Multiple sclerosis (MS)-relapse recovery declines in a linear fashion with increased age, which should be considered when making treatment decisions, according to a recent study. The first and last-ever relapse data (357 relapses in 193 patients) from the Olmsted County population-based multiple sclerosis cohort were systematically reviewed for age, fulminance, location (optic nerve, brainstem/cerebellar, spinal cord), peak deficit, and maximum recovery. 3 different relapse-outcome measures were studied both as paired analyses and as an overall group effect: change from peak deficit to maximum recovery in raw functional system score related to the relapse (ΔFSS), a previously published FSS-based relapse-impact model, and change from peak deficit to maximum recovery in Extended Disability Status Scale (ΔEDSS) score. Researchers found:

• Older age was linearly associated with worse recovery in the ΔFSS outcome, ΔEDSS outcome, and the FSS-based relapse-impact model.
• A multivariate analysis of ΔFSS outcome linked poor recovery to older age, relapse location (transverse myelitis or brainstem/cerebellar syndrome), and relapse fulminance.