Motor and cognitive changes across 2 years: a longitudinal study in early Multiple Sclerosis.
Elisa Gervasoni, Claudio Solaro, Denise Anastasi and 7 others
PMID 40612496WHAT IT FOUND
Early MS patients stayed functionally stable over two years.
Cognition and fatigue did not worsen, and some walking measures even improved. Wearable sensors gave conflicting results. This suggests two years is too short to see decline, so do not assume rapid deterioration in stable patients.
Key findings
01Most participants maintained stable disability levels, with no significant worsening in fatigue, upper limb function, or cognition over the two-year period.
02Instrumented balance data showed contradictory changes: sway complexity worsened (indicating less automatic control) while sway intensity improved (indicating better stability).
03Patients perceived worsening manual ability in strength-based tasks, even though objective dexterity tests showed improvement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The two-year follow-up period was too short to capture long-term disease progression or non-linear changes. The sample size was relatively small (63 participants), which limits the generalizability of the findings. Cognitive tests were not parallel forms, so practice effects may have contributed to the observed stability or slight improvement in scores. The study did not assess cortical activity, so it could not determine if brain compensation mechanisms were masking functional decline.
Declared interests
The authors declared no conflicts of interest. The work was funded by the Italian Multiple Sclerosis Foundation and the Italian Ministry of Health.
The easy way to misread this
Do not interpret the stable clinical scores as proof that the disease is not progressing at a biological level. The authors suggest that brain compensation mechanisms may be masking subtle functional declines, and that two years is simply too short a window to see the full picture.