Compared with open social networks, close-knit personal social networks are associated with worse physical function in patients with multiple sclerosis (MS), according to study results published in Neurology.

As there are limited data on the role of the social network in MS outcomes, the aim of the current study was to investigate the relationship between social network characteristics and physical function in adult patients with MS.

This cross-sectional study included data from 2 academic MS centers, one serving as a discovery group and the other as an extension group. Furthermore, a meta-analysis of the 2 cohorts was completed.

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The primary outcome was the NIH Patient-Reported Outcomes Measurement Information System (PROMIS) physical function scale (0-100), with higher scores signifying better overall physical function. Study researchers mapped the structure and health habits of social networks by using questionnaires that asked participants to identify people whom they had discussed important matters, socialized, or sought support in the last 3 months.

The discovery cohort included 263 participants (81% women; mean age, 48.8 years) with MS, most of whom (78%) had a relapsing remitting MS phenotype. The extension cohort included 164 patients with MS who were younger (71% women; mean age, 44.1 years), less physically disabled, and had shorter disease duration.

A permutation-based omnibus test was used to analyze the presence of an excess of associations for either network structure or composition with the PROMIS T-score. For network structure (the quantitative measure of social ties) the distribution of P-values in the omnibus test was significantly greater than chance (P =.002). For network composition, however, it was only suggestive (P =.047).

In addition, there was a correlation between larger network effective size (a measure of the openness of a network) with better physical function (β=0.170±0.062, P =.006). On the other hand, network constraint (a measure of tightly bound networks) was associated with worse physical function (β=-0.206±0.058, P <.001).

A meta-analysis of the discovery and the extension cohort revealed findings consistent with the discovery study, as there was a correlation of network effective size with PROMIS T-score (β=0.135±0.046, P =.003) and between higher network constraint and lower PROMIS T-score (β=-0.163±0.047, P <.001).

The study had several limitations, including the cross-sectional design and consequent inability to determine causality, potential recall bias due to the use of self-report data, potential selection bias, and missing data on the comorbidity burden.

The researchers concluded that “interventions that target the broader social networks may offer a promising approach to improve physical function and reduce disability in MS.”


Levin SN, Riley CS, Dhand A, et al. Association of social network structure and physical function in patients with multiple sclerosis. Neurology. Published online August 7, 2020. doi:10.1212/WNL.0000000000010460