Evidence map›Paper›PMID 41634506›Full record

Observational studyJournal of neurology2026

Effect of late-onset on multiple sclerosis phenotype and outcome: evidence from a multi-national registry.

Amira Souissi, Francesco Patti, Tim Spelman, Clara Chisari, Amina Gargouri, Nevin John, Allan G Kermode, Tomas Kalincik, Helmut Butzkueven, Seyed Aidin Sajedi and 73 more

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

83 authors.

Amira SouissiNeurology Department, LR18SP03 and Clinical Investigation Center Neurosciences and Mental Health, university hospital center Razi-Mannouba, Tunis, Tunisia.
Francesco PattiDepartment of Medical and Surgical and Advanced Technologies, G F Ingrassia, University of Catania, UOS Sclerosi Multipla, AOU Policlinico "G Rodolico-San Marco", University of Catania, Catania, Italy. francesco.patti@unict.it.
Tim SpelmanDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Clara ChisariDepartment of Medical and Surgical and Advanced Technologies, G F Ingrassia, University of Catania, UOS Sclerosi Multipla, AOU Policlinico "G Rodolico-San Marco", University of Catania, Catania, Italy.
Amina GargouriNeurology Department, LR18SP03 and Clinical Investigation Center Neurosciences and Mental Health, university hospital center Razi-Mannouba, Tunis, Tunisia.
Nevin JohnDepartment of Neurology, Monash Health, Clayton, Australia.
Allan G KermodeSir Charles Gairdner Hospital, Perron Institute for Neurological and Translational Science, QEIIMC, University of Western Australia, Nedlands, Australia.
Tomas KalincikDepartment of Neurology, Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia.
Helmut ButzkuevenDepartment of Neurology, The Alfred Hospital, Melbourne, Australia.
Seyed Aidin SajediDepartment of Neuroscience, School of Translational Medicine, Monash University, Melbourne, Australia.
Jeannette Lechner-ScottHunter Medical Research Institute, University Newcastle, Newcastle, Australia.
Izanne RoosDepartment of Neurology, Neuroimmunology Centre, Royal Melbourne Hospital, Melbourne, Australia.
Guy LaureysDepartment of Neurology, Universitary Hospital Ghent, Ghent, Belgium.
Bruce TaylorRoyal Hobart Hospital, Hobart, Australia.
Raed AlroughaniDivision of Neurology, Department of Medicine-Amiri Hospital, Sharq, Kuwait.
Samia J KhouryNehme and Therese Tohme Multiple Sclerosis Center, American University of Beirut Medical Center, Beirut, Lebanon.
Richard MacdonellAustin Health, Melbourne, Australia.
Bianca Weinstock-GuttmanDepartment of Neurology, Jacobs MS Center for Treatment and Research, New York, USA.
Eva Kubala HavrdovaDepartment of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic.
Davide MaimoneCentro Sclerosi Multipla, UOC Neurologia, Azienda Opsedaliera Per L'Emergenza Cannizzaro, Catania, Italy.
Stephen ReddelDepartment of Neurology, Concord Repatriation General Hospital, Sydney, Australia.
Marzena Fabis-PedriniCentre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Australia.
Barbara WillekensDepartment of Neurology, Laboratory of Experimental Hematology, Vaccine & Infectious Disease Institute (VAXINFECTIO)- Translational Neurosciences Research Group, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
Abdorreza Naser MoghadasiMultiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
Patrice LaliveDepartment of Clinical Neurosciences, Division of Neurology, Unit of Neuroimmunology-Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
Alessandra LugaresiDipartimento Di Scienze Biomediche E Neuromotorie, IRCCS Istituto delle Scienze Neurologiche di Bologna, Università di Bologna, Bologna, Italia.
Serkan OzakbasIzmir University of Economics, Medical Point Hospital, Multiple Sclerosis Research Association, Izmir, Turkey.
Claudio SolaroNeurology Unit, Galliera Hospital, Genoa, Italy.
Simón Cárdenas-RobledoHospital Universitario Nacional de Colombia Bogota, Bogotá, Colombia.
Vahid ShaygannejadIsfahan University of Medical Sciences, Isfahan, Iran.
Masoud EtemadifarMS Institute, Isfahan University Of Medical Sciences, Isfahan, Iran.
Cavit BozDepartment of Neurology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey.
Sara EichauDepartment of Neurology, Hospital Universitario Virgen Macarena, Seville, Spain.
Valentina TomassiniUniversity G. d'Annunzio of Chieti-Pescara, Chieti, Italy.
Murat TerziMedical Faculty, Mayis University, Samsun, Turkey.
Alexandre PratCHUM and Universite de Montreal, Montreal, Canada.
Mario HabekDepartment of Neurology, University Hospital Center Zagreb, Zagreb, Croatia.
