Sexual dysfunction in multiple sclerosis: The impact of different MSISQ-19 cut-offs on prevalence and associated risk factors

M Petracca; A Carotenuto; C Scandurra; M Moccia; L Rosa; S Arena; A Ianniello; A Nozzolillo; M Turrini; L M Streito; G Abbadessa; M Cellerino; S Bucello; E Ferraro; M Mattioli; A Chiodi; M Inglese; S Bonavita; M Clerico; C Cordioli; L Moiola; F Patti; L Lavorgna; M Filippi; G Borriello; E D'Amico; C Pozzilli; V Brescia Morra; R Lanzillo

doi:10.1016/j.msard.2023.104907

Sexual dysfunction in multiple sclerosis: The impact of different MSISQ-19 cut-offs on prevalence and associated risk factors

Mult Scler Relat Disord. 2023 Oct:78:104907. doi: 10.1016/j.msard.2023.104907. Epub 2023 Jul 26.

Authors

M Petracca¹, A Carotenuto¹, C Scandurra¹, M Moccia², L Rosa³, S Arena⁴, A Ianniello⁵, A Nozzolillo⁶, M Turrini⁷, L M Streito⁸, G Abbadessa⁹, M Cellerino¹⁰, S Bucello¹¹, E Ferraro¹², M Mattioli¹³, A Chiodi¹⁴, M Inglese¹⁵, S Bonavita⁹, M Clerico¹⁶, C Cordioli⁷, L Moiola⁶, F Patti⁴, L Lavorgna⁹, M Filippi¹⁷, G Borriello¹⁸, E D'Amico⁴, C Pozzilli¹⁹, V Brescia Morra¹, R Lanzillo²⁰

Affiliations

¹ Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy.
² Department of Molecular Medicine and Medical Biotechnology, Federico II University of Naples, Italy; MS Unit, Federico II University Hospital, Naples, Italy.
³ Department of Public Health, University of Naples Federico II, Naples, Italy.
⁴ Department "G.F. Ingrassia", MS Center, University of Catania, Catania, Italy.
⁵ MS Center, S. Andrea Hospital, Sapienza University of Rome, Rome, Italy.
⁶ Multiple Sclerosis Center, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy.
⁷ Centro Sclerosi Multipla, ASST Spedali Civili di Brescia, Ospedale di Montichiari, Brescia, Italy.
⁸ San Luigi Gonzaga Academic Hospital, Orbassano, TO 10043, Italy.
⁹ Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
¹⁰ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy.
¹¹ Multiple Sclerosis Centre, "E. Muscatello" Hospital - ASP8, Augusta, SR, Italy.
¹² S. Filippo Neri Hospital, Rome, Italy.
¹³ NCL-Istituto di Neuroscienze Gruppo Neuromed, Rome, Italy.
¹⁴ Intradepartmental Program of Clinical Psychology, Federico II University Hospital, Naples, Italy.
¹⁵ Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DiNOGMI), University of Genoa, Genoa, Italy; IRCCS Ospedale Policlinico San Martino, Genoa, Italy.
¹⁶ San Luigi Gonzaga Academic Hospital, Orbassano, TO 10043, Italy; Department of Clinical and Biological Sciences, University of Torino, Torino 10128, Italy.
¹⁷ Multiple Sclerosis Center, Neurology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy; Vita-Salute San Raffaele University, Milan, Italy.
¹⁸ MS Center, San Pietro Hospital Fatebenefratelli, Rome, Italy.
¹⁹ Department of Human Neurosciences, Sapienza University, Rome, Italy.
²⁰ Department of Neurosciences and Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via Pansini 5, Naples 810145, Italy. Electronic address: roberta.lanzillo@unina.it.

PMID: 37523809
DOI: 10.1016/j.msard.2023.104907

Abstract

Background: Although multiple sclerosis (MS) Intimacy and Sexuality Questionnaire-19 (MSISQ-19) is a widely applied tool, no unique definition of sexual dysfunction (SD) based on its score exists.

Objective: To explore the impact of different MSISQ-19 cut-offs on SD prevalence and associated risk factors, providing relevant information for its application in research and clinical settings.

Methods: After defining SD according to two different MSISQ-19 cut-offs in 1155 people with MS (pwMS), we evaluated SD prevalence and association with sociodemographic and clinical features, mood status and disability via logistic regression.

Results: Depending on the chosen cut-off, 45% to 54% of pwMS reported SD. SD defined as MSISQ-19 score >30 was predicted by age (OR=1.01, p=0.047), cognition (OR=0.96, p=0.004) and anxiety (OR=1.03, p=0.019). SD defined as a score >3 on any MSISQ-19 item was predicted by motor disability (OR=1.12, p=0.003) and cognition (OR= 0.96, p=0.002).

Conclusion: Applying different MSISQ-19 cut-offs influences both the estimated prevalence and the identification of risk factors for SD, a finding that should be considered during study planning and data interpretation. Preserved cognition exerts a protective effect towards SD regardless from the specific study setting, representing a key point for the implementation of preventive and therapeutic strategies.

Keywords: Cognition; MSISQ-19; Multiple sclerosis; Outcome measurement; Quality of life; Sexual dysfunction.