Health-Related Quality of Life in Radiologically Isolated Syndrome Resembles Relapsing–Remitting Multiple Sclerosis

TL;DR

People with radiologically isolated syndrome have similar quality of life to those with relapsing-remitting multiple sclerosis, with fatigue being the strongest factor affecting outcomes.

Contribution

This study is the first to compare HRQoL in RIS and RRMS while adjusting for fatigue, cognition, and psychological distress.

Findings

HRQoL in RIS and RRMS was comparable after adjusting for key factors.

Fatigue had the strongest negative impact on HRQoL across all groups.

Psychological distress affected MS-specific HRQoL but not generic HRQoL.

Abstract

Background: Radiologically isolated syndrome (RIS) is defined by MRI findings that are suggestive of multiple sclerosis (MS) in the absence of prior clinical demyelinating events. We aimed to compare the health-related quality of life (HRQoL) between RIS and relapsing–remitting MS (RRMS) after adjusting for fatigue, cognition, and psychological distress, and to contextualize generic HRQoL, relative to healthy controls. Methods: In this cross-sectional analysis of the baseline data, 30 RIS, 29 RRMS, and 30 healthy controls were analyzed. MS-specific HRQoL (patients only) was assessed with the Functional Assessment of Multiple Sclerosis (FAMS), and generic HRQoL (all participants) was assessed with the EuroQol-5D (EQ-5D) visual analogue scale and utility index. Multi-variable linear regression models with robust (HC3) standard errors were used, adjusting for demographics, fatigue impact, cognitive performance, and psychological distress. Results: The FAMS totals were similar in RIS vs. RRMS (median 167.5 vs. 164.0; p = 0.694) and remained non-different after adjustment (β= −2.37, 95% CI −10.18 to 5.44; p = 0.544). EQ-5D outcomes showed an unadjusted gradient across groups, but adjusted differences relative to RIS were not statistically significant. Greater fatigue impact was associated with poorer HRQoL across all models (all p < 0.001). Psychological distress was associated with lower FAMS (β = −14.53; p < 0.001) but not with EQ-5D outcomes. Conclusions: HRQoL in RIS was comparable to RRMS, and fatigue impact was the most consistent correlate of poorer HRQoL.

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