Clinical scales for multiple sclerosis

1996 ◽  
Vol 135 (1) ◽  
pp. 1-9 ◽  
Author(s):  
Basil Sharrack ◽  
Richard A.C. Hughes
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Scales

scholarly journals The Role of Clinical and Instrumented Outcome Measures in Balance Control of Individuals with Multiple Sclerosis

2013 ◽  
Vol 2013 ◽  
pp. 1-10 ◽  
Author(s):  
Neeta Kanekar ◽  
Alexander S. Aruin
Keyword(s):  
Multiple Sclerosis ◽  
Balance Control ◽  
Clinical Test ◽  
Balance Performance ◽  
Performance Deficits ◽  
Clinical Scales ◽  
Balance Confidence ◽  
High Fatigue ◽  
Healthy Control ◽  
Stability Limits

Purpose. The aim of the study was to investigate differences in balance control between individuals with multiple sclerosis (MS) and healthy control subjects using clinical scales and instrumented measures of balance and determine relationships between balance measures, fatigue, and disability levels in individuals with MS with and without a history of falls.Method. Twelve individuals with MS and twelve healthy controls were evaluated using the Berg Balance and Activities-specific Balance Confidence Scales, Modified Clinical Test of Sensory Interaction on Balance, and Limits of Stability Tests as well as Fatigue Severity Scale and Barthel Index.Results. Mildly affected individuals with MS had significant balance performance deficits and poor balance confidence levels (P<0.05). MS group had higher sway velocities and diminished stability limits (P<0.05), significant sensory impairments, high fatigue and disability levels (P<0.05). Sway velocity was a significant predictor of balance performance and the ability to move towards stability limits for the MS group. For the MS-fallers group, those with lower disability levels had faster movement velocities and better balance performance.Conclusion. Implementation of both clinical and instrumented tests of balance is important for the planning and evaluation of treatment outcomes in balance rehabilitation of people with MS.

MMPI Profiles in Exacerbation and Remission of Multiple Sclerosis

1970 ◽  
Vol 27 (2) ◽  
pp. 373-374 ◽  
Author(s):  
Charles S. Cleeland ◽  
Charles G. Matthews ◽  
Cornelius L. Hopper
Keyword(s):  
Multiple Sclerosis ◽  
Profile Analysis ◽  
Clinical Scales

Profile analysis of MMPI profiles generated by 30 patients displaying exacerbation (E) or remission (R) of the symptoms of multiple sclerosis is reported. Profiles classified as “abnormal” were significantly more frequent in the E group. Significantly more E patients had elevations on D greater than 70. The ordering of elevations of the clinical scales was similar in both groups.

scholarly journals New Strategies for Rehabilitation and Pharmacological Treatment of Fatigue Syndrome in Multiple Sclerosis

2020 ◽  
Vol 9 (11) ◽  
pp. 3592
Author(s):  
Ewa Zielińska-Nowak ◽  
Lidia Włodarczyk ◽  
Joanna Kostka ◽  
Elżbieta Miller
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Daily Basis ◽  
Whole Body ◽  
Clinical Scales ◽  
Effective Strategies ◽  
Advantages And Disadvantages ◽  
Fatigue Syndrome ◽  
The Central Nervous System

Multiple sclerosis (MS) is the most common autoimmune disease of the central nervous system (CNS), with an inflammatory demyelinating basis and a progressive course. The course of the disease is very diverse and unpredictable. Patients face many problems on a daily basis, such as problems with vision; sensory, balance, and gait disturbances; pain; muscle weakness; spasticity; tremor; urinary and fecal disorders; depression; and rapidly growing fatigue, which significantly influences quality of life among MS patients. Excessive fatigue occurs in most MS patients in all stages of this disease and is named MS-related fatigue. The crucial issue is the lack of effective treatment; therefore, this review focuses not only on the most common treatment methods, but also on additional novel therapies such as whole-body cryotherapy (WBC), functional electrical stimulation (FES), and non-invasive brain stimulation (NIBS). We also highlight the advantages and disadvantages of the most popular clinical scales used to measure fatigue. The entire understanding of the origins of MS-related fatigue may lead to the development of more effective strategies that can improve quality of life among MS patients. A literature search was performed using MEDLINE, EMBASE, and PEDro databases.

