Relapsing-remitting multiple sclerosis: cognitive functioning and subjective quality of life in patients before and after percutaneous transluminal angioplasty


The uncertainties of the actual etiological basis of multiple sclerosis make it difficult to reach a conclusive statement about the optimal therapeutic management of the disease, which may differ depending on the given case and phase of illness. This has led to an interest in potential novel therapeutic avenues, including percutaneous transluminal angioplasty ( PTA ).
Evidence in support of PTA in the management of multiple sclerosis is scarce and contradictory.

The aim of the study was to provide a preliminary assessment as to whether PTA may impact subjective quality of life and cognitive functioning in severe multiple sclerosis.

Ninety-five multiple sclerosis outpatients were followed-up for 24 months on a scheduled basis using the Milan Overall Dementia Assessment and the short-form 36-item scales, and were clinically evaluated by an appointed neurologist and psychiatrist.

At end point ( month 24 ), only a minority of patients were still active in the study ( n=33 or 34.74% ). Among other measures, those who remained in the study until completion showed a significantly better Expanded Disability Status Scale ( EDSS ) and Milan Overall Dementia Assessment autonomy profile at study entrance compared to those patients who did not remain in the study until completion.

Limitations were: a lack of any active control group; small sample size; Berkson’s bias; and selection by indication biases.

In conclusion, given the burden of multiple sclerosis and its high attrition rate, additional studies, including bigger samples, active control groups, and Cox’s regression and survival analysis in case of randomization, should shed further light on the actual usefulness of PTA for the most severe cases of multiple sclerosis. ( Xagena )

De Pasquale C et al, Neuropsychiatric Disease and Treatment, 2014;10: 1039–1044

XagenaMedicine_2014



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