Disease Duration In Group Research Articles

Effect of disease duration on the use of tofacitinib: a real-world study in elderly patients with rheumatoid arthritis.

This study aims to test the hypothesis that disease duration may affect the response to generic tofacitinib (TOF) and investigate the influence of concomitant medications with TOF on elderly rheumatoid arthritis (RA). This study retrospectively collected 76 elderly patients (age > 60) treated with TOF from 2019 to 2023 and grouped them according to age of disease onset. Data were collected from baseline to the last follow-up visit within 24months. The demographic characteristics and follow-up results were compared. TOF retention and the effect of concomitant drugs (methotrexate, MTX, prednisone) were analyzed using Kaplan-Meier plots and COX regression analysis. Canonical correlation analysis (CCA) was used to explore the correlation among demographic characteristics, medication regimen, and improved clinical outcomes. There was no significant difference in the proportion of patients achieving low disease activity (LDA) between different disease duration groups. Patients in the group of MTX had a shorter time of using TOF in follow-up (log-rank p = 0.041). Prednisone dosage at baseline had a predictive value for functionally disabled situation. We found significant associations between discontinuation of TOF in the last follow-up and getting LDA. A total result of CCA yielded a significant positive correlation with set 1 (demographic characteristics and medication regimen) and set 2 (improved clinical outcomes) (canonical coefficient = 0.887, p < 0.001). Disease duration may not affect response to generic TOF and medication regimen was the factor related to efficacy of generic TOF in elderly RA in the real world. Demographic characteristics and medication regimen were correlated positively with improved clinical outcomes. Key Points • There is scarce data from the western area of China regarding the use of tofacitinib in elderly rheumatoid arthritis patients, despite widespread use. • In this retrospective analysis of 76 elderly patients at a single center, we found disease duration may not affect response to generic TOF. • Concomitant MTX might contribute to better control of the disease activity. • Concomitant prednisone dosage at baseline was the independent risk factor for functionally disabled situation.

Aging is associated with reduced inflammatory disease activity independent of disease duration in relapsing multiple sclerosis trial populations

Background: Higher age is associated with less inflammatory disease activity in relapsing-remitting multiple sclerosis (RRMS). It is unknown whether age itself or disease duration underlies this association. Objectives: This study investigated the effects of age, disease duration, and inflammatory disease activity in people with RRMS. Methods: Individual patient-level data from five large phase III randomized controlled trials (RCTs) was utilized to investigate the association of both age and disease duration with annualized relapse rate (ARR), contrast-enhancing lesions (CELs), and new T2 lesions on magnetic resonance imaging (MRI) at baseline and follow-up. Results: The data set included 5626 participants. Higher age was associated with lower ARRs, lower CEL number on MRI at baseline and follow-up, and lower new T2 lesion numbers at follow-up. This effect was present in all disease duration groups. For example, we found a lower number of new T2 lesions on MRI during follow-up in higher age groups compared to lower age groups, independent of disease duration. Conclusion: Aging in RRMS is associated with a lower risk of inflammatory disease activity, across different disease durations. Age should be taken into account when designing clinical trials and future research should investigate how age should be integrated into personalized predictions of treatment response and risk profiling.

Morphological characteristics of the cubital tunnel as indication for anterior interosseous nerve supercharge end-to-side transfer in treating advanced cubital tunnel syndrome

BackgroundCubital tunnel syndrome (CuTS) is a prevalent compressive neuropathy addressed through various treatments, including the anterior interosseous nerve (AIN) supercharge end-to-side (SETS) transfer for advanced CuTS. Decision to add AIN-SETS is based on various indicators and protocols, but deciding on the appropriate method for borderline cases can be challenging. Therefore, this study aims to non-invasively examine the cubital tunnel anatomy of patients using CT scans and compare the findings with existing indicators and measurements, to determine if they can serve as supplementary indicators to aid in treatment decisions. HypothesisThe bony cubital tunnel volume is correlated to other traditional indicators and can be used as an additional indication for deciding whether to perform AIN-SETS in treating advanced CuTS. Patients and MethodsThis is a single-center retrospective cohort study from South Korea, including 91 patients aged 20–70 years with CuTS. Participants were classified into Group A (n = 43), who underwent both cubital tunnel release (CuTR) and AIN-SETS, and Group B (n = 48), who underwent only CuTR. Preoperative elbow CT data were analyzed for cubital tunnel morphology analysis, with follow-up assessments such as grip strength and electromyography/ nerve conduction velocity (EMG/NCV) tests at 3, 6, and 12 months postoperatively. ResultsGroup A and B showed no significant differences in demographic parameters, except for a longer disease duration in Group A (p = 0.032). Group A had a smaller cubital tunnel volume (CTV) compared to Group B (1150.6 ± 52.8 mm3 vs. 1173.5 ± 56.2 mm3, p = 0.014) and a smaller cross-sectional area (40.9 ± 10.2 mm2 vs. 45.1 ± 11.7 mm2, p = 0.033). Pearson correlation analysis revealed statistically significant positive correlations between CTV measurements and pre-operative grip strength, as well as EMG results, a key indicator for AIN-SETS (R2 = 0.48, 0.23, p = 0.01). DiscussionMeasuring the cubital tunnel anatomy using CT can aid in determining the treatment approach for advanced CuTS patients and assist in deciding whether to perform AIN-SETS surgery, serving as a supplementary indicator for cases at the borderline limits of other indicators. Future research may be necessary to establish control groups without symptoms and determine appropriate cut-off values. Level of evidenceIV.

