Phenotype and prognosis in African-Americans with multiple sclerosis: a retrospective chart review
Phenotype and prognosis in African-Americans with multiple sclerosis: a retrospective chart review
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DOI：
10.1177/1352458506070923
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发表时间：
2006-12-01
影响因子：
5.8
通讯作者：
Cross, A. H.
中科院分区：
文献类型：
--
作者：
Naismith, R. T.;Trinkaus, K.;Cross, A. H.
研究背景：有一组关于非裔美国人（AA）多发性硬化（MS）的文献表明，这一群体的进展更快，预后更差。opticospinal MS的表型已经提出了一些publications.Objective AA MS是否有不同的临床表型，不同的临床亚型分布，和/或不同的残疾水平比高加索人（CA）与MS。具体来说，是残疾归因于严重的小脑疾病，这限制了amperity和功能？设计图：对来自学术MS中心的患者队列的回顾性图表分析。患者共86例AA被确定为MS，79例被随访5年。对照组由80例随机选择的CA伴MS和类似随访组成。结果措施EDSS在诊断，五年随访，最后一次随访;时间步行辅助设备;疾病亚型;涉及的功能system.Results AA MS患者显示更多的小脑功能障碍，更糟糕的EDSS评分在诊断，在4至6年的后续诊断，并在最后一次随访相比，CA MS患者随访时间相似。AA MS患者有更早和更频繁的步态困难，需要使用拐杖或轮椅。AA MS患者有较高的患病率原发性进展（PP）MS（22比9%）和复发缓解（RR）MS（30比52%）相比，CA。结论相比，CA患者，MS在AA的特点是更高的发病率小脑功能障碍和更迅速的残疾积累。在该队列中，AA患者的PPMS亚型发生率相对较高。这些数据表明，AA中MS的临床表型和自然病程存在根本差异。
Context There is an emerging body of literature regarding multiple sclerosis (MS) in African-Americans (AA) that suggests more rapid progression and a worse prognosis in this group. A phenotype of opticospinal MS has been proposed by some publications.Objective To determine whether AA with MS have a different clinical phenotype, different distribution of clinical subtypes, and/or different levels of disability than Caucasians (CA) with MS. Specifically, is the disability attributable to severe cerebellar disease, which limits ambulation and function? Design: Retrospective chart analyses of a patient cohort from an academic MS center.Patients A total of 86 AA were identified with MS, 79 were followed for 5 years. The control group consisted of 80 randomly-selected CA with MS and similar follow-up. Outcome measures EDSS at diagnosis, five-year follow-up, and last follow-up; time to walking assistance device; disease subtype; involved functional systems.Results AA MS patients displayed more cerebellar dysfunction, and worse EDSS scores at diagnosis, at four to six years follow-up from diagnosis, and at last follow-up compared to the CA MS patients with similar length of follow-up. AA MS patients had earlier and more frequent gait difficulty requiring use of a cane or wheelchair. AA MS patients had a higher prevalence of primary progressive (PP) MS (22 versus 9%) and a lower rate of relapsing-remitting (RR) MS (30 versus 52%) compared to CA.Conclusions Compared to CA patients, MS in AA is characterized by a higher incidence of cerebellar dysfunction and a more rapid accumulation of disabilities. In this cohort, AA patients had a relatively higher rate of the PPMS subtype. These data suggest the presence of fundamental differences in the clinical phenotype and the natural history of MS in AA.