Multiple sclerosis and related disorders · 2026
Correlation of cerebrospinal fluid and serum markers with EDSS-assessed baseline disability in multiple sclerosis patients.
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Wang Fang, Zhang Shuyi, Xie Xuhuan, Qin Bin, Huang Wen
Аннотация
OBJECTIVE: To investigate the correlation between cerebrospinal fluid (CSF) and serum biochemical markers and baseline Expanded Disability Status Scale (EDSS) scores in patients with acute-onset multiple sclerosis (MS), and to identify independent predictors of EDSS-assessed baseline disability.
METHODS: A retrospective study included 157 patients with acute-onset MS (82 first-episode, 75 relapse) meeting the 2023 McDonald criteria. Baseline EDSS was assessed during acute exacerbation. CSF and serum samples were collected before corticosteroid administration, and MRI activity was evaluated. Associations were analyzed using Spearman correlation and ordinal logistic regression.
RESULTS: The median baseline EDSS score was 2.50 (IQR: 1.50-3.75). Spearman analysis revealed that EDSS scores were negatively correlated with serum albumin (S-Alb, ρ=-0.418, P = 0.001), and positively with CSF protein (ρ=0.173, P = 0.031), CSF-ADA (ρ=0.188, P = 0.019) and CSF-IgG (ρ=0.273, P = 0.001); serum magnesium had no statistical correlation with EDSS (P > 0.05). Multivariate ordinal logistic regression confirmed S-Alb (OR=0.802, 95% CI: 0.741-0.867, P < 0.001) as an independent protective factor and CSF-ADA (OR=1.223, 95% CI: 1.027-1.456, P = 0.024) as an independent risk factor for EDSS-assessed disability; other markers had no independent predictive value (all P > 0.05). Notably, first-episode/relapse status and MRI activity had no significant association with EDSS scores.
CONCLUSION: S-Alb and CSF-ADA are independent influencing factors for EDSS-assessed baseline disability in acute-onset MS. Elevated S-Alb levels and reduced CSF-ADA activity are associated with lower EDSS scores and milder neurological deficits, serving as exploratory objective biological indicators for baseline disability evaluation and providing evidence for clinical stratified intervention and neuroprotective therapy research.
METHODS: A retrospective study included 157 patients with acute-onset MS (82 first-episode, 75 relapse) meeting the 2023 McDonald criteria. Baseline EDSS was assessed during acute exacerbation. CSF and serum samples were collected before corticosteroid administration, and MRI activity was evaluated. Associations were analyzed using Spearman correlation and ordinal logistic regression.
RESULTS: The median baseline EDSS score was 2.50 (IQR: 1.50-3.75). Spearman analysis revealed that EDSS scores were negatively correlated with serum albumin (S-Alb, ρ=-0.418, P = 0.001), and positively with CSF protein (ρ=0.173, P = 0.031), CSF-ADA (ρ=0.188, P = 0.019) and CSF-IgG (ρ=0.273, P = 0.001); serum magnesium had no statistical correlation with EDSS (P > 0.05). Multivariate ordinal logistic regression confirmed S-Alb (OR=0.802, 95% CI: 0.741-0.867, P < 0.001) as an independent protective factor and CSF-ADA (OR=1.223, 95% CI: 1.027-1.456, P = 0.024) as an independent risk factor for EDSS-assessed disability; other markers had no independent predictive value (all P > 0.05). Notably, first-episode/relapse status and MRI activity had no significant association with EDSS scores.
CONCLUSION: S-Alb and CSF-ADA are independent influencing factors for EDSS-assessed baseline disability in acute-onset MS. Elevated S-Alb levels and reduced CSF-ADA activity are associated with lower EDSS scores and milder neurological deficits, serving as exploratory objective biological indicators for baseline disability evaluation and providing evidence for clinical stratified intervention and neuroprotective therapy research.