Matas E, Bau L, Romero-Pinel L, León I, Arroyo-Pereiro P, Muñoz-Vendrell A, Martínez-Yélamos A, Martínez-Yélamos S
Multiple Sclerosis Unit, Department of Neurology, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Feixa Llarga s/n, 08907, Barcelona, Spain.
Neurologic Diseases and Neurogenetics Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain.
J Neurol. 2025 Nov 5;272(11):747. doi: 10.1007/s00415-025-13402-8.
The concept of benign multiple sclerosis (MS) is a matter of debate. In most definitions, only the Expanded Disability Status Scale (EDSS) score and disease duration are considered, although other factors may influence a patient's disability. The aims of this study were to evaluate the percentage of patients with benign MS in our cohort and to determine the proportion of these patients who remained benign after 20 and 30 years of disease evolution. Clinical and demographic variables related to this outcome were investigated.
Patients fulfilling the criteria for benign MS (EDSS < 3.0 and at least 10 years of MS evolution) were selected from a hospital-based series and followed up prospectively. The EDSS was assessed after 20 and 30 years of MS evolution. Clinical and radiological variables were evaluated. Fatigue, depression and cognition tests were performed.
Eighty-two of the 485 patients evaluated in 1996 fulfilled the criteria for benign MS and were selected. In 51 of the 68 (75%) patients evaluated in 2006, the EDSS score continued to be ≤ 3. In 2016, 35 out of 58 (60%) patients continued to have an EDSS score ≤ 3. None of the clinical variables could predict persistence in the benign group. Eighteen of the 35 benign MS patients completed the questionnaires after 30 years. Fifty percent of them reported fatigue, 22% depression, and 83% had cognitive impairment.
The majority of MS patients maintained a benign status even after 30 years of disease evolution. However, cognitive impairment in this group is notable.
良性多发性硬化症（MS）的概念存在争议。在大多数定义中，仅考虑扩展残疾状态量表（EDSS）评分和病程，尽管其他因素可能影响患者的残疾状况。本研究的目的是评估我们队列中良性MS患者的百分比，并确定这些患者在疾病进展20年和30年后仍保持良性的比例。研究了与该结果相关的临床和人口统计学变量。
从一个基于医院的系列中选择符合良性MS标准（EDSS＜3.0且MS病程至少10年）的患者，并进行前瞻性随访。在MS病程20年和30年后评估EDSS。评估临床和放射学变量。进行疲劳、抑郁和认知测试。
1996年评估的485例患者中有82例符合良性MS标准并被选中。2006年评估的68例患者中有51例（75%）EDSS评分持续≤3。2016年，58例患者中有35例（60%）EDSS评分持续≤3。没有临床变量能够预测患者是否持续处于良性组。35例良性MS患者中有18例在30年后完成了问卷调查。其中50%报告有疲劳，22%有抑郁，83%有认知障碍。
即使在疾病进展30年后，大多数MS患者仍保持良性状态。然而，该组患者的认知障碍较为显著。
