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Correlation between spasticity and quality of life in patients with multiple sclerosis: the CANDLE study

Background: Spasticity is a common symptom in multiple sclerosis (MS) that increases the burden of disease. This study investigated the relationship between the degree of spasticity and patients’ health-related quality of life (QoL). Methods: Epidemiological, multicentre, cross-sectional study in patients with MS spasticity. The SF-12 questionnaire was used to assess QoL. The modified Ashworth scale and a 0–10 Numerical Rating Scale (NRS) were used to assess spasticity severity. Results: Data were analysed for 409 MS patients with spasticity from 53 neurology clinics in Spain. Mean age was 46.4 (±11.0) years; 62.4% were women. Most patients had relapsing-remitting MS (42.1%) or secondary progressive MS (43.9%). Mean time since MS diagnosis was 12.5 (±7.4) years and mean time since first spasticity symptoms was 6.1 (±4.8) years. A total of 71.3% of patients were being treated pharmacologically for spasticity. Moderate to severe spasticity was measured in 59.2% of patients according to the modified Ashworth scale and in 83.4% according to the NRS. Mean scores for the 0–100 Physical Component Summary and Mental Component Summary subscales of the SF-12 questionnaire were 31.0 (±9.3) and 45.4 (±12.0), respectively. Scores on the SF-12 correlated significantly with scores on both spasticity scales ( p ≤ 0.002) but the correlation was stronger with the NRS across all domains. Conclusions: The results confirm an association between spasticity severity and QoL in patients with MS. The correlation between 0–10 NRS scores and QoL was stronger than that between modified Ashworth scale scores and QoL.