This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Hoogervorst, E L. Articles by Polman, C H Search for Related Content PubMed PubMed Citation Articles by Hoogervorst, E L. Articles by Polman, C H Pubmed/NCBI databases Compound via MeSH Substance via MeSH Hazardous Substances DB METHYLPREDNISOLONE Medline Plus Health Information Steroids Social Bookmarking                         What's this?

Differential treatment effect on measures of neurologic exam, functional impairment and patient self-report in multiple sclerosis

Department of Neurology, `Vrije Universiteit' Medical Center, Amsterdam, The Netherlands

N F Kalkers

Department of Neurology, `Vrije Universiteit' Medical Center, Amsterdam, The Netherlands

L ML van Winsen

Department of Neurology, `Vrije Universiteit' Medical Center, Amsterdam, The Netherlands

B MJ Uitdehaag

Department of Neurology, `Vrije Universiteit' Medical Center, Amsterdam, The Netherlands, Department of Clinical Epidemiology and Biostatistics, `Vrije Universiteit' Medical Center, Amsterdam, The Netherlands

C H Polman

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 patients 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.

Key Words: MS • EDSS • MS functional composite • Guy's Neurological Disability Scale • methylprednisolone

Multiple Sclerosis, Vol. 7, No. 5, 335-339 (2001)
DOI: 10.1177/135245850100700510


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				D. Kos, M. Duportail, M. D'hooghe, G. Nagels, and E. Kerckhofs Multidisciplinary fatigue management programme in multiple sclerosis: a randomized clinical trial Multiple Sclerosis, September 1, 2007; 13(8): 996 - 1003. [Abstract] [PDF]

				V. de Groot, H. Beckerman, B. M. J. Uitdehaag, H. C. W. de Vet, G. J. Lankhorst, C. H. Polman, and L. M. Bouter The usefulness of evaluative outcome measures in patients with multiple sclerosis Brain, October 1, 2006; 129(10): 2648 - 2659. [Abstract] [Full Text] [PDF]

				C Vaney, S Vaney, and D T Wade SaGA S, the Short and Graphic A bility Score: an alternative scoring method for the motor components of the Multiple Sclerosis Functional C omposite Multiple Sclerosis, April 1, 2004; 10(2): 231 - 242. [Abstract] [PDF]

				J Craig, C A Young, M Ennis, G Baker, and M Boggild A randomised controlled trial comparing rehabilitation against standard therapy in multiple sclerosis patients receiving intravenous steroid treatment J. Neurol. Neurosurg. Psychiatry, September 1, 2003; 74(9): 1225 - 1230. [Abstract] [Full Text] [PDF]

				E L J Hoogervorst, M J Eikelenboom, B M J Uitdehaag, and C H Polman One year changes in disability in multiple sclerosis: neurological examination compared with patient self report J. Neurol. Neurosurg. Psychiatry, April 1, 2003; 74(4): 439 - 442. [Full Text] [PDF]

				A. J Thompson Developing clinical outcome measures in multiple sclerosis: an evolving process Multiple Sclerosis, October 1, 2002; 8(5): 357 - 358. [PDF]