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The clinical and paraclinical correlates of employment status in multiple sclerosis

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Abstract

Purpose

To identify the clinical and paraclinical markers of employment status in multiple sclerosis (MS).

Methods

This was a cross-sectional sub-study investigating 1226 MS patients. To minimalized confounding effect, two groups of patients, matched by sex, age, and education, were selected: 307 patients with full time employment and 153 unemployed patients receiving disability pension. We explored associations between employment status and Expanded Disability Status Scale (EDSS), 25 Foot Walk Test (25FWT), Nine Hole Peg Test (9HPT), Brief International Cognitive Assessment for MS (BICAMS), Paced Auditory Serial Addition Test (PASAT), Beck Depression Inventory (BDI), SLOAN charts (SLOAN), and brain volumetric MRI measures.

Results

Both groups differed significantly on all variables of interest (p < 0.001). In the univariate analyses, EDSS, SDMT (Symbol Digit Modalities Test) adjusted for BDI, 25FWT, and 9HPT best explained variability in vocational status. In multivariate analyses, the combination of EDSS, 25FWT, SDMT, BDI, and corpus callosum fraction (CCF) explained the greatest variability. As a next step, after patients were matched by EDSS, differences in SDMT, 25FWT (both p < 0.001), 9HPT, CCF, and T2 lesion volume were still present (all p < 0.005) between both groups. The best multivariate model consisted of SDMT, BDI, and T2 lesion volume.

Conclusions

EDSS, walking ability, cognitive performance, and MRI volumetric parameters are independently associated with employment status.

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Funding

The project was supported by the Czech Ministry of Education project PRVOUK-P26/LF1/4, of Health RVO-VFN 64165 and by the Czech Science Foundation GA CR 16-03322S. Funding for biostatistical support was provided by Novartis. Lukas Sobisek has been also supported by the project of the University of Economics, Prague—Internal Grant Agency, project No. 44/2017 “Clustering and regression analysis of micro panel data.”

Author information

Authors and Affiliations

  1. Department of Neurology and Center of Clinical Neuroscience, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic

    Barbora Srpova, Klara Novotna, Tomas Uher, Lucie Friedova, Eva Kubala Havrdova & Dana Horakova

  2. Department of Statistics and Probability, University of Economics in Prague, Prague, Czech Republic

    Lukas Sobisek

  3. Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic

    Manuela Vaneckova & Jan Krasensky

Authors
  1. Barbora Srpova
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  2. Lukas Sobisek
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  3. Klara Novotna
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  4. Tomas Uher
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  5. Lucie Friedova
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  6. Manuela Vaneckova
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  7. Jan Krasensky
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  8. Eva Kubala Havrdova
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  9. Dana Horakova
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Barbora Srpova, Klara Novotna, Lukas Sobisek, Lucie Friedova, and Jan Krasensky. Supervision was performed by Dana Horakova, Tomas Uher, Manuela Vaneckova, and Eva Kubala Havrdova. The first draft of the manuscript was written by Barbora Srpova, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Barbora Srpova.

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Ethics approval

The study received ethical approval from the local ethical committee of General University Hospital in Prague.

Consent to participate

Signed informed consent was obtained from all participants.

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Not applicable.

Conflict of interest

Barbora Srpova has received compensation for travelling and conference fees from Novartis, Sanofi Genzyme and Biogen Idec. Lukas Sobisek has received financial support from Novartis. Tomas Uher has received financial support for conference travel and honoraria from Biogen Idec, Roche, Novartis, Genzyme, and Merck Serono, as well as support for research activities from Biogen Idec and Sanofi (GZ-2017–11718). Eva Kubala Havrdova has received speaker honoraria and consultant fees from Biogen Idec, Merck Serono, Novartis, Genzyme, and Teva, as well as support for research activities from Biogen Idec and Merck Serono. Dana Horakova has received compensation for travel, speaker honoraria, and consultant fees from Biogen Idec, Novartis, Merck, Bayer, Sanofi Genzyme, and Teva, as well as support for research activities from Biogen Idec. Manuela Vaneckova has received compensation for travel, speaker honoraria, and consultant fees from Biogen Idec, Novartis, and Sanofi Genzyme, as well as support for research activities from Biogen Idec.

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Srpova, B., Sobisek, L., Novotna, K. et al. The clinical and paraclinical correlates of employment status in multiple sclerosis. Neurol Sci 43, 1911–1920 (2022). https://doi.org/10.1007/s10072-021-05553-z

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  • DOI: https://doi.org/10.1007/s10072-021-05553-z

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