Cerebellar Dysfunction in Multiple Sclerosis: Considerations for Research and Rehabilitation Therapy

2021 ◽  
pp. 154596832110654
Author(s):  
Erin M. Edwards ◽  
Nora E. Fritz ◽  
Amanda S. Therrien
Keyword(s):  
Multiple Sclerosis ◽  
Motor Control ◽  
Motor Impairment ◽  
Future Research ◽  
Disability Progression ◽  
Cerebellar Dysfunction ◽  
Motor Disability ◽  
Rehabilitation Outcomes ◽  
Critical Knowledge ◽  
The Impact

Introduction. Cerebellar pathology is common among persons with multiple sclerosis (PwMS). The cerebellum is well recognized for its role in motor control and motor learning and cerebellar pathology in multiple sclerosis is associated with enhanced motor impairment and disability progression. The Problem. To mitigate motor disability progression, PwMS are commonly prescribed exercise and task-specific rehabilitation training. Yet, whether cerebellar dysfunction differentially affects rehabilitation outcomes in this population remains unknown. Furthermore, we lack rehabilitation interventions targeting cerebellar dysfunction. The Solution. Here, we summarize the current understanding of the impact of cerebellar dysfunction on motor control, motor training, and rehabilitation in persons with multiple sclerosis. Recommendations. Additionally, we highlight critical knowledge gaps and propose that these guide future research studying cerebellar dysfunction in persons with multiple sclerosis.

Sensory impairments in quiet standing in subjects with multiple sclerosis

2009 ◽  
Vol 15 (1) ◽  
pp. 59-67 ◽  
Author(s):  
D Cattaneo ◽  
J Jonsdottir
Keyword(s):  
Multiple Sclerosis ◽  
Sensory Input ◽  
Balance Control ◽  
Motor Impairment ◽  
Quiet Standing ◽  
Convenience Sample ◽  
Sensory Inputs ◽  
Sensory Disorders ◽  
Sensory Impairments ◽  
The Impact

Balance disorders and falls are frequently observed in subjects with multiple sclerosis (MS). Along with motor impairment, sensory disorders and integration deficits of sensory inputs lead to inadequate motor responses. The assessment of these sensory disorders in an every day tasks, such as upright stance, increases our knowledge of postural control in this pathology, thus promoting more effective treatments. The aim of the study was to describe sensory impairments and sensory strategies in different sensory conditions. A stabilometric assessment was carried out in a consecutive convenience sample of 53 subjects. The age of the sample was 52.7 (21.1) years; the onset of pathology was 27.20 (14.5) years before the assessment. Balance was assessed in six sensory conditions. The impact of pathology on balance control was shown by the high percentage of abnormal scores: 75% of subjects with MS showed abnormal scores even in the eyes open condition. The alteration of a single sensory input led to an increase of abnormal scores in up to 82% of subjects. Almost all subjects showed abnormal scores in the vestibular conditions where 22% of them fell. The pattern of the subjects’ performance in the six sensory conditions suggests that balance control may be more correlated to the number of reliable sensory inputs than the nature of the sensory input itself.

Assessing Depression in Patients with Multiple Sclerosis

2004 ◽  
Vol 6 (3) ◽  
pp. 116-122 ◽  
Author(s):  
Zeeshan Butt ◽  
Heath A. Demaree
Keyword(s):  
Multiple Sclerosis ◽  
Treatment Adherence ◽  
Future Research ◽  
Clinical Implications ◽  
Disease Course ◽  
Symptoms Of Depression ◽  
The Impact

Multiple sclerosis is frequently accompanied by symptoms of depression. Previous research has highlighted the impact of depression on MS disease course and treatment adherence. However, the assessment of depression in the context of MS is complicated by shared symptoms, such as fatigue and concentration difficulties. The goal of this paper is to describe the impact of depression in persons with MS and to review methods commonly used to assess depression in this population. Clinical implications of this review as well as recommendations for future research on the assessment of depression in MS will be discussed.

scholarly journals Multiple sclerosis: Implications for future research on postural control and gait

2020 ◽  
Vol 14 (2) ◽  
pp. 46-49
Author(s):  
Felipe Balistieri Santinelli ◽  
Emerson Sebastião ◽  
Marcela de Oliveira ◽  
Fabio Augusto Barbieri
Keyword(s):  
Multiple Sclerosis ◽  
Postural Control ◽  
Future Research ◽  
Insufficient Information ◽  
Future Studies ◽  
Rehabilitation Programs ◽  
The Central Nervous System ◽  
The Impact ◽  
Gait Impairments

The objective of this letter is to provide a perspective on the impact of multiple sclerosis (MS) on postural control and gait and suggestions for future studies. Although studies on MS with postural control and gait have been carried out for some time, in Brazil and in the World, there is still insufficient information on MS and impairments in postural control and gait.Postural control and gait impairments are recognized to cause several problems for people with MS, these being two of the symptoms that most affect quality of life.Here, we present studies that have investigated impairments in postural control and gait using different experimental designs and discuss the adaptations of the central nervous system (CNS) due to the damage caused by MS.We recommend future studies focus on how the CNS is organized towards postural control and gait, with a better ecological approach, which could assist the development of rehabilitation programs.

