Search

Background: Optic neuritis (ON) can be an initial clinical presentation of multiple sclerosis This study aims to provide a practical predictive model for identifying at-risk ON patients in developing MS., Method: We utilized data from the Optic Neuritis Treatment Trial study, which enrolled 457 patients aged from 18 to 46 years, all diagnosed with acute ON. These patients underwent up to 15 years of neurological and ophthalmologic examinations and imaging. The selection of variables for the developing model was based on clinical importance and statistical significance, and any missing values were appropriately addressed. We developed a Decision Tree (DT) classifier as the primary model and manually tuned its hyperparameters for optimal performance. We employed SHapley Additive exPlanations (SHAP) for feature importance evaluation. All analysis was performed using Python version 3.10.9 and its associated libraries., Results: A total of 388 patients completed the study, of which 154 developed clinically definite multiple sclerosis (CDMS). It was observed that 61% of patients with magnetic resonance imaging (MRI) lesions developed CDMS. The final variables selected for analysis were MRI lesions, neurologic history, ON type, gender, and visual field mean deviation. The DT model achieved an accuracy of 70.1% during cross-validation and 69.1% on the test set, with an area under the curve of 74.9% and 71.7%, respectively. Comparative analysis of DT with other models showed similar performance. SHAP analysis revealed that MRI lesions and ON type emerged as the two most significant features, with relative importance of 61% and 18%, respectively., Conclusion: The decision tree model, with satisfactory performance, effectively stratifies patients, based on baseline findings and offers valuable insights for informed decision-making by physicians., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Rasouli et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: Multiple sclerosis (MS) is characterized by inflammation and demyelination in the central nervous system. Recent studies have suggested a potential association between MS and an increased risk of atherosclerosis, a systemic vascular disease involving arterial wall thickening. Understanding this relationship is crucial, given the heightened cardiovascular risk observed in MS patients., Objective: To investigate factors influencing the development of atherosclerosis in patients with multiple sclerosis (pwMS), focusing on carotid intima-media thickness (CIMT) as a marker., Methods: 114 pwMS (82 females and 32 males) and 127 control subjects (57 females and 70 males) were included. The mean CIMT between the two groups was compared. Additionally, the effects of annual relapse rate, EDSS (Expanded Disability Status Scale), MS duration, treatment duration, and type of Disease-modifying treatment (DMT) on CIMT were evaluated., Results: This study included 241 participants with a mean (SD) age of 41.13 years (10.93). CIMT was significantly higher in pwMS compared to controls (p < 0.001). Even after adjusting for age, sex, and BMI (Body Mass Index), CIMT remained significantly higher in the pwMS group (p < 0.001). Spearman's correlation analysis revealed significant associations between CIMT and age, BMI, EDSS score, and disease duration (all p < 0.05). Additionally, the SPMS (Secondary Progressive Multiple Sclerosis) disease course was significantly associated with higher CIMT (p < 0.001). Linear regression analysis identified age as the most significant predictor of increased CIMT in pwMS (p < 0.001), followed by BMI (p = 0.054)., Conclusion: This study demonstrates a significant association between MS and increased CIMT. Additionally, age emerged as the most prominent predictor of high CIMT in pwMS, followed by BMI. These findings suggest a potential link between MS and increased cardiovascular risk. Further research is warranted to explore the underlying mechanisms and investigate the long-term cardiovascular outcomes in this population., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Najmi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)