Dyslipidemia in cohorts of rheumatoid arthritis presented at Independent University Hospital Faisalabad.

Objective: To determine the frequency of dyslipidemia in RA patients and its association with different factors i.e., age, gender, disease duration and disease score. Study Design: Cross Sectional study. Setting: Independent University Hospital Faisalabad. Period: January 2022 to December 2023. Methods: 200 consecutive RA patients fulfilling inclusion and exclusion criteria, of either sex between age of 20 and 60 years were enrolled. The selection technique was non-probability convenient in this study. Frequency of dyslipidemia was assessed by the National Education Cholesterol Program 2004. The Chi square test was used to compare the frequency of dyslipidemia among different disease scores, different disease duration groups, age groups and gender. A p-valve of &lt; 0.05 was considered statistically significant. Results: The frequency of dyslipidemia in RA patients was assessed. It was more common in female gender and age group of 36-50 years and of moderate disease score, also negative association of dyslipidemia was found when compared with different gender groups. Conclusion: Dyslipidemia, which is an important risk factor for CV diseases, was more prevalent in RA patients. High disease activity and more chronic disease are important association factors in dyslipidemia in RA patients.

Comparative Effectiveness of the Oral versus Topical Ofloxacin to Reduce the Discharge in Chronic Suppurative Otitis Media: A Randomized Control Trial

Objective: The objective of the study was to assess the reduction rate of discharge in chronic suppurative otitis media with the use of oral vs topical Ofloxacin. Methodology: It was a randomized control trial conducted in the Department of Otorhinolaryngology Head and Neck surgery PIMS Islamabad from 26-06-2019 to 26-12-2019. The study was commenced with the approval from the ERB (Ethical Review Board). Non-probability consecutive sampling technique was used. Sample size was calculated using WHO calculator which was 98 with 49 patients in each group A &amp; B. Participants of group A received topical Ofloxacin whereas, in group B received oral/systemic Ofloxacin. Efficacy of oral and topical drug was compared after two weeks of the start of the treatment. Data analysis was done using SPSS version 23. Results: According to gender distribution, there were 67.3% (n=33) males and 32.7% (n=16) were females in group A whereas, there were 61.2% (n=30) males and 38.8% (n=19) were females in group B. The mean age of the participants of group A was recorded as 27.0 years ± 9.4 and 26.6 years ± 10.1 in group B. Mean disease duration in group A was recorded as 2.6 years ± 2.1 and 2.4 years ± 1.9 in group B. A pus discharge was recorded in 73.5% (n=36) patients, pus and blood stained discharge in 26.5%, (n=12), 89.8% (n=44) had redness and 12.2% (n=6) had edema on examination. The values for group B were 95.9% (n=47), 4.1% (n=2), 46.9% (n=23) and 6.1% (n=3), respectively. After two weeks treatment, the outcomes were considerably enhanced in patients treated with topical ofloxacin in comparison to those treated with oral ofloxacin (p&lt;0.05 across all groups). Conclusion: Topical ofloxacin is a better agent as compared to orally available in resumption of discharge in CSOM. More, multicenter studies with an enlarged sample size are suggested to strengthen the evidence.

