Mult Scler 2001 Oct;7(5):335-9
Hoogervorst EL, Kalkers NF, van
Winsen LML, Uitdehaag BM, Polman CH.
Department of Neurology, Vrije Universiteit
Medical Center, Amsterdam, The Netherlands.
OBJECTIVE:
To determine the relative sensitivity
of the Expanded Disability Status Scale (EDSS), the newly developed MS
Functional Composite (MSFC) and the Guy's Neurological Disability Scale
(GNDS) to changes in the neurological condition of Multiple Sclerosis (MS)
patients induced by treatment with intravenous methylprednisolone (IV-MP).
METHODS:
Sixty MS patients were treated with
IV-MP. On the first day of treatment patients were trained for the three
domains of the MSFC; on the second day baseline data were obtained for
all measurements. Follow-up data were obtained 6-8 weeks after IV-MP treatment
RESULTS:
Significant changes were found for
both EDSS and GNDS. Remarkably, the improvements on the GNDS were mainly
due to changes in the subcategories cognition, speech, fatigue and 'others'.
No significant change was found for the MSFC Forty-seven patient reported
a subjective improvement in their condition. Twenty-one patients showed
a significant improvement in the EDSS, 28 patients showed a significant
improvement in the GNDS and a very small number of significant changes
were found on the MSFC (actual number depending on the definition of the
reference population).
CONCLUSION:
The observations in this study show
that the relative sensitivity to change in acute or subacute deterioration
in MS patients, is low for the MSFC and high for the GNDS. It is obvious
from this study that such a treatment can have a differential effect on
measurements of functional impairment, rating of neurologic examination
and patient self-report.
PMID: 11724450 [PubMed - in process]