Is Ovarian Decline Associated with Clinical Disability in Female MS Patients?

Prior research has shown women suffering from multiple sclerosis (MS) often have a more benign initial course than male patients. However, these same female patients tend to quickly transition to secondary progressive disease as their approach menopause.

Despite this finding, researchers have not yet discerned whether this “accumulation of disability” in female MS patients could be attributed to ovarian decline.

Jennifer S. Graves, MD, PhD, MAS, University of San Francisco sought to assess whether ovarian decline — measured by levels of anti-Mullerian hormone (AMH) – is linked to clinical disability or brain atrophy in female MS patients.

Findings were presented at Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) 2016 Forum in New Orleans, LA.

The research cohort included a control group and female patients with MS with up to 10 years of clinical and MRI follow-up. The team measured AMH levels from baseline and years 3,5,8,9,and 10.

The researchers found that of the models controlling for age, AMH levels were similar in the MS and control group. However, in a multivariable model of female MS patients, even with rigorous adjustments for age and disease duration, ovarian reserve was associated with normalized gray matter volume and MS functional composite z-scores.

Though there is no reduction in “follicular (ovarian) reserve in women with MS,” the researchers concluded, “AMH was associated with total gray matter volume and disability in MS patients independent of chronological age and disease duration”.