Comparison of mid-term effectiveness between diabetic secondary stiff shoulder and primary frozen shoulder after arthroscopic shoulder capsular release combined with acromiohumeral distance restoration

To compare the mid-term effectiveness of arthroscopic shoulder capsular release combined with acromiohumeral distance (AHD) restoration in the treatment of diabetic secondary stiff shoulder and primary frozen shoulder. A retrospective analysis was conducted on clinical data of 22 patients with diabetic secondary stiff shoulder (group A) and 33 patients with primary frozen shoulder (group B), who underwent arthroscopic 270° capsular release combined with AHD restoration treatment. There was no significant difference between the two groups in gender, age, affected side, disease duration, and preoperative AHD, shoulder flexion range of motion, abduction range of motion, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS) score, and Constant score ( P>0.05). Only the difference in the internal rotation cone rank and external rotation range of motion between the two groups showed significant differences ( P<0.05). The improvement in shoulder pain and function was evaluated by using VAS score, ASES score, and Constant score before operation and at last follow-up. Active flexion, abduction, external rotation range of motion, and internal rotation cone rank were recorded and compared. AHD was measured on X-ray films. All patients were followed up 24-92 months (median, 57 months). There was no significant difference in follow-up time between group A and group B ( P>0.05). No fractures or glenoid labrum tears occurred during operation, all incisions healed by first intention, and no complication such as wound infection or nerve injury was observed during the follow-up. At last follow-up, there were significant improvements in active flexion, abduction, external rotation range of motion, internal rotation cone rank, AHD, VAS score, ASES score, and Constant score when compared with preoperative ones in both groups ( P<0.05). Except for the difference in change in external rotation range of motion, which had significant difference between the two groups ( P<0.05), there was no significant difference in other indicators between the two groups ( P>0.05). Arthroscopic capsular release combined with AHD restoration can achieve good mid-term effectiveness in the treatment of diabetic secondary stiff shoulder and primary frozen shoulder. However, the improvement in external rotation range of motion is more significant in the patients with diabetic secondary stiff shoulder.

A person-centered approach to characterizing longitudinal ambulatory impairment in Parkinson's disease

Loss of ambulation is common and highly variable in Parkinson’s disease (PD), and poorly understood from the perspectives of those with PD. Gaining insights to the anticipated perceived trajectories and their drivers, will facilitate patient-centered care. Latent class growth analysis, a person-centered mixture modelling approach, was applied to 16,863 people with PD stratified by early (N = 8612; < 3 years), mid (N = 6181; 3–10 years) and later (N = 2070; > 10 years) disease to discern clusters with similar longitudinal patterns of self-reported walking difficulty, measured by EuroQoL 5D-5L that is validated for use in PD. There were four clusters in early and mid-disease strata, with a fifth identified in later disease. Trajectories ranged from none to moderate walking difficulty, with small clusters with severe problems. The percentage of subjects with moderate (early = 17.5%, mid = 26.4%, later = 32.5%) and severe (early = 3.8%, mid = 7.4%, later = 15.4%) walking difficulty at baseline increased across disease duration groups. The trajectories tended to be stable with variability in moderate and severe groups. Across strata, clusters with moderate to severe problems were associated with more severe impairment, depression, anxiety, arthritis, higher BMI, lower income, and lower education, but no consistent race or gender differences. The findings reveal distinct longitudinal patterns in perceived difficulties in walking in PD.

Comparing ECIRS with MPCNL for Complex Renal Calculi: A Retrospective Single-Centre Study on Efficacy and Safety.

Kidney stones, a common urinary system ailment, often necessitate surgical intervention. Endoscopic combined intrarenal surgery (ECIRS) and multi-channel percutaneous nephron lithotripsy (MPCNL) are key modalities for treating complex renal stones, prompting the need for a comparative analysis to enhance clinical decision-making. Patients undergoing surgical treatment for complex kidney stones from April 2018 to April 2022 were divided into the control (MPCNL) and observation (ECIRS) groups. Propensity score matching was used to balance baseline data, and t-tests and chi-square tests were employed to compare the perioperative indicators between the two groups. A total of 210 patients were enrolled in this study for pre-observational comparison, and they were divided into the control group (110 patients) and observation group (100 patients). Following matching, each group comprised 85 patients. Pre-observational comparison revealed significant differences between the groups in age, disease duration, and stone diameter (p < 0.05). However, after matching, baseline data comparison showed no statistically significant differences (p > 0.05). Surgery-related parameters, including operation time, intraoperative blood loss, postoperative activity duration and hospital stay, did not significantly differ between the groups (p > 0.05). The observation group exhibited a significantly higher stone retention-free rate after initial treatment compared with the control group (p < 0.05), although overall stone clearance rates did not significantly differ between the groups (p > 0.05). We found no significant differences in perioperative complications between the two groups (p > 0.05). Moreover, the observation group experienced significantly lower postoperative pain levels at 6, 24 and 48 h compared with the control group (p < 0.001). Conclusively, ECIRS and MPCNL are viable options for treating complex renal calculi, with similar operation times, complication rates and stone clearance rates. ECIRS may offer advantages including lower postoperative pain and higher initial stone clearance rates than MPCNL. However, large-scale studies with long follow-up times are needed for validation.

Disease Duration Affects the Clinical Phenotype of Primary Sjögren Syndrome: A Medical Records Review Study of 952 Cases.

