Introduction: Multiple sclerosis (MS) shows substantial interindividual variability in clinical course, yet early predictors of long-term disability remain incompletely defined. This retrospective cohort study aimed to investigate the impact of demographic characteristics, family history, comorbidities, and initial clinical and radiological features on disability progression over time.
Methods: We retrospectively evaluated MS patients with respect to initial clinical presentation, relapse frequency, baseline magnetic resonance imaging (MRI) characteristics, early radiological progression, and acute relapse treatment. We also examined the association between recovery after the first relapse and long-term disability outcomes, assessed at years 1, 2, 5, and 10.
Results: Of the 346 patients, 69% were female, and the mean age was 43.4±11.0 years. Most patients had relapsing-onset disease (96%). Sensory symptoms and optic neuritis were the most common presenting symptoms, while motor and cerebellar onset were significantly associated with higher EDSS scores at years 1, 2, and 5. Relapse activity within the first year after diagnosis correlated positively with fifth-year EDSS, whereas relapse frequency prior to diagnosis showed no association with long-term progression. Neither the presence nor the number of contrast-enhancing MRI lesions predicted disability progression.Conclusions: Early clinical phenotype and early treatment response carry important prognostic information in MS. Motor or cerebellar onset, incomplete early recovery, and persistent relapse activity after diagnosis identify patients at higher risk for disability accumulation. Spinal cord involvement was the only MRI parameter associated with 10-year EDSS.
Keywords: Disability, magnetic resonance imaging, multiple sclerosis,