Evidence for a two-stage disability progression in multiple sclerosis.

In the group of patients with progressive onset multiple sclerosis, males had a younger age than women, the difference being significant both at multiple sclerosis onset (median 37.6 versus 39.9 years, P < 0.004) and at DSS 3 (median 40.4 versus 42.5 years, P < 0.004), and almost significant at DSS 6 (median 51.0 versus 53.8 years, P = 0.09).

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However, when secondary progressive multiple sclerosis was excluded, the relapses after DSS 3 might still have some influence on disability, although the comparison did not reach statistical significance due to the small numbers of patients.

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