scholarly journals The Clinical Relevance of Force Platform Measures in Multiple Sclerosis: A Review

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Luca Prosperini ◽  
Carlo Pozzilli
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Relevance ◽  
Force Platform ◽  
Dynamic Posturography ◽  
Clinical Scales ◽  
Sensitive Tool ◽  
Risk Of Falls ◽  
Computer Based ◽  
Induced Changes ◽  
Balance Deficit

Balance impairment and falls are frequent in patients with multiple sclerosis (PwMS), and they may occur even at the earliest stage of the disease and in minimally impaired patients. The introduction of computer-based force platform measures (i.e., static and dynamic posturography) has provided an objective and sensitive tool to document both deficits and improvements in balance. By using more challenging test conditions, force platform measures can also reveal subtle balance disorders undetectable by common clinical scales. Furthermore, posturographic techniques may also allow to reliably identify PwMS who are at risk of accidental falls. Although force platform measures offer several theoretical advantages, only few studies extensively investigated their role in better managing PwMS. Standardised procedures, as well as clinical relevance of changes detected by static or dynamic posturography, are still lacking. In this review, we summarized studies which investigated balance deficit by means of force platform measures, focusing on their ability in detecting patients at high risk of falls and in estimating rehabilitation-induced changes, highlighting the pros and the cons with respect to clinical scales.

scholarly journals Variability of Multiple Sclerosis Spasticity Symptoms in Response to THC:CBD Oromucosal Spray: Tracking Cases through Clinical Scales and Video Recordings

2018 ◽  
Vol 10 (2) ◽  
pp. 169-176
Author(s):  
Peter Flachenecker ◽  
Francesco Saccà ◽  
Carlos Vila
Keyword(s):  
Multiple Sclerosis ◽  
Rating Scale ◽  
Demyelinating Disease ◽  
Numerical Rating Scale ◽  
Individual Variability ◽  
Additional Treatment ◽  
Response To Treatment ◽  
Walk Test ◽  
Modest Improvement ◽  
Clinical Scales

Multiple sclerosis (MS) is an inflammatory and neurodegenerative autoimmune demyelinating disease of the central nervous system. Patients exhibit heterogeneous patterns of disabling symptoms, including spasticity. In the majority of patients with MS spasticity, it and its associated symptoms contribute to disability, interfere with performance of everyday activities, and impair quality of life. Even under treatment with oral antispasticity drugs, about a third of patients continue to experience spasticity of moderate to severe intensity, underscoring the need for additional treatment options. The efficacy of tetrahydrocannabinol:cannabidiol (THC:CBD) oromucosal spray as add-on therapy in patients with refractory MS spasticity has been demonstrated in clinical trials and observational studies. To gain insight into patients’ response to treatment at the individual level, in-depth changes from baseline in various clinical scales and video-assessed parameters were evaluated in patients with resistant MS spasticity before and after 1 month of treatment with THC:CBD oromucosal spray. All 6 patients showed ≥20% improvement in the spasticity Numerical Rating Scale (i.e., were initial responders to treatment), but displayed individual variability in other spasticity-related parameters. Improved Modified Ashworth Scale scores were observed in 5 cases, with a reduction of –2/–3 points in lower limb scores for 1 patient who also showed benefit in terms of a more stable gait but modest improvement in the timed 10-meter walk test (10MWT). Improvement in the 10MWT (or 25-foot walk test) was noted in 4 of the 6 cases. THC:CBD oromucosal spray also improved upper limb function as indicated by faster 9-Hole Peg Test results.

The use of quality of life measures in multiple sclerosis research

2003 ◽  
Vol 9 (1) ◽  
pp. 63-72 ◽  
Author(s):  
M W Nortvedt ◽  
T Riise
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Disease Activity ◽  
Clinical Scales ◽  
Additional Information ◽  
Quality Of Life Measures ◽  
Quality Of Life Questionnaires ◽  
Study Designs ◽  
The Impact

