02. The Role of Early Diagnosis in Multiple Sclerosis Disease Trajectories: A Multidimensional Analysis of Clinical and MRI Outcomes

Multiple Sclerosis (MS) is a chronic inflammatory and demyelinating disease that affects the central nervous system (CNS) and is known to be more prevalent in women than in men. MS activity and progression are often monitored through clinical evaluations, such as the Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC), which includes Timed 25-Foot Walk, 9-Hole Peg Test, and PASAT scores, and magnetic resonance imaging (MRI), which can identify new and/or contrast-enhancing lesions.
The timing of diagnosis and treatment may influence the course of the disease and the severity of both MRI findings and clinical outcomes. Recent studies have shown that disease-modifying therapies are more effective when initiated early in the disease course. In patients who have only had one attack of neurological symptoms consistent with MS, the initiation of DMT right after the attack has been found to delay its conversion to Clinically Definite Multiple Sclerosis (CDMS). A disconnect between the clinical symptoms and MRI findings can occur, highlighting the limitations of relying solely on MRIs to monitor the disease.
Motivated by the heterogeneity and multifactoriality of MS, this study uses hierarchical mixed-effects models applied to a large clinical trial cohort from CombiRx to assess the relationship between the timing of MS diagnosis and disease trajectory based on multiple functional outcomes used to assess the MSFC scores. Additionally, we evaluate the association between the timing of MS diagnosis and the evolution of MRI-based markers of disease activity, based on joint modeling of the components of the MSFC Z4 composite score. Finally, we explore the impact of diagnosis timing on overall disease burden, including relapse rate and persistent functional decline related to disease progression.

Multiple Sclerosis

Mixed-Effects Models

Multivariate Approach

Chronic Disease

Clinical Outcomes


MRI-Based Outcomes 

Mid-Level

Knowledge

Women in Statistics and Data Science 2025