{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:15:41Z","timestamp":1790306141761,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T00:00:00Z","timestamp":1491436800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"MSBase Fellowship 2015"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Several natural history studies on primary progressive multiple sclerosis (PPMS) patients detected a consistent heterogeneity in the rate of disability accumulation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To identify subgroups of PPMS patients with similar longitudinal trajectories of Expanded Disability Status Scale (EDSS) over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>All PPMS patients collected within the MSBase registry, who had their first EDSS assessment within 5 years from onset, were included in the analysis. Longitudinal EDSS scores were modeled by a latent class mixed model (LCMM), using a nonlinear function of time from onset. LCMM is an advanced statistical approach that models heterogeneity between patients by classifying them into unobserved groups showing similar characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 853 PPMS (51.7% females) from 24 countries with a mean age at onset of 42.4 years (standard deviation (SD): 10.8 years), a median baseline EDSS of 4 (interquartile range (IQR): 2.5\u20135.5), and 2.4 years of disease duration (SD: 1.5 years) were included. LCMM detected three different subgroups of patients with a mild ( n = 143; 16.8%), moderate ( n = 378; 44.3%), or severe ( n = 332; 38.9%) disability trajectory. The probability of reaching EDSS 6 at 10 years was 0%, 46.4%, and 81.9% respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Applying an LCMM modeling approach to long-term EDSS data, it is possible to identify groups of PPMS patients with different prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458517703800","type":"journal-article","created":{"date-parts":[[2017,4,6]],"date-time":"2017-04-06T05:08:06Z","timestamp":1491455286000},"page":"642-652","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":40,"title":["Long-term disability trajectories in primary progressive MS patients: A latent class growth analysis"],"prefix":"10.1177","volume":"24","author":[{"given":"Alessio","family":"Signori","sequence":"first","affiliation":[{"name":"Department of Health Sciences (DISSAL), Section of Biostatistics, University of Genoa, Genova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillermo","family":"Izquierdo","sequence":"additional","affiliation":[{"name":"Hospital Universitario Virgen Macarena, Sevilla, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Lugaresi","sequence":"additional","affiliation":[{"name":"Department of Biomedical and Neuromotor Sciences(DIBINEM), Alma Mater Studiorum, University of Bologna, Italy\/IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Hupperts","sequence":"additional","affiliation":[{"name":"Zuyderland Ziekenhuis, Sittard, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Grand\u2019Maison","sequence":"additional","affiliation":[{"name":"Clinique Neuro Rive-Sud, Greenfield Park, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Sola","sequence":"additional","affiliation":[{"name":"Nuovo Ospedale Civile S. Agostino-Estense, Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Horakova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Havrdova","sequence":"additional","affiliation":[{"name":"Department of Neurology and Center of Clinical Neuroscience, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Prat","sequence":"additional","affiliation":[{"name":"H\u00f4pital Notre-Dame, Montreal, QC, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Girard","sequence":"additional","affiliation":[{"name":"H\u00f4pital 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