Age is a critical determinant in recovery from multiple sclerosis relapses

Brittani L. Conway, Burcu Zeydan, Uğur Uygunoğlu, Martina Novotna, Aksel Siva, Sean J. Pittock, Elizabeth J. Atkinson, Moses Rodriguez, Orhun H. Kantarci

Research output: Contribution to journalArticlepeer-review

35 Scopus citations


Objective: To evaluate the impact of age on recovery from multiple sclerosis relapses. Background: Increasing disability in multiple sclerosis is a consequence of progressive disease and incomplete relapse recovery. Methods: The first and last-ever relapse data (357 relapses in 193 patients) from the Olmsted County population-based multiple sclerosis cohort were systematically reviewed for age, fulminance, location (optic nerve, brainstem/cerebellar, spinal cord), peak deficit, and maximum recovery. Three different relapse-outcome measures were studied both as paired analyses and as an overall group effect: change from peak deficit to maximum recovery in raw functional system score related to the relapse (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. Results: Older age was linearly associated with worse recovery in the ΔFSS outcome (p = 0.002), ΔEDSS outcome (p < 0.001), and the FSS-based relapse-impact model (p < 0.001). A multivariate analysis of ΔFSS outcome linked poor recovery to older age (p = 0.015), relapse location (transverse myelitis or brainstem/cerebellar syndrome; p < 0.001), and relapse fulminance (p = 0.004). Conclusion: Multiple sclerosis-relapse recovery declines in a linear fashion with increased age, which should be considered when making treatment decisions.

Original languageEnglish (US)
Pages (from-to)1754-1763
Number of pages10
JournalMultiple Sclerosis Journal
Issue number13
StatePublished - Nov 1 2019
Externally publishedYes

Bibliographical note

Publisher Copyright:
© The Author(s), 2018.


  • Multiple sclerosis
  • age
  • extended disability status score
  • fulminance
  • population-based cohort
  • recovery
  • relapse


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