2023 American Academy of Neurology Abstract Website

Objective:

To describe differences in MS symptom severity by PDDS score.

Background:

The SymptoMScreen was developed to assess the severity of symptoms among persons with multiple sclerosis (pwMS). Patient Determined Disease Steps (PDDS), a self-reported measure of disability, was used as a criterion measure for the composite SymptoMScreen score. Although strongly associated, each individual SymptoMScreen domain can provide additional insight on the severity of MS symptoms. Evidence suggests that pwMS who report greater disability also experience increased severity across many symptoms (Gustaven 2021). It is necessary to understand symptom severity as MS progresses to identify ways to improve quality of life in pwMS.

Design/Methods:

The study sample included US participants who responded to the North American Research Committee on Multiple Sclerosis survey at least once in Fall 2017–Fall 2019 and completed the PDDS score and SymptoMScreen questions. When multiple surveys were available, the most recent information was used. Individual SymptoMScreen symptom domains, which utilize a seven-point Likert scale, were summarized overall and by PDDS score.

Results:

The sample included 7646 pwMS across all PDDS scores (normal, 15%; mild, 14%; moderate, 9%; gait disability, 11%; early cane, 13%; late cane, 9%; bilateral support, 13%; wheelchair/scooter, 15%; bedridden, 1%). At normal, mild and moderate PDDS scores, the most frequently reported symptoms that were mild or more severe were fatigue (56%), cognition (37%) and bladder control (34%). At early cane or more severe PDDS scores, the most frequently reported symptoms that were moderate or more severe were bladder (73%), spasticity (64%) and fatigue (63%). All symptom domains increased in severity as PDDS score increased.

Conclusions:

All SymptoMScreen symptom domains increased in severity with higher disability levels; however, the most common symptoms differed at higher and lower PDDS scores. Interventions that can address MS symptoms can be insightful in selecting treatment.