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COMMENTS AND OPINIONS
Spinchter Symptoms as Predictors of Long-term Disability in Multiple Sclerosis—Reply
Annette Langer-Gould, MD
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In reply
This group of clinicians raises important points about the subjectiveness of bladder symptoms in multiple sclerosis and their need for confirmation with urodynamic testing. The studies included in our systematic review did not clearly define the variable, sphincter symptoms, and because many of the studies collected information about symptoms at onset retrospectively, it is likely that this variable represents significant, subjective sphincter symptoms as patients with milder symptoms would be more likely to forget them (recall bias). Future studies should clearly define variables to aid interpretation of findings.
The findings from our systematic review suggest that sphincter symptoms at onset (as defined and reported by the authors of the included studies) is an important predictor of poor long-term prognosis and thus may help guide clinicians in selecting patients for whom the potential benefit of toxic therapies for multiple sclerosis (such as natalizumab or mitoxantrone) might . . . [Full Text of this Article] AUTHOR INFORMATION
RELATED LETTER
Spinchter Symptoms as Predictors of Long-term Disability in Multiple Sclerosis
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Arch Neurol. 2007;64(9):1359.
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Clinical and Demographic Predictors of Long-term Disability in Patients With Relapsing-Remitting Multiple Sclerosis: A Systematic Review
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Arch Neurol. 2006;63(12):1686-1691.
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