2026 American Academy of Neurology Abstract Website

Objective:

To determine if social drivers of health (SDoH) are associated with ambulatory capacity in people with stiff person syndrome spectrum disorders (SPSD).

Background:

While SDoH have been linked to worse outcomes in other autoimmune neurological disorders like multiple sclerosis and myasthenia gravis, their impact on SPSD remains unexplored.

Design/Methods:

As part of an ongoing longitudinal observational study at a tertiary care center, data were systematically collected. We used multivariate logistic regression to examine relationships between SDoH and ambulatory capacity in people with SPSD, controlling for age at symptom onset and SPS phenotype (classic SPS, SPS plus, partial SPS, and Progressive Encephalomyelitis with Rigidity and Myoclonus). We report odds ratios (OR) for having more severe ambulatory impairment, their 95% confidence intervals (CIs), and p-values.

Results:

We included 230 people with SPSD; 41.74% required ambulatory assistance. Non-white identity (OR 2.23, 95% CI 1.22-3.73, p = 0.008) and prior heavy alcohol use (OR 15.89, 95% CI 2.56-98.63, p = 0.003) were associated with greater odds of ambulatory impairment, while male sex (OR 0.35, 95% CI 0.18-0.68, p = 0.002) appeared protective. Marital status, educational attainment, tobacco use, and illicit drug use were not significantly associated with ambulatory status in our cohort.

Conclusions:

As in other autoimmune neurologic conditions, outcomes in SPSD may be influenced by SDoH. In our cohort, non-white individuals and those with a history of heavy alcohol use had increased odds of ambulatory impairment, while male individuals had reduced odds. These associations warrant further investigation to better understand underlying mechanisms and inform equitable care strategies.