To investigate the impact of disease duration on clinical phenotypes in Chinese patients with primary Sjögren syndrome (pSS) and examine the correlation between clinical phenotypes and onset age, age at diagnosis, and disease duration. Data from 952 patients diagnosed with pSS in China between January 2013 and March 2022 were analyzed based on medical records. Patients were categorized into 3 groups based on disease duration: short (<5 years), moderate (≥5 and <10 years), and long (≥10 years) group. Clinical characteristics were compared among the 3 groups, and pSS patients with a long disease duration were compared with the other patients after matching age at diagnosis and age at onset. Among the patients, 20.4% had a disease duration over 10 years. After matching for age at onset and age at diagnosis, pSS patients with a long disease duration exhibited a significantly higher prevalence of dry mouth ( p <0.001), dry eyes ( p <0.001), fatigue ( p <0.001), arthralgia ( p <0.001), and dental caries ( p <0.001) and higher rates of anti-Sjögren syndrome A ( p < 0.05), anti-Ro52 ( p < 0.05), and anti-SSB ( p < 0.05) positivity than their control groups, with prevalence increasing with disease duration ( ptrend < 0.001). However, no differences were noted in the prevalence of interstitial lung disease and leukopenia between different disease duration groups after matching for age at onset, although differences were shown when matching for age at diagnosis. Longer disease duration in pSS patients correlates with increased prevalence of sicca symptoms, fatigue, and arthralgia and higher positivity of autoantibodies associated with pSS. However, the prevalence of interstitial lung disease and leukopenia did not correlate with disease duration after matching for age at onset.

22 Cognitive Reserve's Relationship to Brain Burden in Parkinson's Disease Without Dementia

Objective:Individuals with Parkinson's disease (PD) have varying trajectories of cognitive decline. One reason for this heterogeneity may be "cognitive reserve": where higher education/IQ/current mental engagement compensates for increasing brain burden (Stern et al., 2020). With few exceptions, most studies examining cognitive reserve in PD fail to include brain metrics. This study's goal was to examine whether cognitive reserve moderated the relationship between neuroimaging indices of brain burden (diffusion free water fraction and T2-weighted white matter changes) and two commonly impaired domains in PD: executive function and memory. We hypothesized cognitive reserve would mitigate the relationship between higher brain burden and worse cognitive performance.Participants and Methods:Participants included 108 individuals with PD without dementia (age mean=67.9±6.3, education mean=16.6±2.5) who were prospectively recruited for two NIH-funded projects at the University of Florida. All received neuropsychological measures of executive function (Trails B, Stroop, Letter Fluency) and memory (delayed recall: Hopkin's Verbal Learning Test-Revised, WMS-III Logical Memory). Domain specific z-score composites were created using data from age/education matched non-PD peer controls (N=62). For the Cognitive Reserve (CR) proxy, a z-score composite included years of education, WASI-II Vocabulary, and Wechsler Test of Adult Reading. At the time of testing, participants completed multiple MRI scans (T1-weighted, diffusion, Fluid Attenuated Inversion Recovery) from which the following were extracted: 1) whole-brain free water within the white matter (a measure of microstructural integrity and neuroinflammation), 2) white matter hyperintensities/white matter total volume (WMH/WMV), and bilaterally-averaged edge weights of white matter connectivity between 3) dorsolateral prefrontal cortex and caudate and 4) entorhinal cortex and hippocampi. Separate linear regressions for each brain metric used executive function and memory composites as dependent variables; predictors were age, CR proxy, respective brain metric, and a residual centered interaction term (brain metric*CR proxy). Identical models were run in dichotomized short and long disease duration groups (median split=6 years).Results:In all models, a lower CR proxy significantly predicted worse executive function (WMH/WMV: beta=0.49, free water: beta=0.54, frontal edge weight: beta=0.49, p's&lt;0.001) and memory (WMH/WMV: beta=0.42, free water: beta=0.35, temporal edge weight: beta=0.39, p's &lt;0.01). For neuroimaging metrics, higher free water significantly predicted worse executive function (beta=-0.39, p=0.002) but not memory. No other brain metrics were significant predictors of either domain. Accounting for PD duration, higher free water predicted worse executive function for those with both short (beta=-0.49, p=0.04) and long disease duration (beta=-0.48, p=0.02). Specifically in those with long disease duration, higher free water (beta=-0.57 p=0.02) and lower edge weights between entorhinal cortex and hippocampi (beta=0.30, p=0.03) predicted worse memory. Overall, no models contained significant interactions between the CR proxy and any brain metric.Conclusions:Results replicate previous work showing that a cognitive reserve proxy relates to cognition. However, cognitive reserve did not moderate brain burden's relationship to cognition. Across the sample, greater neuroinflammation was associated with worse executive function. For those with longer disease duration, higher neuroinflammation and lower medial temporal white matter connectivity related to worse memory. Future work should examine other brain burden metrics to determine whether/how cognitive reserve influences the cognitive trajectory of PD.

