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年轻人多发性硬化症残疾结局的纵向分析。

Longitudinal analysis of disability outcomes among young people with MS.

机构信息

School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, QC, Canada; Center for Outcomes Research and Evaluation (CORE), The Research Institute of the McGill University Health Center (RI-MUHC), Montreal, QC, Canada.

School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.

出版信息

Mult Scler Relat Disord. 2021 Jul;52:102966. doi: 10.1016/j.msard.2021.102966. Epub 2021 Apr 20.

Abstract

BACKGROUND

The age of onset of MS appears to influence the course of disease progression and people with younger age of onset might have a different disability trajectory.

OBJECTIVES

To identify longitudinal patterns of disability progression, as measured by changes in the Multiple Sclerosis Functional Composite (MSFC), of young people in MS drug trials and to estimate the extent to which disability progression differ in two age groups (≤25 years and 26 - 35 years).

METHODS

Data from the Multiple Sclerosis Outcomes Assessment Consortium (MSOAC) was used. Longitudinal patterns on the MSFC were identified using group-based trajectory models (GBTM). For difference between the expected and observed proportions of people with pediatric-onset MS chi-square statistic was used. Linear mixed models were used to estimate the average change in performance over time, age and sex.

RESULTS

GBTM results showed little variability in performance over time. Mixed modeling showed that the younger group performed better for gait speed, dexterity, and cognition. Men performed poorer on dexterity and cognition. Distribution of people with pediatric-onset MS differed from expected on dexterity, cognition, and the EDSS.

CONCLUSIONS

The combined use of trajectory models and linear mixed models provided rich information about the variability in function over time.

摘要

背景

多发性硬化症(MS)的发病年龄似乎会影响疾病进展的过程,发病年龄较小的患者可能会有不同的残疾轨迹。

目的

在多发性硬化症药物试验中,确定年轻人的残疾进展的纵向模式,即多发性 sclerosis 功能综合评分(MSFC)的变化,并估计两个年龄组(≤25 岁和 26-35 岁)残疾进展的差异程度。

方法

使用多发性硬化症结局评估联盟(MSOAC)的数据。使用基于群组的轨迹模型(GBTM)确定 MSFC 上的纵向模式。使用卡方统计量比较预期和观察到的儿科发病多发性硬化症患者比例的差异。线性混合模型用于估计随时间、年龄和性别变化的性能平均变化。

结果

GBTM 结果显示,随着时间的推移,表现的变化很小。混合模型表明,年轻组在步态速度、灵巧性和认知方面表现更好。男性在灵巧性和认知方面表现较差。儿科发病多发性硬化症患者的分布在灵巧性、认知和 EDSS 方面与预期不同。

结论

轨迹模型和线性混合模型的结合使用提供了关于随时间推移功能变化的丰富信息。

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