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Edwards EM, Stanley JA, Daugherty AM, Lynn J, Borich MR, Fritz NE. Associations between myelin water imaging and measures of fall risk and functional mobility in multiple sclerosis. J Neuroimaging 2023; 33:94-101. [PMID: 36266780 DOI: 10.1111/jon.13064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/26/2022] [Accepted: 10/08/2022] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND AND PURPOSE Myelin water fraction (MWF) deficits as measured by myelin water imaging (MWI) have been related to worse motor function in persons with multiple sclerosis (PwMS). However, it is unknown if measures from MWI metrics in motor areas relate to fall risk measures in PwMS. The objective of this study was to examine the relationship between MWI measures in motor areas to performance on clinical measures of fall risk and disability in PwMS. METHODS Sixteen individuals with relapsing-remitting MS participated (1 male, 15 female; age 47.1 years [12.3]; Expanded Disability Status Scale 4.0 [range 0-6.5]) and completed measures of walking and fall risk (Timed 25 Foot Walk [T25FW] and Timed Up and Go). MWF and the geometric mean of the intra-/extracellular water T2 (geomT2IEW ) values reflecting myelin content and contribution of large-diameter axons/density, respectively, were assessed in three motor-related regions. RESULTS The geomT2IEW of the corticospinal tract (r = -.599; p = .018) and superior cerebellar peduncles (r = -.613; p = .015) demonstrated significant inverse relationships with T25FW, suggesting that decreased geomT2IEW was related to slower walking. Though not significant, MWF in the corticospinal tract and superior cerebellar peduncles also demonstrated fair relationships with the T25FW, suggesting that worse performance on the T25FW was associated with lower MWF values. CONCLUSIONS MWI of key motor regions was associated with walking performance in PwMS. Further MWI studies are needed to identify relationships between pathology and clinical function in PwMS to guide targeted rehabilitation therapies aimed at preventing falls.
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Affiliation(s)
- Erin M Edwards
- Translational Neuroscience Program, Wayne State University, Detroit, Michigan, USA.,Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, Michigan, USA
| | - Jeffrey A Stanley
- Translational Neuroscience Program, Wayne State University, Detroit, Michigan, USA.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Ana M Daugherty
- Department of Psychology, Wayne State University, Detroit, Michigan, USA.,Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Jonathan Lynn
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, Michigan, USA
| | - Michael R Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Nora E Fritz
- Translational Neuroscience Program, Wayne State University, Detroit, Michigan, USA.,Neuroimaging and Neurorehabilitation Laboratory, Wayne State University, Detroit, Michigan, USA.,Department of Health Care Sciences, Wayne State University, Detroit, Michigan, USA.,Department of Neurology, Wayne State University, Detroit, Michigan, USA
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Zackowski KM, Freeman J, Brichetto G, Centonze D, Dalgas U, DeLuca J, Ehde D, Elgott S, Fanning V, Feys P, Finlayson M, Gold SM, Inglese M, Marrie RA, Ploughman M, Sang CN, Sastre-Garriga J, Sincock C, Strum J, van Beek J, Feinstein A. Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance. Mult Scler 2021; 27:989-1001. [PMID: 33720795 PMCID: PMC8151585 DOI: 10.1177/1352458521999970] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background: People with multiple sclerosis (MS) experience myriad symptoms that negatively affect their quality of life. Despite significant progress in rehabilitation strategies for people living with relapsing-remitting MS (RRMS), the development of similar strategies for people with progressive MS has received little attention. Objective: To highlight key symptoms of importance to people with progressive MS and stimulate the design and implementation of high-quality studies focused on symptom management and rehabilitation. Methods: A group of international research experts, representatives from industry, and people affected by progressive MS was convened by the International Progressive MS Alliance to devise research priorities for addressing symptoms in progressive MS. Results: Based on information from the MS community, we outline a rationale for highlighting four symptoms of particular interest: fatigue, mobility and upper extremity impairment, pain, and cognitive impairment. Factors such as depression, resilience, comorbidities, and psychosocial support are described, as they affect treatment efficacy. Conclusions: This coordinated call to action—to the research community to prioritize investigation of effective symptom management strategies, and to funders to support them—is an important step in addressing gaps in rehabilitation research for people affected by progressive MS.
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Affiliation(s)
- Kathleen M Zackowski
- KM Zackowski Patient Management Care and Rehabilitation Research, National Multiple Sclerosis Society, 733 3rd Avenue, 3rd floor, New York, NY 10017, USA.
| | - Jennifer Freeman
- School of Health Professions, University of Plymouth, Plymouth UK
| | | | - Diego Centonze
- Department of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Ulrik Dalgas
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - John DeLuca
- Department of Research, Kessler Foundation, West Orange, NJ, USA
| | - Dawn Ehde
- Department of Rehabilitation Medicine, University of Washington Medicine, Seattle, WA, USA
| | - Sara Elgott
- Global Director of Patient Affairs, MedDay Pharmaceuticals, Maidenhead, UK
| | - Vanessa Fanning
- People Affected by MS Committee, International Progressive MS Alliance, Canberra, ACT, Australia
| | - Peter Feys
- Department of Rehabilitation Sciences and Physiotherapy, Universiteit Hasselt, Hasselt, Belgium
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Stefan M Gold
- Department of Neuropsychiatry, Charitè—University of Medicine Berlin, Berlin, Germany
| | - Matilde Inglese
- Department of Neurology, Radiology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ruth Ann Marrie
- Departments of Internal Medicine and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Michelle Ploughman
- Department of Physical Medicine and Rehabilitation, Memorial University of Newfoundland, St. Johns, NL, Canada
| | - Christine N Sang
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Caroline Sincock
- Scientific Steering Committee, International Progressive MS Alliance, Glasgow, UK
| | - Jonathan Strum
- Scientific Steering Committee, International Progressive MS Alliance, Long Beach, CA, USA
| | - Johan van Beek
- Global International Scientific Director, Neuroimmunology, F. Hoffmann-La Roche, Ltd., Basel, Switzerland
| | - Anthony Feinstein
- Department of Psychiatry, University of Toronto and Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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