What is the role of sensitization in carpal tunnel syndrome where pain impacts functional capacity?

Aims: Expression of carpal tunnel syndrome (CTS) caused by the entrapped median nerve includes pain, paraesthesia and numbness. Extra median spread of pain can furthermore be seen as a clinical requirement defined by neuro inflammation. Central sensitization (CS) constructs a similar mechanism. This study aims to evaluate sensitization in patients diagnosed with CTS.&#x0D; Methods: A total number of 152 patients diagnosed with CTS were evaluated, prospectively. Patients data such as gender, age, body mass index (BMI), disease duration, pain severity (NRS), painDETECT questionnaire, Boston CTS symptom severity scale (SSS) and functional status scale (FSS), CS scale, electroneuromyography results have been collected by the author and then the patients are divided into three groups.&#x0D; Results: Regarding the age, BMI and CS rate, there was no statistical difference between the three patient groups (p&gt;0.05). However, a statistically significant difference was found between these groups in disease duration, day-time and night-time NRS, Boston SSS, FSS, and pain DETECT scores (p0.05). Yet, statistically significant differences were found in a comparison of the patients with and without CS, in disease duration, NRS night scores, and painDETECT scores (p

Non-linear relationship between serum osteocalcin and diabetic retinopathy in postmenopausal women with type 2 diabetes mellitus

BackgroundType 2 diabetes mellitus (T2DM) is associated with diabetic retinopathy (DR), but effective interventions are lacking. The relationship between osteocalcin (OC) and DR in postmenopausal women with T2DM is understudied. Methods: This study examined 950 postmenopausal women with T2DM (T2DR group: n = 299; T2DM group: n = 651). Results:Significant differences (p < 0.05) were observed between the groups in disease duration, age, gender, body mass index (BMI), glycated haemoglobin (HbA1c), low-density lipoprotein (LDL-C), parathyroid hormone (PTH), total type I collagen amino acid-prolonging peptide (TPINP), OC, and 25 hydroxyvitamin D (25(OH)D3). Logistic regression revealed associations of LDL-C, PTH, and 25(OH)D3 with DR. A non-linear relationship (p < 0.05) between OC and DR was found. The lowest DR risk occurred at OC levels of 15.0–25.3 ng/ml (OR, 0.66; 95 % CI, 0.44, 0.98) compared to 11.1–15.0 ng/ml. Risk remained unchanged below 11.1 ng/ml or above 25.3 ng/ml. Conclusion: In conclusion, among postmenopausal women with T2DM, OC levels showed a non-linear relationship with DR. Optimal OC levels (15.0–25.3 ng/ml) were associated with minimal DR occurrence, while risk was constant below 11.1 ng/ml or above 25.3 ng/ml. Maintaining optimal OC levels may reduce DR risk in this population.

Leveraging patient-reported outcomes to discern mobility trajectories in Parkinson’s disease (P10-11.003)

<h3>Objective:</h3> To characterize subgroups of persons with Parkinson’s disease (PWP) with similar longitudinal mobility impairment patterns based on an easy-to-use patient-reported outcome (PRO) measure. <h3>Background:</h3> Mobility impairments are common, complex symptoms experienced by PWP. The underlying mechanisms and accrual patterns are not well understood, which impedes therapeutic shared-decision making. <h3>Design/Methods:</h3> Latent class growth analysis (LCGA) uses finite mixture models to estimate discrete groups of trajectory parameters using maximum likelihoods. Using longitudinal data available through Fox Insight Data Exploration Network, LCGA was applied to 16,863 PWP stratified by early (N=8612; &lt;3 years), mid (N=6181; 3–10 years) and later (N=2070; &gt;10 years) disease duration spanning ~4.5 years, to empirically discern clusters of PWP with similar longitudinal mobility impairment patterns. Mobility impairment was measured using a generic health-related quality of life tool that has shown construct validity in PWP (EuroQol 5 dimensions [EQ-5D-5L] mobility component). Associations were evaluated between latent trajectory classes and sociodemographic/clinical factors. <h3>Results:</h3> In the early and mid-disease duration strata, four clusters were identified, while a fifth cluster was identified in the later disease duration strata. The subgroup trajectories ranged from none to moderate mobility problems, with a smaller cluster of subjects with severe mobility problems. The percentage of subjects with moderate (early=17.5%, mid=26.4%, later=32.5%) and severe (early=3.8%, mid=7.4%, later=15.4%) mobility problems at baseline increased across disease duration groups. The trajectories tended to be variable or slightly worsening in the early and later duration group and more stable in the mid-duration group. Across strata, the clusters with moderate to severe mobility problems were associated with more severe impairment, depression, anxiety and arthritis, higher BMI, lower income, and lower education. There were no differences by race. <h3>Conclusions:</h3> The approach described and applied to PWP provides a novel template for using a easy-to-use PRO to improve our understanding of mobility trajectories in Parkinson’s disease. <b>Disclosure:</b> Doug Gunzler has nothing to disclose. Dr. Gunzler has received research support from NIH/NINDS. The institution of Dr. Gunzler has received research support from Biogen. The institution of Dr. Gunzler has received research support from Amneal. Dr. Gunzler has received research support from Michael J Fox Foundation. The institution of Prof. Briggs has received research support from NIH. The institution of Prof. Briggs has received research support from Michael J. Fox Foundation.

