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Far SS, Amiri B, Sahebozamani M, Ebrahimi HA, Zemková E. The effect of multi-function swing suspension training on upper and lower extremities function and quality of life in multiple sclerosis women with different disability status. Mult Scler Relat Disord 2023; 80:105113. [PMID: 37924713 DOI: 10.1016/j.msard.2023.105113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/05/2023] [Accepted: 10/27/2023] [Indexed: 11/06/2023]
Abstract
BACKGROUND Multiple sclerosis (MS) can lead to impaired upper and lower extremity function (ULEF), which reduces the quality of life (QoL). Exercise is beneficial for symptom management, but newer approaches like multi-function swing suspension training (MFSST) need further investigation. Additionally, tailoring exercises to individual needs remains a challenging area of investigation. AIM To investigate the effect of an MFSST program on ULEF, and QoL in MS women according to the expanded disability status scale (EDSS) score. METHODS Forty-seven MS women meeting selection criteria were randomly assigned to intervention groups A (EDSS 2-4) and B (EDSS 4.5-6.5), and the control group (EDSS 2-6.5). Intervention groups did an 8-week MFSST program with 3 × 1hr sessions/week. Prior to the intervention, and after 4, 6, and 8 weeks, the 9-hole peg test (9HPT) and the timed 25-foot walk (T25FW) test were performed for both the intervention groups and the control group. The Short Form questionnaire (SF-36) was used to measure their QoL. RESULTS Significant main effects for time were observed in both the 9HPT (F = 52.48, p = 0.001, Pη2 = 0.78) and the T25FW (F = 85.63, p = 0.000, Pη2 = 0.859). Speed increased between the pre-test, 4th week, 6th week, and 8th week in both tests. These tests revealed significant interaction effects between group and time. The 9HPT had an F-value of 9.01 (p = 0.001, Pη2 = 0.392), while the T25FW had an F-value of 13.812 (p = 0.000, Pη2 = 0.497). Across both tests, Group B, with higher EDSS scores, demonstrated greater speed improvement over the three-time measurements (4th week, 6th week, and 8th week) than Group A. The control group did not exhibit any improvement in speed. Intervention groups showed improvement in all QoL subscales except emotional role limitation. CONCLUSIONS An 8-week MFSST improves ULEF and QoL in women with MS, particularly those with higher EDSS scores (more than 4.5). Notably, significant improvements were observed after four weeks of the intervention. The incorporation of a variety of exercises in a single device provides a significant advantage over traditional exercise programs. Therefore, MFSST can be a valuable and efficient tool for improving symptoms and QoL in MS patients. TRIAL REGISTRATION IRCT20220526054997N1.
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Affiliation(s)
- Sara Sepehri Far
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Banafsheh Amiri
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran; Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
| | - Mansour Sahebozamani
- Department of Sports Injuries and Corrective Exercises, Faculty of Physical Education and Sport, Shahid Bahonar University of Kerman, Kerman, Iran.
| | | | - Erika Zemková
- Department of Biological and Medical Sciences, Faculty of Physical Education and Sport, Comenius University in Bratislava, Slovakia
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Arsenault S, Benoit RY, Clift F, Moore CS. Does the use of the Bruton Tyrosine Kinase inhibitors and the c-kit inhibitor masitinib result in clinically significant outcomes among patients with various forms of multiple sclerosis? Mult Scler Relat Disord 2022; 67:104164. [PMID: 36126539 DOI: 10.1016/j.msard.2022.104164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 08/16/2022] [Accepted: 09/05/2022] [Indexed: 11/19/2022]
Abstract
Multiple sclerosis (MS) is an immune-mediated demyelinating disease of the central nervous system accompanied by chronic inflammation, axonal loss, and neurodegeneration. Traditionally, MS has been thought of as a T-cell mediated disease, but research over the past decade has demonstrated the importance of B cells in both acute demyelination and disease progression. The highly selective irreversible Bruton Tyrosine Kinase (BTK) inhibitors evobrutinib, tolebrutinib, and orelabrutinib, and the reversible BTK inhibitor fenebrutinib, all target B-cell activation and aspects of innate immunity, including macrophage and microglia biology. The c-KIT inhibitor masitinib mitigates neuroinflammation by controlling the survival, migration, and degranulation of mast cells, leading to the inhibition of proinflammatory and vasoactive molecular cascades that result from mast cell activation. This article will review and critically appraise the ongoing clinical trials of two classes of receptor tyrosine kinase inhibitors that are emerging as potential medical treatments for the varying subtypes of MS: BTK inhibitors and c-KIT inhibitors. Specifically, this review will attempt to answer whether BTK inhibitors have measurable positive clinical effects on patients with RRMS, SPMS with relapses, relapse-free SPMS, and PPMS through their effect on MRI T1 lesions; annualized relapse rate; EDSS scale; MSFC score; and time to onset of composite 12-week confirmed disability progression. Additionally, this review will examine the literature to determine if masitinib has positive clinical effects on patients with PPMS or relapse-free SPMS through its effect on EDSS or MSFC scores.
