Fatigue and Reduced Leg Function Can Signal Transition to Progressive MS, Study Reports

Fatigue and limited leg function are more common among older people with progressive multiple sclerosis than in those with relapsing forms of the disease, according to a study.

In fact, they are a sign that the disease of a person with relapsing MS is becoming worse by reaching the progressive MS stage.

The researchers hope these insights can translate into more personalized MS treatments.

Eighty to 85 percent of people with MS are initially diagnosed with relapsing-remitting MS, which is marked by symptom flare-ups followed by periods of remission. Most people eventually transition to secondary progressive MS. It is not characterized by wide swings in symptoms but rather a slow, steady worsening of the disease.

Older patients with fatigue and leg problems “were more likely to progress from relapsing-remitting MS to secondary progressive MS within five years,” Bianca Weinstock-Guttman, the author of the study, said in a news release. She is a neurology professor at the State University of New York at Buffalo.

“While more research needs to be done, this study brings us closer to understanding which older adults with MS may be at higher risk of getting worse,” she added.

Researchers presented the findings at the American Academy of Neurology’s annual meeting in Boston, April 22-28. The presentation was titled “Self-Reported Fatigue and Lower Limb Problems Predictive of Conversion to Secondary Progressive Multiple Sclerosis in an Aging Sample of Patients.”

The study enrolled 155 patients around 50 years old who had had relapsing-remitting MS at least 15 years. Researchers assessed patients’ symptoms and disability at the start of the study and five years later.

Thirty percent of the patients developed secondary progressive MS during the five years. This group was four times more likely to experience fatigue than those whose disease did not progress, regardless of age and the severity and duration of the disease.

In addition, patients who developed progressive MS during the five years were three times more likely to have impaired leg function than those whose disease failed to progress. Impaired function included symptoms such as leg weakness or spasms.

Importantly, researchers discovered that MS progression was more prevalent in patients who were older at the start of the study — 55 or more — and whose disability was worse when the research began.

“Better understanding who is at high risk of getting worse may eventually allow us to tailor more specific treatments to these people,” Weinstock-Guttman said. “With the aging population, this information will be vital as people with MS, their families and policy-makers make decisions about their care.”