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The following is a summary of “Beyond EDSS: multidomain impairments are detectable and associated with walking disorders in low-disabled people with multiple sclerosis,” published in the May 2025 issue of Journal of Neurology by Gervasoni et al. 

Multiple sclerosis involves motor, sensory, and cognitive impairments that may go unnoticed in low-disabled people with multiple sclerosis (PwMS). Identifying subtle deficits early is essential to monitor disease progression and treatment impact. 

Researchers conducted a retrospective study to assess the prevalence of multidomain impairments in minimally disabled PwMS.  

They assessed 80 PwMS with EDSS < 2.5 using EDSS Functional Scores (EDSS FS) and clinical scales for lower limb strength (Squat Jump test), tactile sensitivity (Monofilament Test), balance (instrumented test), fatigue (Fatigue Severity Scale), and cognition (Symbol Digit Modalities Test). Walking was measured subjectively with the Six-Minute Walking Test (6MWT) and the MS Walking Scale-12 (MSWS-12). 

The results showed that over 50% (95% CI 43–65%) had impaired Pyramidal FS, and over 20% (95% CI 13–32%) had sensory FS deficits. Compared to norms, 30% had reduced strength (95% CI 21–41%), impaired sensation (95% CI 20–40%), and increased fatigue (95% CI 9–26%). EDSS FS moderately predicted MSWS-12 and 6MWT, while strength (β = 8.62, P < 0.001) and fatigue (β = 0.10, P < 0.001) were stronger predictors. 

Investigators found that low-disabled people with multiple sclerosis had multidomain impairments. They suggested that sensitive clinical assessments enabled early detection and targeted mobility interventions. 

Source: link.springer.com/article/10.1007/s00415-025-13128-7