Determination of the Demographic Characteristics of Multiple Sclerosis Patients in Aksaray Province and İnvestigation of Factors İnvolved in Transition to Secondary Multiple Sclerosis

Abstract

Aim: This study aims to describe the demographic and clinical characteristics of multiple sclerosis (MS) patients in Aksaray province and to investigate factors influencing transition to the secondary progressive MS (SPMS) subtype. Materials and Methods: This retrospective study included 240 MS patients followed at Aksaray University Training and Research Hospital between 29 July 2024 and 29 July 2025. Clinical, imaging, and treatment data were systematically evaluated. Group comparisons were performed using the Kruskal–Wallis test and Dunn post-hoc analyses. Categorical variables were analyzed with Fisher’s Exact test and z tests with Bonferroni correction. Determinants of SPMS transition were assessed via logistic regression and ROC analysis. Results: Significant increases in age, disease duration, Expanded Disability Status Scale (EDSS) score, plaque diameter, infratentorial lesions, brain atrophy, and treatment changes were observed in SPMS patients (p < 0.001). ROC analysis for plaque diameter yielded an AUC of 0.867, with 82.1% accuracy at a cutoff of ≥18.4 mm. Logistic regression showed that each one-point increase in EDSS score raised SPMS risk 3.83-fold, while brain atrophy increased risk 10.46-fold. Motor symptoms, insomnia, and urinary incontinence were more frequent in the SPMS group. Conclusion: Structural and clinical indicators may serve as predictive markers in the transition to SPMS. Parameters such as plaque diameter, brain atrophy, and EDSS score emerge as potential biomarkers. Regional epidemiological data reveal the influence of environmental factors on disease course and highlight the need for early, personalized interventions to delay or prevent SPMS transition.

Keywords

• Multiple sclerosis
• Secondary progressive multiple sclerosis
• Aksaray
• Epidemiology

Aksaray İlindeki Multipl Skleroz Hastalarının Demografik Özelliklerinin Belirlenmesi ve Sekonder Multipl Skleroza Geçişte Rol Oynayan Faktörlerin Araştırılması

Abstract

Amaç: Bu çalışma, Aksaray ilindeki multipl skleroz (MS) hastalarının demografik ve klinik özelliklerini tanımlamayı ve sekonder progresif MS (SPMS) alt tipine geçişi etkileyen faktörleri araştırmayı amaçlamaktadır. Gereç ve Yöntem: Bu retrospektif çalışma, 29 Temmuz 2024 ile 29 Temmuz 2025 tarihleri arasında Aksaray Üniversitesi Eğitim ve Araştırma Hastanesi’nde takip edilen 240 MS hastasını içermektedir. Klinik, görüntüleme ve tedavi verileri sistematik olarak değerlendirilmiştir. Grup karşılaştırmaları Kruskal–Wallis testi ve Dunn post-hoc analizleri ile yapılmıştır. Kategorik değişkenler Fisher’s Exact testi ve Bonferroni düzeltmeli z testleri ile analiz edilmiştir. SPMS geçişinin belirleyicileri lojistik regresyon ve ROC analizi ile değerlendirilmiştir. Bulgular: SPMS hastalarında yaş, hastalık süresi, Genişletilmiş Özürlülük Durum Ölçeği (EDSS) skoru, plak çapı, infratentorial lezyonlar, beyin atrofisi ve tedavi değişikliklerinde anlamlı artışlar gözlenmiştir (p < 0.001). Plak çapı için ROC analizi, 0.867 AUC değeri ile ≥18.4 mm eşik değerinde %82.1 doğruluk göstermiştir. Lojistik regresyon, EDSS skorundaki her bir puan artışının SPMS riskini 3.83 kat artırdığını, beyin atrofisinin ise riski 10.46 kat artırdığını ortaya koymuştur. Motor semptomlar, uykusuzluk ve üriner inkontinans SPMS grubunda daha sık görülmüştür. Sonuç: Yapısal ve klinik göstergeler, SPMS’ye geçişte öngörücü belirteçler olarak kullanılabilir. Plak çapı, beyin atrofisi ve EDSS skoru gibi parametreler potansiyel biyobelirteçler olarak öne çıkmaktadır. Bölgesel epidemiyolojik veriler, çevresel faktörlerin hastalık seyrine etkisini ortaya koymakta ve SPMS geçişini geciktirmek veya önlemek için erken, kişiselleştirilmiş müdahalelerin gerekliliğini vurgulamaktadır.

Keywords

• Multipl skleroz
• Sekonder progresif multipl skleroz
• Aksaray
• Epidemiyoloji

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