Shorter disease duration in females with sporadic frontotemporal dementia

AbstractBackgroundPrevious reported sex differences on disease duration (DD) of frontotemporal dementia (FTD) have been inconsistent and lack the comparison between genetic and sporadic FTD. Our aim was to study the difference in disease duration between males and females in genetic and sporadic FTD.MethodMortality data was obtained from 61 deceased patients with genetic FTD (52% male) and 117 deceased patients with sporadic FTD (64% male) from the international FTD cohort previously reported by de Boer et al., 2021. The age at symptom onset (AAO), age at death (AAD) and the DD (defined as the time between age at symptom onset and age at death) were compared between males and females in the genetic and sporadic FTD group using Mann Whitney U tests.ResultGenetic FTD did not show significant sex differences in AAO, AAD and DD (p = 0.3, p = 0.3, p = 0.8 respectively, Figure 1). In sporadic FTD, the AAO and AAD did not significantly differ between males and females (p = 0.8 and p = 0.2 respectively). The DD in the sporadic FTD group was significantly shorter in females (median DD 7.0 years) in comparison to males (median DD 8.0 years, p = 0.01, Figure 2).ConclusionIn this study we show that females with sporadic FTD have a shorter disease duration than males whereas in genetic FTD the disease duration does not differ between sex. These findings suggest the existence of sex‐related differences in the disease course of sporadic FTD. We urge the need for international epidemiological FTD studies to further explore the role of sex in both genetic and sporadic FTD.

Heterogeneous pain trajectories in persons with Parkinson's disease

IntroductionPain is a common and complex symptom in Parkinson's disease. The underlying mechanisms and longitudinal patterns are not well understood, which impedes therapeutic decision making. The objectives of this study were to characterize longitudinal pain trajectories, identify clusters (subgroups) with similar patterns, and examine associations with sociodemographic and clinical characteristics. MethodsLatent class growth analysis was applied to 16,863 people with Parkinson's disease stratified by early (N = 8612; <3 years), mid (N = 6181; 3–10 years) and later (N = 2070; >10 years) disease duration over ∼4.5 years (2017–2021) using the Fox Insight Data Exploration Network, to discern clusters of individuals with similar longitudinal patterns of self-reported pain. Associations were evaluated between cluster membership and sociodemographic and clinical factors. ResultsAcross the disease duration strata, five clusters were identified. The clusters ranged from none to moderate pain, with a small cluster of subjects with severe pain. The percentage of subjects with moderate (early = 17.3%, mid = 24.2%, later = 34.4%) and severe (early = 2.3%, mid = 4.4%, later = 6.5%) pain at baseline increased across disease duration groups. The trajectories tended to be variable or slightly worsening in the early duration group, more stable in the mid duration group, and improving in the later duration group. Across strata, the clusters with moderate to severe pain were associated with more severe impairment, depression, anxiety and arthritis, higher body mass index, lower income, and lower education. ConclusionThis latent class growth analysis, applied to people with Parkinson's disease, provides a template for using self-reported outcomes to improve our understanding of pain trajectories.

The co-activation patterns of multiple brain regions in Juvenile Myoclonic Epilepsy.

