Motor evoked potentials in multiple sclerosis patients without walking limitation: amplitude vs. conduction time abnormalities

2007 ◽  
Vol 254 (2) ◽  
pp. 220-227 ◽  
Author(s):  
Andrea Gagliardo ◽  
Francesca Galli ◽  
Antonello Grippo ◽  
Aldo Amantini ◽  
Cristiana Martinelli ◽  
...  
2010 ◽  
Vol 17 (2) ◽  
pp. 198-203 ◽  
Author(s):  
Sven G Meuth ◽  
Stefan Bittner ◽  
Carola Seiler ◽  
Kerstin Göbel ◽  
Heinz Wiendl

Background and Objective: The objective of this study was to examine the effects of natalizumab on functional parameters assessed by evoked potentials (visual [VEP], somatosensory [SEP] and motor evoked potentials [MEP]) in a cohort study in relapsing–remitting multiple sclerosis patients. Methods: EP data of 44 patients examined 12 months prior to natalizumab treatment, at the timepoint of treatment initiation and 1 year later were compared. Sum scores (VEP, MEP, SEP) were evaluated and correlated with the Expanded Disability Status Scale. Results: Improvement of the VEP sum score was found in 33% of natalizumab-treated patients but only in 9% of the same patients prior to treatment ( p = 0.041). A comparable situation was found for SEP (improvement: 32% versus 5%; worsening: 11% versus 37%; p = 0.027). For MEP no significant differences were seen (improvement: 10% versus 18%; worsening: 5% versus 29%; p = 0.60). EP recordings (VEP = SEP > MEP) have the capacity to demonstrate treatment effects of natalizumab on a functional level. Conclusions: Natalizumab therapy increases the percentage of patients showing stable or even ameliorated electrophysiological parameters in the investigated functional systems.


2009 ◽  
Vol 15 (3) ◽  
pp. 355-362 ◽  
Author(s):  
A Rico ◽  
B Audoin ◽  
J Franques ◽  
A Eusebio ◽  
F Reuter ◽  
...  

The aim of the present study was to determine the sensitivity and the profile of motor evoked potentials (MEP) in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). We measured the central motor conduction time (CMCT), amplitude ratio (AR), and surface ratio (SR) in tibialis anterior and first dorsal interosseous muscles in 22 patients with CIS. In 12 patients, the triple stimulation technique (TST) was also performed. AR was abnormal in 50% of patients, CMCT in 18% of patients, and TST in 25% of patients. AR had the highest sub-clinical sensitivity and the best positive predictive value. In the absence of clinical pyramidal signs, an early AR decrease seems to result from demyelination inducing excessive temporal dispersion of the MEP, while in territories with clinical pyramidal signs, it seems to result from conduction failure, which suggests that clinical pyramidal signs may be attributable to conduction failure. This study demonstrates that MEP, especially the AR, is sensitive to motor pathway dysfunction right from the early stages of MS.


2019 ◽  
Author(s):  
DANIELA MARILENA TROFIN ◽  
DAN TROFIN ◽  
BOGDAN IGNAT ◽  
ANDREI CIOBICA ◽  
TEODOR STAMATE ◽  
...  

Abstract Backgound : the purpose of the study is to consider the utility of Transcranial Magnetic Stimulation (TMS) in patients with Multiple Sclerosis (MS) and walking impairment, treated with Fampridine, as correlated with the 25-Foot-Walk test (T25-FW). It is known that clinical benefits should be identified within two to four weeks after starting the treatment; otherwise, if there is no benefit reported by patients, it should be discontinued. Methods: 15 MS patients with walking impairment, ranked between 3.5 and 7 on the Expanded Disability Status Scale (EDSS), were investigated by T25-FW and TMS. Evaluations were performed prior to Fampridine 10 mg twice daily administration, 5 and 12 days afterwards, and also 1 and 3 months later. The medium age was 42.8 years and an average duration of the disease was 12.06 years. Results: we assessed an improvement of walking by 2.1 seconds measured on the T25-FW after the first 12 days in 9 patients, which correlated with a 2 miliseconds improvement of the Central Motor Conduction Time (CMCT). For the other 6 patients there was no visible clinical improvement. Nevertheless, CMCT dropped by 0.5 ms and the motor conduction speed by 1 millisecond in 4 of these 6 patients. Fampridine administration was continued in the 4 cases. At the end of the 3 months period, their walking speed measured as on the T25-FW also improved by 2 sec. Conclusions: the amelioration of TMS parameters anticipated the improvement of speed on the T25-FW. In spite of the early false negative clinical response, electrophysiological findings could predict a future clinical improvement if treatment is continued.


2001 ◽  
Vol 15 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Kadriye Armutlu ◽  
Rana Karabudak ◽  
Gülay Nurlu

Objective: This study was planned to investigate the efficacy of neuromuscular rehabilitation and Johnstone Pressure Splints in the patients who had ataxic multiple sclerosis. Methods: Twenty-six outpatients with multiple sclerosis were the subjects of the study. The control group (n = 13) was given neuromuscular rehabilitation, whereas the study group (n = 13) was treated with Johnstone Pressure Splints in ad dition. Results: In pre- and posttreatment data, significant differences were found in sensation, anterior balance, gait parameters, and Expanded Disability Status Scale (p < 0.05). An important difference was observed in walking-on-two-lines data within the groups (p < 0.05). There also was a statistically significant difference in pendular movements and dysdiadakokinesia (p < 0.05). When the posttreatment values were compared, there was no significant difference between sensation, anterior balance, gait parameters, equilibrium and nonequilibrium coordination tests, Expanded Disability Status Scale, cortical onset latency, and central conduction time of somatosensory evoked potentials and motor evoked potentials (p > 0.05). Comparison of values re vealed an important difference in cortical onset-P37 peak amplitude of somatosen sory evoked potentials (right limbs) in favor of the study group (p < 0.05). Conclu sions : According to our study, it was determined that physiotherapy approaches were effective to decrease the ataxia. We conclude that the combination of suitable phys iotherapy techniques is effective multiple sclerosis rehabilitation. Key Words: Multi ple sclerosis—Ataxia—Physical therapy.


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