Yolanda BlancoCenter of Neuroimmunology, Service of Neurology, Hospital Clinic de Barcelona, Barcelona, Spain.
Ayse AltintasDepartment of Neurology, School of Medicine and Koc University Research Center for Translational Medicine (KUTTAM), School of Medicine, Koc University, Istanbul, Turkey.
Oliver GerlachAcademic MS Center Zuyd, Department of Neurology, Zuyderland Medical Center, Sittard-Geleen, Heerlen, Netherlands.
Recai TurkogluDepartment of Neurology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Katherine BuzzardDepartment of Neurosciences, Eastern Health Clinical School, Box Hill Hospital, Monash University, Box Hill, Australia.
Olga SkibinaDepartment of Neurology, Box Hill Hospital, Box Hill, Australia.
Aysun SoysalBakirkoy Education and Research Hospital for Psychiatric and Neurological Diseases, Istanbul, Turkey.
Anneke van der WaltDepartment of Neurology, The Alfred Hospital, Melbourne, Australia.
Stella HughesRoyal Victoria Hospital, Belfast, UK.
Vincent van PeschDepartment of Neurology, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
Matteo FoschiDepartment of Neuroscience, MS Center, Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy.
Andrea SurcinelliDepartment of Neuroscience, MS Center, Neurology Unit, S. Maria Delle Croci Hospital, AUSL Romagna, Ravenna, Italy.
Julie PrevostCSSS Saint-Jérôme, Saint-Jerome, Canada.
Cristina Ramo-TelloDepartment of Neuroscience, Hospital Germans Trias I Pujol, Badalona, Spain.
Chris McGuiganSt Vincent's University Hospital, Dublin, Ireland.
Maria Jose SaDepartment of Neurology, Centro Hospitalar Universitario de Sao Joao, Porto, Portugal.
Jens KuhleDepartment of Neurology, University Hospital and University of Basel, Basel, Switzerland.
Daniele SpitaleriAzienda Ospedaliera Di Rilievo Nazionale San Giuseppe Moscati Avellino, Avellino, Italy.
Bhim SinghalBombay Hospital Institute of Medical Sciences, Mumbai, India.
Radek AmpapaNemocnice Jihlava, Jihlava, Czech Republic.
Koen de GansGroene Hart Ziekenhuis, Gouda, Netherlands.
Thor PetersenAarhus University Hospital, Arhus C, Denmark.
Mihaela SimuUniversity of Medicine and Pharmacy Victor Babes Timisoara, Timisoara, Romania.
Emmanuelle LapointeMedicine, Division of Neurology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Canada.
Jose Luis Sanchez-MenoyoDepartment of Neurology, Usansolo University Hospital, Osakidetza-Basque Health Service, Galdakao, Spain.
Orla GraySouth Eastern HSC Trust, Belfast, UK.
Justin GarberDepartment of Neurology, Westmead Hospital, Sydney, Australia.
Eduardo Aguera-MoralesDepartment of Medicine and Surgery, University of Cordoba, Cordoba, Spain.
Katrin Gross-PajuMultiple Sclerosis Centre, West-Tallinn Central Hospital, Multiple Sclerosis Centre, Tallinn, Estonia.
Tamara Castillo-TriviñoHospital Universitario Donostia and IIS Biodonostia, San Sebastián, Spain.
Abdullah Al-AsmiCollege of Medicine & Health Sciences, Sultan Qaboos University, Al-Khodh, Oman.
Nikolaos GrigoriadisDepartment of Neurology, AHEPA University Hospital, Thessaloniki, Greece.
Jihad InshasiRashid Hospital, Dubai, United Arab Emirates.
Talal Al-HarbiNeurology Department, King Fahad Specialist Hospital-Dammam, Dammam, Saudi Arabia.
Todd A HardyCentre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth, Australia.
Sudarshini RamanathanUniversity of Sydney, Sydney, Australia.
Melissa CambronNeurology, Az Sint-Jan Brugge, Bruges, Belgium.
Neil ShueyVincents Hospital, Fitzroy, Melbourne, Australia.
Angel Perez SempereNeurology Unit, Hospital General Universitario de Alicante, Angel Perez Sempere, Alicante, Spain.
Tunde CsepanyDepartment of Neurology, Faculty of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary.
Irene Treviño-FrenkDepartment of Neurology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Csilla RozsaJahn Ferenc Teaching Hospital, Budapest, Hungary.
Marija CauchiNeurosciences Department, Mater Dei Hospital, Birkirkara, Malta.
Rana KarabudakDepartment of Neurological Sciences, Faculty of Medicine, Clinical Neuroimmunology & MS Unit, Koşuyolu Hospital, Yeditepe University, Istanbul, Turkey.
Saloua MrabetNeurology Department, LR18SP03 and Clinical Investigation Center Neurosciences and Mental Health, university hospital center Razi-Mannouba, Tunis, Tunisia.
Riadh GouiderNeurology Department, LR18SP03 and Clinical Investigation Center Neurosciences and Mental Health, university hospital center Razi-Mannouba, Tunis, Tunisia. riadh.gouider@gnet.tn.ORCID http://orcid.org/0000-0001-9615-3797

