Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark.
Institute of Regional Health Research, University of Southern Denmark, Odense, Denmark/Department of Neurology, MS-Clinic of Southern Jutland (Sønderborg, Esbjerg, Kolding), Sønderborg, Denmark.
Mult Scler. 2021 Sep;27(10):1477-1485. doi: 10.1177/1352458520936231. Epub 2020 Jul 2.
Impairments across multiple domains are a disabling consequence of multiple sclerosis (MS). Originating from preventive medical strategies, the "time matters"-perspective has become a focal point when treating MS. In particular, early detection of physical and cognitive deficits, along with deficits in patient-reported outcomes seems crucial to further optimize both pharmacological and non-pharmacological MS treatment strategies. Therefore, this topical review investigates the level of impairments across multiple domains (physical function, cognitive function, and patient-reported outcomes) in the early stage of MS (⩽5 years since diagnosis, including clinically isolated syndrome (CIS)), when compared to matched healthy controls. Even at early disease stages, studies show impairments corresponding to 8%-34% and small-to-large numerical effect sizes (0.35-2.85) in MS/CIS patients across domains. This evidence call for early screening programs along with early interventions targeting the multiple impaired domains. This further highlights the importance of preventive initiatives preserving and/or restoring physical and cognitive reserve capacity if possible.
多种障碍是多发性硬化症 (MS) 的致残后果。源于预防医学策略，“时间至关重要”的观点已成为治疗 MS 的重点。特别是，早期发现身体和认知缺陷以及患者报告的结果缺陷似乎对于进一步优化药物和非药物 MS 治疗策略至关重要。因此，本专题综述调查了 MS 的早期阶段（诊断后 ⩽5 年，包括临床孤立综合征 (CIS)）中多个领域（身体功能、认知功能和患者报告的结果）的障碍程度，并与匹配的健康对照组进行了比较。即使在疾病早期阶段，研究表明 MS/CIS 患者在多个领域的障碍程度相当于 8%-34%和小到大的数值效应大小 (0.35-2.85)。这一证据呼吁开展早期筛查计划，并针对多个受损领域进行早期干预。这进一步强调了预防措施的重要性，如果可能的话，预防措施可以保留和/或恢复身体和认知储备能力。