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Affiliation(s)
- Shane Arsenault
- Discipline of Medicine (Neurology), Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
| | - Rochelle Y Benoit
- Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, Newfoundland and Labrador A1B 3V6, Canada
| | - Fraser Clift
- Discipline of Medicine (Neurology), Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada
| | - Craig S Moore
- Discipline of Medicine (Neurology), Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada; Division of Biomedical Sciences, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Drive, St. John's, Newfoundland and Labrador A1B 3V6, Canada
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Muslim AM, Mashohor S, Gawwam GA, Mahmud R, Hanafi MB, Alnuaimi O, Josephine R, Almutairi AD. Brain MRI dataset of multiple sclerosis with consensus manual lesion segmentation and patient meta information. Data Brief 2022; 42:108139. [PMID: 35496484 PMCID: PMC9043670 DOI: 10.1016/j.dib.2022.108139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/30/2022] [Accepted: 04/01/2022] [Indexed: 12/02/2022] Open
Abstract
Magnetic resonance imaging (MRI) provides a significant key to diagnose and monitor the progression of multiple sclerosis (MS) disease. Manual MS-lesion segmentation, expanded disability status scale (EDSS) and patient's meta information can provide a gold standard for research in terms of automated MS-lesion quantification, automated EDSS prediction and identification of the correlation between MS-lesion and patient disability. In this dataset, we provide a novel multi-sequence MRI dataset of 60 MS patients with consensus manual lesion segmentation, EDSS, general patient information and clinical information. On this dataset, three radiologists and neurologist experts segmented and validated the manual MS-lesion segmentation for three MRI sequences T1-weighted, T2-weighted and fluid-attenuated inversion recovery (FLAIR). The dataset can be used to study the relationship between MS-lesion, EDSS and patient clinical information. Furthermore, it also can be used for the development of automated MS-lesion segmentation, patient disability prediction using MRI and correlation analysis between patient disability and MRI brain abnormalities include MS lesion location, size, number and type.
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Affiliation(s)
- Ali M. Muslim
- Department of Computer Science, Dijlah University College, Baghdad, Iraq
- Department of Computer and Communication System Engineering, Universiti Putra Malaysia, Serdang, Malaysia
| | - Syamsiah Mashohor
- Department of Computer and Communication System Engineering, Universiti Putra Malaysia, Serdang, Malaysia
- Corresponding author.
| | | | - Rozi Mahmud
- Department of Imaging, Universiti Putra Malaysia, Serdang, Malaysia
| | - Marsyita binti Hanafi
- Department of Computer and Communication System Engineering, Universiti Putra Malaysia, Serdang, Malaysia
| | - Osama Alnuaimi
- Department of Radiology and Medical Imaging, Elias Emergency University Hospital, Bucharest, Romania
| | - Raad Josephine
- Department of Radiology and Medical Imaging, Elias Emergency University Hospital, Bucharest, Romania
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Kenney R, Liu M, Patil S, Alroughani R, Ampapa R, Bergamaschi R, Boz C, Butzkueven H, Gomez JC, Cartechini E, Madueño SE, Ferraro D, Grand-Maison F, Granella F, Horakova D, Izquierdo Ayuso G, Kalincik T, Lizrova Preiningerova J, Lugaresi A, Onofrj M, Ozakbas S, Patti F, Sola P, Soysal A, Spitaleri DLA, Terzi M, Turkoglu R, van Pesch V, Saidha S, Thorpe LE, Galetta SL, Balcer LJ, Kister I, Spelman T. Long-term outcomes in patients presenting with optic neuritis: Analyses of the MSBase registry. J Neurol Sci 2021; 430:118067. [PMID: 