Data_Sheet_1_Trajectories of quality of life in people with diabetes mellitus: results from the survey of health, ageing and retirement in Europe.docx

IntroductionPrevious longitudinal studies identified various factors predicting changes in Quality of Life (QoL) in people with diabetes mellitus (PwDM). However, in these studies, the stability of QoL has not been assessed with respect to individual differences.MethodsWe studied the predictive influence of variables on the development of QoL in PwDM across three waves (2013–2017) from the cross-national panel dataset Survey of Health, Ageing, and Retirement in Europe (SHARE). To determine clinically meaningful changes in QoL, we identified minimal clinically important difference (MCID). Linear regressions and Linear Mixed Models (LMM) were conducted to determine factors associated with changes in QoL.ResultsOn average, QoL remained stable across three waves in 2989 PwDM, with a marginal difference only present between the first and last wave. However, when looking at individual trajectories, 19 different longitudinal patterns of QoL were identified across the three time-points, with 38.8% of participants showing stable QoL. Linear regression linked lower QoL to female gender, less education, loneliness, reduced memory function, physical inactivity, reduced health, depression, and mobility limitations. LMM showed that the random effect of ID had the strongest impact on QoL across the three waves, suggesting highly individual QoL patterns.ConclusionThis study enhances the understanding of the stability of QoL measures, which are often used as primary endpoints in clinical research. We demonstrated that using traditional averaging methods, QoL appears stable on group level. However, our analysis indicated that QoL should be measured on an individual level.</p

Additional file 1: of Dysregulation of chemokine receptor expression and function in leukocytes from ALS patients

ALS patient information and supplemental material and methods. (DOCX 97 kb

Clinical characteristics of participants.

<p>Clinical characteristics of participants.</p

Regression analysis of VBI-processed T1 intensities of all ALS patients and their ALSFRS-R.

<p>Clusters of significant correlation between VBI intensity and ALSFRS-R scores are given in coronal slices (a, level at b). Projection on VBI group mean generic brain, CST highlighted according to JHU DTI atlas (yellow). Mean intensity inside ROIs in the PLIC (f, 5 mm sphere), paraventricular (e, 10 mm sphere) and subcentral white matter (d, 10 mm sphere) reveals overall decrease in intensity (mean VBI intensity versus ALSFRS-R; g, right; h, left). This illustrates a disability-related MRI intensity change in ‘core’ regions of ALS-related white matter disturbances. Inference was done using Threshold Free Cluster Enhancement (10000 permutations). Color spectrum giving p-value indication (c).</p

Group comparison of bulbar and limb phenotype patient subgroups versus healthy controls.

<p>Wholebrain group-mean of VBI images projected on generic brain (c) and Maximum Intensity Projection (MIP) of significantly different regions (d, e, f). The patterns of MRI intensity change in bulbar (a) and limb (b) subgroups significantly differ despite no significant differences in age, sex or ALSFRS-R score between groups. Coronal (d), sagittal (e) and axial (f) MIPs illustrate apparently more widespread involvement of cerebral white matter in bulbar-onset ALS. Inference was done using Threshold Free Cluster Enhancement (10000 permutations) und Family-wise error rate correction for multiple comparisons. Color spectrum giving p-value indication (g).</p

Intensity response in key CST areas and control regions.

<p>Mean intensity inside ROIs along the CST and in ALS independent white matter regions are shown. The absolute difference of the mean in patients versus controls is referenced to the total white matter intensity spread to allow comparability to other study settings. Significances are given as * (p<0.05), ** (p<0.01), ***(P<0.001) or as not significant (n.s.). The highest response was found in the left PLIC (8.7% higher intensity in patients than in controls). The non ALS disease related white matter regions did not significantly differ between patients and controls.</p

Group comparison of ALSFRS-R stratified patient subgroups versus healthy controls.

<p>Wholebrain group-mean of VBI images projected on generic brain (a, b) and Maximum Intensity Projection of significantly different regions (d, e). The extent of MRI intensity change in ‘low’ disability group (a, d) is significantly less widespread than in the ‘high’ disability group (b, e). Inference was done using Threshold Free Cluster Enhancement (10000 permutations) und Family-wise error rate correction for multiple comparisons. Color spectrum giving p-value indication (c).</p

Group comparison of ALS patients versus healthy controls.

<p>Wholebrain group-mean of VBI images projected on generic brain. Coronal (a), sagittal (b) und axial (c) sections illustrate significantly higher intensity in the CST, corpus callosum and posterior limb of the internal capsule (PLIC). Significant VBI increases were see descending from the motor-cortical level (d) into the cerebral peduncle, rendering areas like the radiate corona (e), PLIC (f) to the midbrain nuclei (g). Inference was done using Threshold Free Cluster Enhancement (10000 permutations) und Family-wise error rate correction for multiple comparisons. Color spectrum gives p-value indication (h).</p

Scheme of the data SWI processing pipeline.

<p>Scheme of the data SWI processing pipeline.</p

Group comparison of SWI images between ALS patients and healthy controls.

<p>ALS patients showed lower SWI signal in deep white matter tracts, including corpus callosum, corticospinal and superior longitudinal fascicle most prominent in its frontal parts. The statistical parametric maps are displayed at a threshold <i>P</i> < 0.05 and corrected for multiple comparisons using FWE.</p