Clinical and Biochemical Characteristics of Multiple Sclerosis in the Tyumen Region: Analysis of 492 Cases with Assessment of Prognostic Factors and Pathogenetic Mechanisms

The aim is to analyze the clinical, demographic, neurological, and biochemical features of 492 patients with multiple sclerosis (MS) in various types of its course – remitting (RMS), secondary-progressive (SPMS), and primary-progressive (PPMS). Results. It was found that different types of MS course are characterized by significant heterogeneity. Significant differences were found in the age of onset (the earliest in RMS is 23.1 years, the latest in PPMS is 33.4 years) and gender distribution (predominance of women overall and relative predominance of men in PPMS). Neurological deficit, the degree of disability (according to the EDSS), and the frequency of cognitive impairment (54.3% overall, with progression in SPMS and PPMS) were significant in progressive forms. Biochemical analysis revealed increased lipid peroxidation (increased diene conjugates and Schiff bases), decreased antioxidant defense (SOD activity, α-tocopherol content), and modification of the lipid composition of erythrocyte membranes. Statistically significant correlations were found between biochemical parameters (phospholipase A2 activity, lipid peroxidation product levels, and SOD activity) and clinical indicators (EDSS score, progression rate). Conclusion. The results confirm the important role of oxidative stress and membrane pathological processes in the pathogenesis of MS, particularly in progressive forms, and open up prospects for the development of new pathogenetic therapies.