34537678 DOI: 10.1016/j.jns.2021.118067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 08/11/2021] [Accepted: 09/01/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Short-term outcomes of optic neuritis (ON) have been well characterized. Limited data exists on longer-term visual outcomes in patients who present with ON. The large MSBase registry allows for characterization of long-term visual outcomes after ON. METHODS Via the MSBase Registry, data on patients from 41 centers was collected during routine clinical and research visits. Physical and visual disability were measured using the expanded disability status scale (EDSS) and the visual function score (VFS). Inclusion criteria for this analysis included age ≥ 18 years, clinically isolated syndrome (CIS), ON-onset, baseline visit within 6 months of onset, and at least one follow-up visit. Survival analysis was used to evaluate the association of disease-modifying treatment with time to conversion to clinically definite MS or sustained EDSS/VFS progression. RESULTS Data from 60,933 patients were obtained from the MSBase registry in July 2019. Of these, 1317 patients met inclusion criteria; 935 were treated at some point in disease course, while 382 were never treated. At baseline, mean age was 32.3 ± 8.8 years, 74% were female, median EDSS was 2 (IQR 1-2), and median VFS was 1 (IQR 0-2). Median follow-up time was 5.2 years (IQR 2.4-9.3). Treatment was associated with reduced risk and delayed conversion to clinically definite MS (HR = 0.70, p < 0.001), sustained EDSS progression (HR = 0.46, p < 0.0001) and sustained VFS (HR = 0.41, p < 0.001) progression. CONCLUSIONS In the MSBase cohort, treatment after ON was associated with better visual and neurological outcomes compared to no treatment. These results support early treatment for patients presenting with ON as the first manifestation of MS.
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Affiliation(s)
- Rachel Kenney
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Sachi Patil
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA.
| | | | - Radek Ampapa
- Neurologicka Klinika Jihlava, Jihlava, Czech Republic
| | | | - Cavit Boz
- KTU Medical Faculty Farabi Hospital, Trabzon, Turkey
| | | | | | | | | | - Diana Ferraro
- University of Modena and Reggio Emilia, Modena, Province of Modena, Italy.
| | | | - Franco Granella
- Department of Medicine and Surgery, University of Parma, Italy.
| | - Dana Horakova
- Charles University in Prague and General University Hospital, Prague, Czech Republic.
| | | | - Tomas Kalincik
- MS Centre, Royal Melbourne Hospital, CORe, Department of Medicine, University of Melbourne, Melbourne, AU.
| | | | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy; Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italy.
| | - Marco Onofrj
- University G. d'Annunzio, Chieti-Pescara, Italy.
| | | | - Francesco Patti
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Catania, Italy.
| | - Patrizia Sola
- Nuovo Ospedale Civile S. Agostino-Estense, Baggiovara, MO, Italy.
| | - Aysun Soysal
- Bakirkoy Hospital Of Mental Disorders And Neuro, Bakirkoy/Istanbul, Turkey
| | | | | | - Recai Turkoglu
- Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey
| | | | - Shiv Saidha
- Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Lorna E Thorpe
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA.
| | - Steven L Galetta
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA.
| | - Laura J Balcer
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA; Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA; Department of Ophthalmology, New York University Grossman School of Medicine, New York, NY, USA.
| | - Ilya Kister
- Department of Neurology, New York University Grossman School of Medicine, New York, NY, USA.