Juvenile myoclonic epilepsy (JME) as an idiopathic generalized epilepsy has been studied by many advanced neuroimaging techniques to elucidate its neuroanatomical basis and pathophysiological mechanisms. In this paper, we used co-activation patterns (CAPs) to explore the differences of dynamic brain activity changes in resting state between JME patients and healthy controls. 27 cases JME patients and 27 cases healthy of fMRI data were collected. The structural image data of the subjects were analyzed by voxel-based morphological analysis, and the regions with gray matter volume atrophy and high voxel were selected as the regions of interest. Further, the mean disease duration was used as boundary to divide the patients' data into the below-average time and the above-average time groups, which were defined as patient disease duration groups. And these data were used to construct CAPs and to compare changes in brain dynamics. It was found that the number of patterns occurrences and the possibility of switching between patterns were smaller than those in the healthy control, which indicated patients with damage to brain regions. For the patient time control group, the number of patterns occurrences and the possibility of switching between patterns were similar, while there was linear regression between the three values and disease duration. Collectively, this study provides important evidence for revealing the key brain regions of JME by studying the transformation between CAPs. Future studies could investigate the effects of receiving treatment on patient dynamic brain activity.

Pathomorphological Changes in Vater-Pacinian Corpuscles in Palmar Fascial Fibromatosis Depending on the Dupuytren’s Contracture Degree

Background. World literature data indicate the involvement of Vater-Pacinian corpuscles in the pathogenesis of palmar fascial fibromatosis, but the information about their pathomorphological changes and histomorphometric characteristics is contradictory.&#x0D; Purpose a comparative analysis of qualitative and quantitative changes in Vater-Pacinian corpuscles in patients with Dupuytrens contracture of varying degrees.&#x0D; Methods. The analysis of case histories and material resected during operations from 100 patients with Dupuytrens contracture, was made. The patients were divided into two groups: group 1 those with degree I-II contracture (n = 31), group 2 those with degree III-IV (n = 69). Histomorphometry of 122 Vater-Pacinian corpuscles, in which the cut plane passed through the central nucleus, was performed in paraffin and semi-thin sections of the patients surgical material.&#x0D; Results. At the time of the disease onset, the difference in age medians in the groups was not statistically significant. The age median at the time of surgery (group 1 56.0 years; group 2 61.0 years, p = 0.001) and the median of the disease duration (group 1 5.0 years; group 2 9.0 years, р = 0.006) were higher in group 2, the variability in the disease duration was comparable. As it has been established, Vater-Pacinian corpuscles undergo successive reactive-destructive changes in the form of death of the central axon, stratification of the capsule, inflammation, fibrosis, deformation and destruction. The number of corpuscles is greater (р = 0.040) in group 1 1 (0; 3) than in group 2 0 (0; 6). In group 2, the corpuscles have larger diameters (group 1 0.85 mm; group 2 0.96 mm, p = 0.072), more layers of the outer capsule (group 1 17; group 2 20, p = 0.032).&#x0D; Conclusions. In patients with Dupuytrens contracture, along with compensatory and adaptive changes in Vater-Pacinian corpuscles (hyperplasia and hypertrophy), their irreversible destructive changes develop, which, when the disease progresses to grade 3-4, lead to a loss in the number of bodies.

Predicting Ulcerative Colitis Relapse in Clinical Remission With Fecal Immunochemical Occult Blood Test or Prostaglandin E-Major Urinary Metabolite.

The fecal immunochemical occult blood test (FIT) and prostaglandin E-major urinary metabolite (PGE-MUM) have been reported to predict the relapse of ulcerative colitis (UC) during remission. In this study, we directly compared FIT and PGE-MUM in predicting relapse and examined the effect of disease duration on these biomarkers. Measurements of 2 biomarkers and endoscopic examination were performed in 73 patients with UC in remission. The patients were followed up for 12 months, and clinical relapse was evaluated. In addition, we divided the patients into long-term disease duration and short-term disease duration groups for analysis. Twenty-one patients (28.8%) relapsed within 12 months. FIT and PGE-MUM levels were significantly higher in the relapsed group than in the remission group. Cutoff values of FIT and PGE-MUM for predicting relapse using receiver operating characteristic analysis were 65.0 ng/mL (area under the curve [AUC]: 0.723) and 25.2 μg/g·Cr (AUC: 0.701), respectively. Patients with FIT ≥ 65.0 ng/mL and PGE-MUM ≥ 25.2 μg/g·Cr had a higher risk of clinical relapse. In the short-term disease duration group, the AUCs of FIT were larger than those of PGE-MUM using receiver operating characteristic analysis, in most instances. By contrast, the AUCs of PGE-MUM were larger than those of FIT in most cases in the long-term disease groups. FIT and PEG-MUM were highly accurate in predicting clinical relapse in UC patients with short and long disease durations in remission, respectively.

