Milano–Torino Staging and Long-Term Survival in Chinese Patients with Amyotrophic Lateral Sclerosis

• Published in: Cells (Basel, Switzerland) Vol. 10; no. 5; p. 1220
• Main Authors: He, Ruojie, Zheng, Minying, Lian, Ling, Yao, Xiaoli
• Format: Journal Article
• Language: English
• Published: Basel MDPI AG 17.05.2021; MDPI
• Subjects: Activities of daily living; Age; Amyotrophic lateral sclerosis; Anxiety; Clinical trials; Disease; long-term survival; Medical prognosis; Mental disorders; Milano–Torino staging; neuropsychiatric factors; Ostomy; Patients; Sensitivity analysis; Sleep; Survival
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells10051220

(1) Background: The aim of this longitudinal study was to evaluate the association between disease progression according to the Milano–Torino staging (MITOS) system and long-term survival in Chinese patients with amyotrophic lateral sclerosis (ALS). We also examined factors affecting MITOS progression. (2) Methods: Patients were enrolled and underwent follow-up at 6, 12, 18, and 24 months, and their demographic and clinical data, including the Milano–Torino stage, Amyotrophic Lateral Sclerosis Functional Rating Scale—Revised (ALSFRS-R) score and neuropsychiatric data, were evaluated. The sensitivity and specificity of predicting survival outcomes based on MITOS progression and ALSFRS-R score decline from baseline to 6 months were compared. The associations between MITOS progression from baseline to 6 months and survival outcome at 12, 18 and 24 months were examined, and factors associated with disease progression were evaluated with subgroup analyses. (3) Results: Among the 100 patients included, 74% were in stage 0 at baseline, and approximately 95% progressed to a higher stage of the MITOS system at 24 months. MITOS progression from baseline to 6 months and ALSFRS-R decline showed comparable value for predicting survival at 12, 18, and 24 months. MITOS progression from baseline to 6 months is strongly associated with death outcomes. Older age at onset and increased depression and anxiety scores may be related to disease progression. (4) Conclusions: MITOS progression during the early disease course could serve as a prognostic marker of long-term survival and may have utility in clinical trials. Age at onset and diagnosis and neuropsychiatric factors might be associated with disease progression.