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Fig 1.

Distribution of the initial manifestations.

Motor weakness was the most common initial symptom in about 71.4% (175/245) of patients included in our multicenter cohort, followed by cerebellar manifestations in 14.7% (36/245) and sensory disturbances in 8.6% (21/245). Other initial manifestations such as brain stem syndromes, visual disturbances, cognitive symptoms, complex focal seizures or urinary disturbances were present in 6.3% (13/245).

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Fig 1 Expand

Table 1.

Clinical features of primary progressive multiple sclerosis (PPMS) patients.

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Table 1 Expand

Table 2.

Summary of the results of lumbar puncture (LP) in patients with primary progressive multiple sclerosis (PPMS).

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Table 3.

Prevalence of single positive AI against measles (M), Rubella (R) and varicella-zoster virus (Z) and different combinations in our PPMS cohort.

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Fig 2.

Correlation between CSF-lactate and EDSSLP and yearly progression rate in the entire cohort, EDSSLP and LPD.

Spearman correlation between the CSF-lactate and expanded disability score scale at the LP (EDSSLP) and yearly progression rate showed consistently statistically significant positive correlation in the entire cohort, treatment-näive patients PPMSTN and in the results of the diagnostic LP (LPD). On the other side, a significant correlation between CSF-lactate and EDSSLP was found only in the LPD.

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Table 4.

Spearman correlation (ρ) between CSF-lactate and EDSS at the lumbar puncture (EDSSLP) and the yearly progression rate in the entire cohort, treatment-naïve PPMS patients (PPMSTN) and at the LP at the year of diagnosis (LPD).

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Table 4 Expand