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple Sclerosis (MS) severity is influenced by several factors. Understanding the impact of age at disease onset may help to better characterize clinical and disease features across age groups. This study aimed to characterize the clinical features and disability outcomes of late-onset MS (LOMS) and very late-onset MS (vLOMS), compared to adult-onset MS (AOMS).

methodsWe conducted an observational study using data from the MSBase registry and categorized patients based on age at MS onset: AOMS (18-39 years), transition onset (40-49 years), LOMS (50-59 years), and vLOMS (≥ 60 years). Disease progression was assessed using the 24 week confirmed disability progression, EDSS4 and 6 milestones, conversion to secondary progressive MS(SPMS), and the first progression independent of relapse activity (PIRA) event. Cox proportional hazard regression models were used to determine unadjusted hazard ratios(HR), and propensity score inverse probability of treatment weighting(PS-IPTW) balanced covariate distributions.

resultsAmong 81,236 patients, 5.2% had LOMS and 1% had vLOMS. Primary progressive MS was more frequent in LOMS and vLOMS (21.7 and 24%, respectively). Patients with LOMS and vLOMS had a significantly increased risk of 24 week confirmed disability progression (HR:LOMS = 1.39, vLOMS = 1.80), EDSS 4 (HR:LOMS = 2.14, vLOMS = 2.95), EDSS 6 (HR:LOMS = 2.33, vLOMS = 6.33), SPMS (HR:LOMS = 1.62, vLOMS = 2.38), and first PIRA event (HR:LOMS = 2.12, vLOMS = 2.93).

conclusionLOMS and vLOMS exhibited a more progressive disease onset and higher disability milestones compared with AOMS.

Indexed as

Multiple SclerosisRegistriesAdolescentAdultAge of OnsetDisease ProgressionFemaleHumansMaleMiddle AgedPhenotypeYoung AdultAgingImmunosenescenceMultiple SclerosisPrognosisProgression

Identifiers

PMID41634506

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.