{
  "abstract": "Background: Late-onset multiple sclerosis (LOMS), defined here as symptom onset at age 50 years or later, is associated with diagnostic complexity, a higher prevalence of progressive phenotypes, greater disability, and challenging disease-modifying therapy (DMT) decisions. We characterized clinical manifestations, magnetic resonance imaging (MRI) lesion distribution, disability outcomes, and DMT patterns in a Latvian tertiary-care cohort.\n\nMethods: We retrospectively reviewed medical records from Riga East University Hospital. Of 518 patients in the source multiple sclerosis dataset, 59 met the LOMS definition; after exclusion of two patients with clinically isolated syndrome and one with an unspecified phenotype, 56 patients with relapsing-remitting, primary progressive, or secondary progressive multiple sclerosis were analyzed. Clinical symptoms, MRI lesion localization, baseline and five-year Expanded Disability Status Scale (EDSS) scores, EDSS change, and initial and current DMT patterns were assessed using nonparametric and exact tests.\n\nResults: The cohort included 38 women and 18 men; 38 patients had relapsing-remitting multiple sclerosis and 18 had progressive multiple sclerosis. Progressive phenotypes were associated with more frequent pyramidal/motor symptoms (100.0% vs. 76.3%; p = 0.045) and bowel/bladder dysfunction (72.2% vs. 42.1%; p = 0.035). Baseline EDSS was higher in progressive disease (median 3.75 vs. 2.00; p < 0.001), as was five-year EDSS among the 39 patients with available follow-up (median 6.00 vs. 3.00; p < 0.001), whereas EDSS change did not differ significantly ( p = 0.377). Anti-CD20 and other high-efficacy DMTs were used more frequently in progressive phenotypes and in patients with greater observed disability.\n\nConclusion: Progressive LOMS phenotypes were associated with greater motor and sphincter symptom burden and higher disability, but the absence of a difference in unadjusted EDSS change should not be interpreted as equivalent disability progression. Treatment associations primarily describe real-world selection and are subject to confounding by indication.",
  "abstract_shown": true,
  "affiliations": [
    "Faculty of Medicine, Rīga Stradin´š University",
    "Neurology and Neurosurgery Department, Riga East University Hospital",
    "Neurology and Neurosurgery Department, Rīga Stradin´š University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ruslan Alomar"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Elīna Polunosika"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Guntis Karelis"
    },
    {
      "affs": [
        1,
        2
      ],
      "name": "Daina Pastare"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b85yjkvg4ghbc.bib",
  "cited_by": 0,
  "doi": "10.3389/fneur.2026.1966162",
  "fulltext_url": null,
  "id": "b85yjkvg4ghbc",
  "issns": [
    "1664-2295"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1966162/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2734|Multiple Sclerosis Research Studies"
    ]
  ],
  "openalex": "W7223092988",
  "pdf_url": "https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2026.1966162/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-21",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/b85yjkvg4ghbc.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:16Z",
      "native_id": "10.3389/fneur.2026.1966162",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fneur.2026.1966162/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:1664-2295",
      "subfield": "neurology"
    }
  ],
  "title": "Clinical characteristics, disability outcomes, and disease-modifying therapy patterns in late-onset multiple sclerosis: a single-center retrospective cohort study",
  "title_text": "Clinical characteristics, disability outcomes, and disease-modifying therapy patterns in late-onset multiple sclerosis: a single-center retrospective cohort study",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:16Z",
  "url": "https://research.draconitic.com/paper/b85yjkvg4ghbc",
  "venue": "Frontiers in Neurology",
  "versions": []
}