said that the findings from the retrospective observational study, which was published in Frontiers of Neurology, provides clinical evidence for prognostic evaluations and early interventions in patients with MS.

Most patients with MS have intermittent disease that becomes progressive over time. Focal inflammation is considered to be the basis of the onset and relapse-remitting period of MS, during which patients may experience a decline in limb function in the early stage of the disease, potentially affecting their ability to work and conduct daily activities.

“Physical disability is an important factor that affects the quality of life of patients with multiple sclerosis; therefore, it is particularly important to actively explore factors influencing the degree of physical disability,” wrote the investigators.

Currently, clinical studies on the factors affecting disability severity primarily focus on gender, age, course of disease, number of recurrences, and blood lipids. Reporting on the influence of serum protein levels, which may serve as a pathological mechanism of MS, on the degree of disability in MS is limited.

The investigators reviewed data from 72 patients with relapsing-remitting MS who were admitted to the Department of Neurology at the Shanxi Medical University First Hospital for MS in China between June 2015 and June 2021. There were 27 men and 45 women, the mean (SD) age was 41.79 (12.55) years, and the mean (SD) disability score as determined by the Expanded Disability Status Scored (EDSS) was 6.76 (3.23).

All patients underwent head MRI scans and a blood test for serum total protein, albumin, prealbumin, triglycerides, total cholesterol, and high-density and low-density lipoprotein cholesterol. The patients also completed an EDSS assessment on the day of admission.

Univariate analysis demonstrated that age, annual recurrence rate, number of relapses, disease duration, drug use, albumin, triglycerides, and total number of lesions in the group with an EDSS score of 3 or less significantly differed from those in patients with an EDSS score of greater than 3 (P < .05).

In the multiple logistic regression analysis, the investigators found that albumin, total number of lesions, and drug use were independent factors influencing the severity of MS-related disability, with the difference between the factors being statistically significant (P < .05).

Furthermore, patients with MS who were receiving disease-modifying therapies (DMTs) were found to have less limb disability than patients who were not, which was consistent with results from other studies. The investigators said that this result may suggest that DMTs play an important role in reducing recurrence and delaying disease progression.

The main limitations of the study included that China has a low incidence of MS, leading the investigators to have a limited number of reports to analyze. Additionally, the retrospective nature of the study failed to collect cerebrospinal fluid–related protein indicators, and it was not possible for the investigators to longitudinally detect changes in various indicators as the disease progressed.

“The results of this study need to be further confirmed by prospective, longitudinal studies with a larger sample size….Close monitoring of related risk factors and early intervention may help improve the prognosis and quality of life of patients with multiple sclerosis,” the investigators noted.


Xue H, Yang Z, Wang L, et al. Factors influencing the degree of disability in patients with multiple sclerosis. Front Neurol. 2021;12:714631. doi:10.3389/fneur.2021.714631