Comparison of nano-hydroxyapatite/polyamide 66 bioactive support and autologous iliac bone in bone grafting and fusion for elderly patients with lumbar tuberculosis

To investigate the safety of nano-hydroxyapatite/polyamide 66 (n-HA/PA66) bioactive support in bone grafting and fusion for elderly patients with lumbar tuberculosis, and to analyze its effectiveness and advantages by comparing with autologous iliac bone grafting. A retrospective analysis was performed on 48 elderly patients with lumbar tuberculosis who met the selection criteria between January 2017 and January 2020. The patients all underwent one-stage posterior pedicle screw internal fixation combined with anterior lesion removal and bone grafting and fusion, of which 23 cases applied n-HA/PA66 bioactive support+allogeneic bone graft (n-HA/PA66 group) and 25 cases applied autologous iliac bone graft (autologous iliac bone group). There was no significant difference between the two groups in gender, age, bone density, disease duration, lesion segment, and preoperative pain visual analogue scale (VAS) score, Japanese Orthopaedic Association (JOA) score, and Cobb angle ( P>0.05). The operation time, intraoperative blood loss, and postoperative complications, as well as the VAS score, JOA score, American Spinal Injury Association (ASIA) spinal cord injury grading, Cobb angle, and bone fusion were recorded and compared between the two groups. The operations were completed successfully in both groups. n-HA/PA66 group had significantly less operation time and intraoperative blood loss than the autologous iliac bone group ( P<0.05). All patients were followed up 12-24 months, with an average of 15.7 months. And the difference in follow-up time between the two groups was not significant ( P>0.05). Postoperative complications occurred in 3 cases (13%) in the n-HA/PA66 group and 10 cases (40%) in the autologous iliac group, and the difference in the incidence of complications between the two groups was significant ( χ 2=4.408, P=0.036). The postoperative VAS scores and JOA scores significantly improved when compared with the preoperative scores in both groups ( P<0.05), and the difference was significant ( P<0.05) between 2 weeks after operation and the last follow-up. The difference in VAS score at 2 weeks after operation was significant between the two groups ( P<0.05), and there was no significant difference ( P>0.05) at the other time points. At last follow-up, according to the ASIA grading, the effective improvement rate was 86% (18/21) in the n-HA/PA66 group and 90% (18/20) in the autologous iliac group, with no significant difference ( χ 2=0.176, P=0.675). Imaging review showed that grade Ⅰ bony fusion was obtained in both groups, and the fusion time of bone graft in the n-HA/PA66 group was significantly longer than that in the autologous iliac bone group ( P<0.05). There was no significant difference in the Cobb angle at each time point between the two groups ( P>0.05). No recurrence of tuberculosis, loosening or fracture of the internal fixator, or displacement of the bone graft was observed during follow-up. In elderly patients with lumbar spine tuberculosis, the n-HA/PA66 bioactive support combined with allogeneic bone graft can effectively restore and maintain the fusion segment height and physiological curvature of the lumbar spine, and the fusion rate of bone graft is similar to that of autologous iliac bone, which can achieve better effectiveness.

P367 Quality of life in patients with Inflammatory Bowel Disease

Abstract Background Inflammatory bowel disease (IBD) has a lengthy natural history with significant symptomatic impacts. Crohn’s disease (CD) and Ulcerative colitis (UC) both have a major impact on patient Health Related Quality of Life (HRQoL). This study aims to evaluate the postulated negative effect of IBD on HRQoL in the Lebanese population. Methods Cross sectional data was collected from a group of, 55 Lebanese patients with IBD (43 with CD and, 12 with UC). Demographic and disease-related data were recorded. Health Related Quality of Life was assessed by disease-specific and generic questionnaires, Inflammatory Bowel Disease Questionnaire (IBDQ) and Short Form Health Survey (SF-36), respectively. Disease activity was assessed based on Harvey-Bradshaw Index (HBI) and the Colitis Activity Index (CAI) for CD and UC patients, respectively. Results IBD resulted in sub-optimal scores in both IBDQ-32 and SF-36, especially in UC patients (mean IBDQ-32 of, 174.8 [UC]vs, 208.8 [CD]; P&amp;lt;0.01 and mean SF-36 of, 111.4 [UC] vs, 130.3[CD]; P&amp;lt;0.05) and in patients classified in the increased disease activity group “Severe symptoms” (P&amp;lt;0.01 for both questionnaires). In addition, only IBDQ-32 scores were significantly decreased for patients classified in the long disease duration group “&amp;gt;60 months” (P&amp;lt;0.05). Last but not least, treatment modality had a significant relation to HRQoL for all studied treatment subtypes. Conclusion Health Related Quality of Life in Lebanese patients is negatively impacted by IBD, but relatively to a lesser degree than what has been previously reported from other countries using IBDQ questionnaire as an assessment tool. More specifically, patients with UC, longer disease duration and higher disease activity have an increased negative impact on HRQoL. Treatment modality had significant relation to HRQoL, but larger scale studies are still needed to reach more reliable conclusions.