| | - Tim Spelman
- MSBase Foundation, Alfred Centre, Melbourne, Australia; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
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Bose G, Rush C, Atkins HL, Freedman MS. A real-world single-centre analysis of alemtuzumab and cladribine for multiple sclerosis. Mult Scler Relat Disord 2021; 52:102945. [PMID: 33901969 DOI: 10.1016/j.msard.2021.102945] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 02/24/2021] [Accepted: 04/07/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Highly active MS may warrant higher efficacy treatments for disease control. However, these often confer more risk and have not been compared in head-to-head clinical trials, making relative efficacy and safety difficult to interpret. Alemtuzumab and cladribine are two high-efficacy treatments given as discrete courses separated by one year, followed by a durable response that potentially does not require ongoing treatment. Before the approval of oral cladribine, our centre had been treating patients with a bioequivalent intravenous (IV) regimen since 2010. The objective of this study is to report the safety and efficacy data of alemtuzumab and cladribine in a real-world, single centre setting. METHODS We retrospectively reviewed all patients treated with alemtuzumab or cladribine at the Ottawa Hospital MS Clinic with 2 or more years of follow-up. Information on baseline demographic variables, previous treatment, and prior disease activity was collected. Outcomes investigated were "no evidence of disease activity" (NEDA) and its constituents: new clinical relapse, new MRI activity, and Expanded Disability Status Scale (EDSS) progression; as well as any adverse events or treatment discontinuation. We performed univariate and multiple logistic regression to determine differences in 2-year NEDA and time-to-event analyses with Cox regression models to determine factors associated with each outcome through the study period. RESULTS Forty-six patients were treated with alemtuzumab and 65 with cladribine of whom 51 (78%) received the intravenous regimen, followed for a total of 420.1 person-years. The cladribine group was older (p=.0002), with higher baseline EDSS (p=.0015), and more likely secondary progressive (p<.0001). Alemtuzumab had a higher rate of 2-year NEDA than cladribine (OR 4.78, 95%CI: 1.57-14.50, p=.006), but beyond 2 years the difference was not statistically significant (HR 0.50, 95%CI: 0.25-1. 30, p=.061). More prior treatments were associated with lower likelihood of retaining NEDA (HR 1.26, 95%CI: 1.03-1.54, p=.027). Alemtuzumab had more infusion reactions (80% vs. 17%, p<.0001), shingles (22% vs. 2%, p=.005), and secondary autoimmunity (52% vs. 3%, p<.0001) than cladribine, but there was no difference in grade 3 or higher adverse events (21.7% vs. 18.5%, p=1.0). CONCLUSION In our cohort alemtuzumab and cladribine achieved similar rates of NEDA in long-term follow-up, with overall less adverse events with cladribine. Patient registries would allow more robust comparisons, detection of adverse events, and assessment of a durable response.
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Affiliation(s)
- Gauruv Bose
- University of Ottawa and The Ottawa Hospital Research Institute, Department of Medicine, The Ottawa Hospital Civic Campus, 1053 Carling Ave, Ottawa ON K1Y 4E9, Canada.
| | - Carolina Rush
- University of Ottawa and The Ottawa Hospital Research Institute, Department of Medicine, The Ottawa Hospital General Campus, Multiple Sclerosis Clinic, 501 Smyth Road, Box 601, Ottawa ON K1H 8L6, Canada.
| | - Harold L Atkins
- University of Ottawa and The Ottawa Hospital Research Institute, Department of Medicine, The Ottawa Hospital General Campus, Blood and Marrow Transplant Program, 501 Smyth Road, Box 926, Ottawa, ON K1H 8L6, Canada.
| | - Mark S Freedman
- University of Ottawa and The Ottawa Hospital Research Institute, Department of Medicine, The Ottawa Hospital General Campus, Multiple Sclerosis Clinic, 501 Smyth Road, Box 601, Ottawa ON K1H 8L6, Canada.
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Ashtari F, Esmaeil N, Mansourian M, Poursafa P, Mirmosayyeb O, Barzegar M, Pourgheisari H. An 8-year study of people with multiple sclerosis in Isfahan, Iran: Association between environmental air pollutants and severity of disease. J Neuroimmunol 2018; 319:106-11. [PMID: 29526408 DOI: 10.1016/j.jneuroim.2018.02.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The evidence for an impact of ambient air pollution on the incidence and severity of multiple sclerosis (MS) is still limited. In the present study, we assessed the association between daily air pollution levels and MS prevalence and severity in Isfahan city, Iran. Data related to MS patients has been collected from 2008 to 2016 in a referral university clinic. The air quality index (AQI) data, were collected from 6 monitoring stations of Isfahan department of environment. The distribution map presenting the sites of air pollution monitoring stations as well as the residential address of MS patients was plotted on geographical information system (GIS). An increase in AQI level in four areas of the city (north, west, east and south) was associated with higher expanded disability status scale (EDSS) of MS patients[logistic regression odds ratio = 1.01 (95% CI = 1.008,1.012)]. Moreover, significant inverse association between the complete remission after the first attack with AQI level in total areas [logistic regression odds ratio = 0.987 (95% CI = 0.977, 0.997)] was found in crude model. However, after adjustment for confounding variables through multivariate logistic regression, AQI level was associated with degree of complete remission after first attack 1.005 (95% CI = 1.004, 1.006). The results of our study suggest that air pollution could play a role in the severity and remission of MS disease. However, more detailed studies with considering the complex involvement of different environmental factors including sunlight exposure, diet, depression and vitamin D are needed to determine the outcome of MS.