Q uality of life research contributes knowledge essential to the health and healthcare of multiple sclerosis (MS) patients. This article reviews 83 MS studies in English that have presented data on quality of life. The studies may be classified into three categories, according to the application and the main focus: 1) evaluating the development and validity of quality of life questionnaires and clinical scales (n-27); 2) evaluating factors that might influence the quality of life or comparing the quality of life among various groups (n-37); and 3) using quality of life questionnaires as outcome measures in medical trials and other interventions (n-19). The studies have shown that quality of life questionnaires more broadly measure the impact of MS than do the most frequently used measures of disease activity and effects. Using quality of life measures provides additional information in evaluating the effects of treatment and in studying the development of the disease. Such information is crucial in planning interventions for MS patients. A challenge in this field is to improve the study designs, including reaching some agreement on how to measure the quality of life.

scholarly journals Molecular models of multiple sclerosis severity identify heterogeneity of pathogenic mechanisms

2020 ◽  
Author(s):  
Christopher Barbour ◽  
Peter Kosa ◽  
Mihael Varosanec ◽  
Mark Greenwood ◽  
Bibiana Bielekova
Keyword(s):  
Multiple Sclerosis ◽  
Temporal Distribution ◽  
Dna Aptamer ◽  
Training Dataset ◽  
Csf Biomarkers ◽  
Molecular Heterogeneity ◽  
Clinical Scales ◽  
Random Forest Models ◽  
The Central Nervous System ◽  
Aptamer Assay

The inability to measure putative pathogenic processes in the central nervous system (CNS) of living subjects precludes the determination of their temporal distribution, intra-individual heterogeneity, and their ability to predict disease course. Using multiple sclerosis (MS) as an example of a complex neurological disorder, we sought to determine if cerebrospinal fluid (CSF) biomarkers can be aggregated to predict future rates of MS progression and provide molecular insight into mechanisms of CNS destruction. 1,305 CSF biomarkers were analyzed blindly in the longitudinal training dataset (N=129) of untreated MS patients, using DNA-aptamer assay. Random forest models, validated in an independent longitudinal cohort (N=64), uncovered signatures of MS severity, measured by clinical scales and volumetric brain imaging. Cluster analysis revealed intra-individual molecular heterogeneity of disease mechanisms that include both CNS- and immune-related pathways and may represent novel targets for inhibiting MS progression.

scholarly journals Machine learning-optimized Combinatorial MRI scale (COMRISv2) correlates highly with cognitive and physical disability scales in Multiple Sclerosis patients

2021 ◽  
Author(s):  
Erin Kelly ◽  
Mihael Varosanec ◽  
Peter Kosa ◽  
Mary Sandford ◽  
Vesna Prchkovska ◽  
...  
Keyword(s):  
Machine Learning ◽  
Multiple Sclerosis ◽  
Physical Disability ◽  
Brain Mri ◽  
Cognitive Disability ◽  
Mri Imaging ◽  
Tissue Destruction ◽  
Clinical Scales ◽  
Volumetric Features ◽  
Multiple Sclerosis Patients

AbstractComposite MRI scales of central nervous system tissue destruction correlate stronger with clinical outcomes than their individual components in multiple sclerosis (MS) patients. Using machine learning (ML), we previously developed Combinatorial MRI scale (COMRISv1) solely from semi-quantitative (semi-qMRI) biomarkers. Here, we asked how much better COMRISv2 might become with the inclusion of quantitative (qMRI) volumetric features and employment of more powerful ML algorithm.The prospectively acquired MS patients, divided into training (n=172) and validation (n=83) cohorts underwent brain MRI imaging and clinical evaluation. Neurological examination was transcribed to NeurEx app that automatically computes disability scales. qMRI features were computed by LesionTOADS algorithm. Modified random forest pipeline selected biomarkers for optimal model(s) in the training cohort.COMRISv2 models validated moderate correlation with cognitive disability (Rho = 0.674; Linh’s concordance coefficient [CCC] = 0.458; p<0.001) and strong correlations with physical disability (Spearman Rho = 0.830-0.852; CCC = 0.789-0.823; p<0.001). The NeurEx led to the strongest COMRISv2 model. Addition of qMRI features enhanced performance only of cognitive disability model, likely because semi-qMRI biomarkers measure infratentorial injury with greater accuracy.COMRISv2 models predict most granular clinical scales in MS with remarkable criterion validity, expanding scientific utilization of cohorts with missing clinical data.

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