الفهرس 
PATHOPHYSIOLOGY & PHENOTYPESOnly 14 pages are availabe for public view
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Abstract
Background: Secondary progressive multiple sclerosis (SPMS) represents a critical phase in the clinical course of multiple sclerosis (MS), characterized by a transition from the initial relapsing-remitting phase to a progressive phase marked by gradual accumulation of disability. It is characterized by a diversity of symptoms and functional impairments. A better understanding of the clinical characteristics of SPMS through accurate thoughtful evaluation with reliable tools is crucial for informing clinical practice, guiding treatment decisions, and improving outcomes for individuals.
Aim of the Work: This study was firstly concerned with and aimed to assess the clinical characteristics of patients with active SPMS, targeting different affected domains, and secondly to compare these characteristics with 6-month and 12-month assessments in a longitudinal hospital-based study.
Patienta and Methods: The study was conducted, in the period from December 2021 to December 2023, in the Multiple sclerosis unit at the neurology department, Ain-Shams University Hospital, Cairo, Egypt. The study was approved by The Faculty of Medicine Ain-Shams University Research Ethics Committee (FMASUREC). Informed written consents were taken from participants before enrolment.
Results: Regarding the first aim of the study and the clinical characteristics of enrolled patients during the baseline assessment, The EDSS mean value was 5.859 ± 1.015(SD) and showed a positive correlation with the patient’s age, total duration of illness, and SPMS duration as well as presence of incoordination and focal spinal lesion manifestations in the first attack. The cognitive effection was assessed by SDMT with 89 % of participants scored less than 34, and a mean value of 23.705 ± 8.722(SD). T25FWT, for assessing the mobility and leg function performance, the mean value was 16±16 seconds which was about 4 times the time needed by a healthy person.
Conclusion: The physical subscale of MFIS showed a statistically significant correlation with EDSS, T25FWT, and 9HPT. The cognitive subscale showed a significant correlation with SDMT results. Modified fatigue impact scale results highlighted the importance of the patients’ perceptions in assessing SPMS, and that it is should be carefully considered alongside the clinical evaluation. These findings pointed out that, despite ambulation being a significant aspect of disability in MS, disease progression can manifest in various other ways beyond mobility issues.