بررسي درجه ناتواني گشترش يافته در مبتلايان به اسكلروز متعدد قبل و بعد از درمان با متيل پردنيزولون

Expanded Disability Status Scale surveillance in multiple sclerosis patients before and after methylprednisolone treatment

Background: Mult iple scle rosis (MS) is a chronic inflammatory disease of the central nervous sys tem resulting from demyelination and axonal loss. Although treatment of MS has progressed, patients continue to have attacks and treatment for such epi sodes rem ain s a subject of ongoi ng study. The obj ect of thi s study is to det ermine the effec t of intravenou s meth ylprednisol one (lVMP) on {he degree of disability in MS patients. Methods: Thi s cross-sec tional study invo lved 63 patient s with a definite diagn osi s of MS, based on the MacDonald criteria, at the Iranian Cente r for Neurological Rese arch at Imam Khomeini Hospital , Te hran, Iran , from March 2004 throu gh March 2005. Aft er obtaining informed consent , investi gators gathered data including each patientʹs age , gender, pyramidal activity status, con ical, cerebella r and brain stem ac tivity status, sensory signals in the extremities, including vibration, touch, pain , positi on, visual status , as well as bladder and intestin al activity, and Expanded Disability Status Scale (EDSS) score . SPSS vers ion II was used for data analysis. Results: A five-da y regimen of IVMP (5g) significantly redu ced the immediate posttreatm ent score from 4.595 to 3.635, whi ch repr esent s a 96% improvement in the EDSS. The greatest change in functio nal sys tem disability was seen in the pyramid al system with a mean score of 1.13 . After treatment , the rate of disability redu ction in the sensory sys tem, ce rebellum, vision, bladder and intestin al activ ity was 0.57, 0.49, 0.46, 0.4, and 0.38, respecti vely. Pati ent s who had exp erienc ed fewer relapses respo nde d better to treatment. There was no statistically significant relati onsh ip betw een pati ent age and the level of respon se to treatment. However, the rate of disability reduction after treatment was grea ter in males than females (p=O .OS) . Conclusion: These results show that IVMP trea tment induc es an immediate posttreatment effect that could partl y account for clinica l and rad iological impro vement in MS patients. However, furthe r stud y is required to dete rmine the possibl e long-term, or even interm ediate-term , effec ts of methylp redni solone treatm ent on the course of this disease.