Accelerometry Reveals Differences in Gait Variability Between Patients with Multiple Sclerosis and Healthy Controls

Many falls in persons with multiple sclerosis (PwMS) occur during daily activities such as negotiating obstacles or changing direction. While increased gait variability is a robust biomarker of fall risk in PwMS, gait variability in more ecologically related tasks is unclear. Here, the effects of turning and negotiating an obstacle on gait variability in PwMS were investigated. PwMS and matched healthy controls were instrumented with inertial measurement units on the feet, lumbar, and torso. Subjects completed a walk and turn (WT) with and without an obstacle crossing (OW). Each task was partitioned into pre-turn, post-turn, pre-obstacle, and post-obstacle phases for analysis. Spatial and temporal gait measures and measures of trunk rotation were captured for each phase of each task. In the WT condition, PwMS demonstrated significantly more variability in lumbar and trunk yaw range of motion and rate, lateral foot deviation, cadence, and step time after turning than before. In the OW condition, PwMS demonstrated significantly more variability in both spatial and temporal gait parameters in obstacle approach after turning compared to before turning. No significant differences in gait variability were observed after negotiating an obstacle, regardless of turning or not. Results suggest that the context of gait variability measurement is important. The increased number of variables impacted from turning and the influence of turning on obstacle negotiation suggest that varying tasks must be considered together rather than in isolation to obtain an informed understanding of gait variability that more closely resembles everyday walking.

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ASSESSMENT OF FATIGUE ACROSS SEASONS OVER YEAR IN MULTIPLE SCLEROSIS PATIENTS AND HEALTHY CONTROLS

10.26226/morressier.5ab4d4eed462b80296ca4dac ◽

2018 ◽

Author(s):

Daphne Bakalidou

Keyword(s):

Multiple Sclerosis ◽

Healthy Controls ◽

Multiple Sclerosis Patients

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Upper Extremity Motor Fatigability as an Early Indicator in Pediatric Onset Multiple Sclerosis

Journal of Child Neurology ◽

10.1177/0883073821999889 ◽

2021 ◽

pp. 088307382199988

Author(s):

Giuseppina Pilloni ◽

Martin Malik ◽

Raghav Malik ◽

Lauren Krupp ◽

Leigh Charvet

Keyword(s):

Multiple Sclerosis ◽

Grip Strength ◽

Upper Extremity ◽

Static Fatigue ◽

Healthy Controls ◽

Fatigue Index ◽

Left Hand ◽

Right Hand ◽

Computer Based ◽

Pediatric Onset

Aim: To adopt a computer-based protocol to assess grip fatigability in patients with pediatric-onset multiple sclerosis to provide detection of subtle motor involvement identifying those patients most at risk for future decline. Method: Pediatric-onset multiple sclerosis patients were recruited during routine outpatient visits to complete a grip assessment and compared to a group of healthy age- and sex-matched controls. All participants completed a computer-based measurement of standard maximal grip strength and repetitive and sustained grip performance measured by dynamic and static fatigue indices. Results: A total of 38 patients with pediatric-onset multiple sclerosis and 24 healthy controls completed the grip protocol (right-hand dominant). There were no significant group differences in maximal grip strength bilaterally (right: 21.8 vs 19.9 kg, P = .25; left: 20.4 vs 18.7 kg, P = .33), although males with pediatric-onset multiple sclerosis were significantly less strong than healthy controls (right: 26.53 vs 21.23 kg, P = .009; left; 25.13 vs 19.63 kg, P = .003). Both dynamic and static fatigue indices were significantly higher bilaterally in pediatric-onset multiple sclerosis compared with healthy control participants (left-hand dynamic fatigue index: 18.6% vs 26.7%, P = .003; right-hand static fatigue index: 28.3% vs 41.3%, P < .001; left-hand static fatigue index: 31.9% vs 42.6%, P < .001). Conclusion: Brief repeatable grip assessment including measures of dynamic and sustained static output can be a sensitive indicator of upper extremity motor involvement in pediatric-onset multiple sclerosis, potentially identifying those in need of intervention to prevent future disability.

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Central neuropathic pain in multiple sclerosis is associated with impaired innocuous thermal pathways and neuronal hyperexcitability

Pain Medicine ◽

10.1093/pm/pnab103 ◽

2021 ◽

Author(s):

Michal Rivel ◽

Anat Achiron ◽

Mark Dolev ◽

Yael Stern ◽

Gaby Zeilig ◽

...

Keyword(s):

Multiple Sclerosis ◽

Neuropathic Pain ◽

Cross Sectional Study ◽

Healthy Controls ◽

Sectional Study ◽

Sensory Testing ◽

Cross Sectional ◽

Central Neuropathic Pain ◽

Body Regions ◽

Thermal Grill Illusion

Abstract Objective About a third of patients with multiple sclerosis (MS) suffer from chronic and excruciating central neuropathic pain (CNP). The mechanism underlying CNP in MS is not clear, since previous studies are scarce and their results are inconsistent. Our aim was to determine whether CNP in MS is associated with impairment of the spinothalamic-thalamocortical pathways (STTCs) and/or increased excitability of the pain system. Design Cross sectional study Setting General hospital Subjects 47 MS patients with CNP, 42 MS patients without CNP, and 32 healthy controls. Methods Sensory testing included the measurement of temperature, pain, and touch thresholds and the thermal grill illusion (TGI) for evaluating STTCs function, and hyperpathia and allodynia as indicators of hyperexcitability. CNP was characterized using interviews and questionnaires. Results The CNP group had higher cold and warm thresholds (p < 0.01), as well as higher TGI perception thresholds (p < 0.05), especially in painful body regions compared to controls, whereas touch and pain thresholds values were normal. The CNP group also had a significantly greater prevalence of hyperpathia and allodynia. Regression analysis revealed that whereas presence of CNP was associated with a higher cold threshold, CNP intensity, and the number of painful body regions were associated with allodynia and hyperpathia, respectively. Conclusions CNP in MS is characterized by a specific impairment of STTC function; the innocuous thermal pathways, and by pain hyperexcitability. Whereas CNP presence is associated with STTC impairment, its severity and extent are associated with pain hyperexcitability. Interventions that reduce excitability level may therefore mitigate CNP severity.

