Formation of beneficial and pathological neuroplasticity depending on the nature of the prognosis in different types of the course in patients with sporadic and familial forms of multiple sclerosis

Abstract

The purpose of the study: is to assess the influence of the nature of the prognosis on the formation of beneficial and pathological neuroplasticity, taking into account the type of course in sporadic and familial forms of multiple sclerosis (MS). Research methods: by questionnaire and neurological examination in 84 patients, the analysis of clinical parameters occurring at different time stages in relapsing MS (RMS) and secondary-progressive MS (SPMS) (debut, relapsing stage (RS) in RMS and SPMS, progression stage in SPMS) in sporadic (54 patients) and fa- milial (30 patients) forms of multiple sclerosis (MS) was carried out. The nature of the prognosis (favourable for RMS — 38 patients; unfavourable for SPMS — 46 patients) was evaluated based on previously developed clinical diagnostic criteria using mathematical analysis. To study the mechanisms of formation of beneficial and pathological neuroplasticity on the models of different prognosis variants (favourable and unfavourable), the frequency of clinical indicators for the two forms of the disease was analyzed. With a favourable prognosis of RMS, mild debuts in sporadic and moderate debuts in familial forms significantly (p < 0.05) prevail. A tendency to predominance (p > 0.05) was obtained for monosyndromic debuts in sporadic and short oligosyndromic debuts in combination with an alternation of mild and mod- erate relapses in familial forms. For the unfavourable prognosis of SPMS, the steady variant of progression in the familial form significantly prevails. A tendency to predominance was found for polysyndromic debut of moderate severity in sporadic and short remission after debuting in combination with an alternation of severe and mild relapses in familial forms of RS. The data obtained indicate a less benign course of the familial form compared to the sporadic form due to the predominance of some clinical parameters with important prognostic value. The formation of alternative variants of prognosis (favourable in RMS and unfavourable in SPMS) oc- curs by selective involvement in a single pattern of clinical indicators at each time stage of the disease. The overwhelming majority of “different sets” of clinical parameters in sporadic and familial forms of MS indicates the differential involvement of beneficial neuroplasticity mechanisms for a favourable prognosis in RMS and pathological neuroplasticity for an unfavourable prognosis in SPMS.