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Shroff G. Evaluation of patients with multiple sclerosis using reverse nutech functional score and expanded disability status scale after human embryonic stem cell therapy. Clin Transl Med 2016; 5:43. [PMID: 27766605 PMCID: PMC5073081 DOI: 10.1186/s40169-016-0124-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 10/05/2016] [Indexed: 11/25/2022] Open
Abstract
Background The expanded disability status scale (EDSS) is a validated and reliable tool to assess the extent of disabilities in patients with multiple sclerosis (MS). However, the use of this tool has been found to be limited in assessing various symptoms of MS that are important. Our study aimed at evaluating the efficacy of a new scoring system, reverse nutech functional score (RNFS) as compared to EDSS in assessing patients with MS treated with human embryonic stem cell (hESC) therapy. Methods The MS patients were treated with hESC therapy for one treatment period. All the patients were evaluated with EDSS and RNFS at baseline and after the hESC therapy. Results The study included a total of 24 MS patients with mean age of 45 year. The patients showed an improvement in parameters (sleeping disorders, paralysis, paraesthesia, myalgia, muscle weakness, memory, language, irritability, eye pain, depression and coordination, communication, breathing pattern, attention and appetite) associated with MS when evaluated with RNFS. This improvement went unnoticed when the patients were assessed with EDSS. Conclusion RNFS can efficiently assess the effectiveness of hESC therapy in treating patients with MS. It could be a suitable scoring system for patients with MS as it can assess the slightest improvements in the patients. Use in other settings would be helpful in assessing its utility.
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Affiliation(s)
- Geeta Shroff
- Nutech Mediworld, H-8, Green Park Extension, New Delhi, 110016, India.
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Neva JL, Lakhani B, Brown KE, Wadden KP, Mang CS, Ledwell NHM, Borich MR, Vavasour IM, Laule C, Traboulsee AL, MacKay AL, Boyd LA. Multiple measures of corticospinal excitability are associated with clinical features of multiple sclerosis. Behav Brain Res 2016; 297:187-95. [PMID: 26467603 PMCID: PMC4904787 DOI: 10.1016/j.bbr.2015.10.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/04/2015] [Accepted: 10/05/2015] [Indexed: 10/22/2022]
Abstract
In individuals with multiple sclerosis (MS), transcranial magnetic stimulation (TMS) may be employed to assess the integrity of corticospinal system and provides a potential surrogate biomarker of disability. The purpose of this study was to provide a comprehensive examination of the relationship between multiple measures corticospinal excitability and clinical disability in MS (expanded disability status scale (EDSS)). Bilateral corticospinal excitability was assessed using motor evoked potential (MEP) input-output (IO) curves, cortical silent period (CSP), short-interval intracortical inhibition (SICI), intracortical facilitation (ICF) and transcallosal inhibition (TCI) in 26 individuals with MS and 11 healthy controls. Measures of corticospinal excitability were compared between individuals with MS and controls. We evaluated the relationship(s) between age and clinical demographics such as age at MS onset (AO), disease duration (DD) and clinical disability (EDSS) with measures of corticospinal excitability. Corticospinal excitability thresholds were higher, MEP latency and CSP onset delayed and MEP durations prolonged in individuals with MS compared to controls. Age, DD and EDSS correlated with corticospinal excitability thresholds. Also, TCI duration and the linear slope of the MEP amplitude IO curve correlated with EDSS. Hierarchical regression modeling demonstrated that combining multiple TMS-based measures of corticospinal excitability accounted for unique variance in clinical disability (EDSS) beyond that of clinical demographics (AO, DD). Our results indicate that multiple TMS-based measures of corticospinal and interhemispheric excitability provide insights into the potential neural mechanisms associated with clinical disability in MS. These findings may aid in the clinical evaluation, disease monitoring and prediction of disability in MS.
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Affiliation(s)
- J L Neva
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - B Lakhani
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K E Brown
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - K P Wadden
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - C S Mang
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - N H M Ledwell
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
| | - M R Borich
- Division of Physical Therapy, Department of Rehabilitation Medicine, School of Medicine, Emory University, Atlanta, GA, USA
| | - I M Vavasour
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada
| | - C Laule
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Pathology & Laboratory Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - A L Traboulsee
- Division of Neurology, Department of Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada
| | - A L MacKay
- Department of Radiology, The University of British Columbia, Vancouver, BC, Canada; Department of Physics & Astronomy, The University of British Columbia, Vancouver, BC, Canada
| | - L A Boyd
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada
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