Ergi KAYA, Sinem OZCELIK, Asiye Tuba OZDOGAR, Ela Simay ZENGIN, Serkan OZAKBAS
Van Medical Journal - 2026;33(4):400-407
Introduction: Primary progressive multiple sclerosis (PPMS) and secondary progressive multiple sclerosis (SPMS) represent the two major progressive phenotypes of MS. While both forms share neurodegenerative mechanisms, differences in their clinical trajectories remain underexplored. The aim of this study is to compare physical, cognitive, and disability progression profiles of individuals with PPMS and SPMS over three years. Materials and Methods: This study included individuals diagnosed with PPMS or SPMS from a prospective observational MS registry. A secondary analysis of this prospective study was conducted. Disability progression was evaluated using Expanded Disability Status Scale (EDSS) score, Timed 25-Foot Walk (T25FW), and Nine-Hole Peg Test (NHPT). Cognitive function was assessed with the Brief International Cognitive Assessment for MS (BICAMS). EDSS-plus was defined as sustained worsening in EDSS, NHPT, or T25FW, independent of relapse activity. Results: At baseline, individuals with SPMS showed significantly worse performance on T25FW and NHPT than those with PPMS. California Verbal Learning Test-II (CVLT-II) scores were also lower in SPMS. Over three years, both groups exhibited comparable trajectories in EDSS, physical performance, BICAMS, and EDSS-plus. Conclusions: Despite greater baseline disability and functional impairment in SPMS, the longitudinal progression patterns in physical, cognitive, and relapse-independent domains were similar between SPMS and PPMS over three years.
