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Journal of neurology
Feb, 2021;268 (2): 559-568.

Comorbidities contribute substantially to the severity of common multiple sclerosis symptoms.

Lara Marie Pangan Lo, Bruce V Taylor, Tania Winzenberg, Andrew J Palmer, Leigh Blizzard, Ingrid van der Mei
Author Information
  1. Lara Marie Pangan Lo: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. ORCID
  2. Bruce V Taylor: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
  3. Tania Winzenberg: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
  4. Andrew J Palmer: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
  5. Leigh Blizzard: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia.
  6. Ingrid van der Mei: Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, TAS, 7000, Australia. Ingrid.vanderMei@utas.edu.au. ORCID
PMID: 32876720 DOI: 10.1007/s00415-020-10192-z

Abstract

BACKGROUND: More research is needed to understand the contribution of comorbidities to MS symptomatology.
OBJECTIVES: To examine the dose-response relationship between the number of comorbidities and severity of MS symptoms and to assess the relative contribution of comorbidity groups and individual comorbidities to the severity of each symptom.
METHODS: We surveyed 1223 participants of the Australian MS Longitudinal Study for the presence of 30 comorbidities and the severity of 13 MS symptoms (0-10 scale). The associations between comorbidities and symptoms were assessed using negative binomial regression. The relative contributions of comorbidities to the severity of symptoms were assessed using general dominance analysis.
RESULTS: Higher number of comorbidities was most strongly associated with a higher severity of pain and feelings of anxiety and depression (ratios of means ≥ 0.12 per comorbidity increase). Comorbidities explained between 3.7% (spasticity) and 22.0% (feelings of anxiety) of the total variance of symptom severity. Mental health and musculoskeletal disorders contributed most strongly to the severity of the most common symptoms in MS.
CONCLUSIONS: Our findings support that early recognition and optimal management of comorbidities, particularly of mental health and musculoskeletal disorders, could have a positive impact on the severity of symptoms of people with MS.

Keywords

Comorbidity Mental health disorder Multiple sclerosis Musculoskeletal disorder Prevalence Symptoms

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MeSH Term

Anxiety Disorders
Australia
Comorbidity
Humans
Longitudinal Studies
Multiple Sclerosis
Journal Article
Article has an altmetric score of 1

Word Cloud

Created with Highcharts 10.0.0severitycomorbiditiessymptomsMShealthcontributionnumberrelativecomorbiditysymptomassessedusingstronglyfeelingsanxietyComorbiditiesMentalmusculoskeletaldisorderscommonsclerosisdisorderBACKGROUND:researchneededunderstandsymptomatologyOBJECTIVES:examinedose-responserelationshipassessgroupsindividualMETHODS:surveyed1223participantsAustralianLongitudinalStudypresence30130-10scaleassociationsnegativebinomialregressioncontributionsgeneraldominanceanalysisRESULTS:Higherassociatedhigherpaindepressionratiosmeans ≥ 012perincreaseexplained37%spasticity220%totalvariancecontributedCONCLUSIONS:findingssupportearlyrecognitionoptimalmanagementparticularlymentalpositiveimpactpeoplecontributesubstantiallymultipleComorbidityMultipleMusculoskeletalPrevalenceSymptoms

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