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Analysis of spectral domain optical coherence tomography measurements in optic neuritis: differences in neuromyelitis optica, multiple sclerosis, isolated optic neuritis and normal healthy controls

Acta Ophthalmologica ◽

10.1111/aos.12215 ◽

2013 ◽

Vol 92 (1) ◽

pp. e57-e65 ◽

Cited By ~ 34

Author(s):

Kyung-Ah Park ◽

Jaeryung Kim ◽

Sei Yeul Oh

Keyword(s):

Multiple Sclerosis ◽

Optical Coherence Tomography ◽

Optic Neuritis ◽

Neuromyelitis Optica ◽

Spectral Domain ◽

Healthy Controls ◽

Optical Coherence

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Prevalence of restless legs syndrome and REM sleep behavior disorder in multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458506074644 ◽

2007 ◽

Vol 13 (6) ◽

pp. 805-808 ◽

Cited By ~ 71

Author(s):

M.J. Gómez-Choco ◽

A. Iranzo ◽

Y. Blanco ◽

F. Graus ◽

J. Santamaria ◽

...

Keyword(s):

Multiple Sclerosis ◽

Restless Legs Syndrome ◽

Rem Sleep ◽

Neurological Disease ◽

Age Distribution ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Healthy Controls ◽

Sleep Behavior ◽

Restless Legs

A total of 135 consecutive, unrelated, multiple sclerosis (MS) patients were interviewed for symptoms suggestive of restless legs syndrome (RLS) and REM sleep behavior disorder (RBD), using semi-structured questionnaires. Some 118 unrelated healthy controls of similar sex and age distribution were included for comparison. Patients and controls with equivocal symptoms were re-evaluated by a sleep disorders specialist and video-polisomnography in those who fulfilled the criteria for RBD. We did not find significant differences in frequency (13.3 versus 9.3%), proportion of females (66.7 versus 58.5%), and mean age (42.1±12.6 versus 43±7.8 years) among MS patients and controls with RLS. RBD was found in three patients (1.4%), one associated with antidepressant intake, but in none of the controls. Our study shows that RLS in MS is not more frequent than in the general population, and that RBD, although uncommon, may occur in the setting of this neurological disease. Multiple Sclerosis 2007; 13: 805-808. http://msj.sagepub.com

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TNF-alpha Production by Peripheral Blood Monocytes in Multiple Sclerosis Patients and Healthy Controls

Immunological Investigations ◽

10.3109/08820139.2015.1059851 ◽

2015 ◽

Vol 44 (6) ◽

pp. 590-601 ◽

Cited By ~ 9

Author(s):

Mehrdad Farrokhi ◽

Masoud Etemadifar ◽

Maryam Sadat Jafary Alavi ◽

Sayyed Hamid Zarkesh-Esfahani ◽

Mohaddeseh Behjati ◽

...

Keyword(s):

Multiple Sclerosis ◽

Peripheral Blood ◽

Tnf Alpha ◽

Healthy Controls ◽

Blood Monocytes ◽

Peripheral Blood Monocytes ◽

Alpha Production ◽

Multiple Sclerosis Patients

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Reduced peripheral blood regulatory B cell levels are not associated with the Expanded Disability Status Scale score in multiple sclerosis

Journal of International Medical Research ◽

10.1177/0300060518783083 ◽

2018 ◽

Vol 46 (9) ◽

pp. 3970-3978 ◽

Cited By ~ 4

Author(s):

Shujun Guo ◽

Qingqing Chen ◽

Xiaoli Liang ◽

Mimi Mu ◽

Jing He ◽

...

Keyword(s):

Multiple Sclerosis ◽

B Cells ◽

Peripheral Blood ◽

Plasma Cells ◽

Serum Levels ◽

Memory B Cells ◽

Healthy Controls ◽

Expanded Disability Status Scale ◽

Disability Status ◽

Edss Score

Objective To investigate levels of regulatory B (Breg) cells, plasma cells, and memory B cells in the peripheral blood, and interleukin (IL)-10 in the serum of multiple sclerosis (MS) patients, and to determine the correlation between Breg cell levels and the Expanded Disability Status Scale (EDSS) score. Methods Levels of Breg cells, plasma cells, and memory B cells in the peripheral blood of 12 MS patients were measured using flow cytometry. IL-10 serum levels were measured by enzyme-linked immunosorbent assay. The correlation between Breg cell levels and MS EDSS score was measured using Pearson’s correlation coefficient. Results Compared with healthy controls, MS patients had decreased levels of CD19+CD24hiCD38hi Breg cells in their peripheral blood and reduced serum levels of IL-10; however, the ratios of CD19+CD27hiCD38hi plasma cells and CD19+CD27+CD24hi memory B cells to total B cells did not differ significantly between healthy controls and MS patients. CD19+CD24hiCD38hi Breg cell levels in the peripheral blood of MS patients were not significantly correlated with MS EDSS score. Conclusion Peripheral blood CD19+CD24hiCD38hi Breg cell levels and serum IL-10 levels were reduced in MS patients compared with controls, but Breg cell levels were not correlated with MS EDSS score.

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