scholarly journals The Impact of Motor Disability and the Level of Fatigue on Adherence to Therapeutic Recommendations in Patients with Multiple Sclerosis Treated with Immunomodulation

2021 ◽  
Vol 18 (15) ◽  
pp. 3609-3614
Author(s):  
Robert Ślusarz ◽  
Joanna Olkiewicz ◽  
Robert Bonek ◽  
Karolina Filipska ◽  
Monika Biercewicz ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Disability ◽  
Therapeutic Recommendations ◽  
The Impact

scholarly journals Human-machine-human interaction in motor control and rehabilitation: a review

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Emek Barış Küçüktabak ◽  
Sangjoon J. Kim ◽  
Yue Wen ◽  
Kevin Lynch ◽  
Jose L. Pons
Keyword(s):  
Motor Control ◽  
Motor Learning ◽  
Task Performance ◽  
Human Interaction ◽  
Future Research ◽  
Physical Interaction ◽  
Interaction Type ◽  
Partner Characteristics ◽  
The Impact ◽  
Individual Motor

Abstract Background Human-human (HH) interaction mediated by machines (e.g., robots or passive sensorized devices), which we call human-machine-human (HMH) interaction, has been studied with increasing interest in the last decade. The use of machines allows the implementation of different forms of audiovisual and/or physical interaction in dyadic tasks. HMH interaction between two partners can improve the dyad’s ability to accomplish a joint motor task (task performance) beyond either partner’s ability to perform the task solo. It can also be used to more efficiently train an individual to improve their solo task performance (individual motor learning). We review recent research on the impact of HMH interaction on task performance and individual motor learning in the context of motor control and rehabilitation, and we propose future research directions in this area. Methods A systematic search was performed on the Scopus, IEEE Xplore, and PubMed databases. The search query was designed to find studies that involve HMH interaction in motor control and rehabilitation settings. Studies that do not investigate the effect of changing the interaction conditions were filtered out. Thirty-one studies met our inclusion criteria and were used in the qualitative synthesis. Results Studies are analyzed based on their results related to the effects of interaction type (e.g., audiovisual communication and/or physical interaction), interaction mode (collaborative, cooperative, co-active, and competitive), and partner characteristics. Visuo-physical interaction generally results in better dyadic task performance than visual interaction alone. In cases where the physical interaction between humans is described by a spring, there are conflicting results as to the effect of the stiffness of the spring. In terms of partner characteristics, having a more skilled partner improves dyadic task performance more than having a less skilled partner. However, conflicting results were observed in terms of individual motor learning. Conclusions Although it is difficult to draw clear conclusions as to which interaction type, mode, or partner characteristic may lead to optimal task performance or individual motor learning, these results show the possibility for improved outcomes through HMH interaction. Future work that focuses on selecting the optimal personalized interaction conditions and exploring their impact on rehabilitation settings may facilitate the transition of HMH training protocols to clinical implementations.

scholarly journals Care Partners and Multiple Sclerosis

2015 ◽  
Vol 17 (6) ◽  
pp. 253-260 ◽  
Author(s):  
Tamara McKenzie ◽  
Mary Elizabeth Quig ◽  
Tuula Tyry ◽  
Ruth Ann Marrie ◽  
Gary Cutter ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Caregiver Burden ◽  
Psychological Health ◽  
Well Being ◽  
Future Research ◽  
Online Questionnaire ◽  
Research Committee ◽  
Care Partners ◽  
Male Care ◽  
The Impact

Background: Caring for someone with multiple sclerosis (MS) can be a stressful experience that requires clinical attention. We investigated the impact of caregiver stress on the emotional well-being and physical health of the MS care partner using the North American Research Committee on Multiple Sclerosis (NARCOMS) Registry. Methods: Care partners of NARCOMS participants were invited to complete an online questionnaire that captured demographic characteristics, health status, caregiver burden as measured by the Zarit Caregiver Burden Interview, and impact of caregiving on employment. Results: Of 1446 care partners who agreed to participate, 1333 had complete data. Most were men (n = 825, 61.9%), with a mean (SD) age of 51.1 (11.2) years. The mean (SD) Zarit total score was 24.6 (15.1), placing the overall group in the mild caregiver burden range. Compared with male care partners, female care partners reported higher levels of burden and stress and more medication use for stress/anxiety and mood disorders. Male care partners were more likely to report physical concerns. Care partners of people with primary progressive MS reported greater perceived burden than did partners of people with secondary progressive MS and relapsing-remitting MS. More than 40% of care partners (559 of 1288) had missed work during the past year owing to caregiving responsibilities. Conclusions: Care partners of people with MS have substantial physical and psychological health concerns and experience an adverse impact on employment. Future research should evaluate how to mitigate the adverse effects of caregiving and evaluate positive aspects of the role.

scholarly journals Polymorphisms in the CIITA −168A/G (rs3087456) and CIITA +1614G/C (rs4774) may influence severity in multiple sclerosis patients

2019 ◽  
Vol 77 (3) ◽  
pp. 166-173 ◽  
Author(s):  
Valéria Coelho Santa Rita Pereira ◽  
Fabrícia Lima Fontes-Dantas ◽  
Eduardo Ribeiro Paradela ◽  
Fabíola Rachid Malfetano ◽  
Simone de Souza Batista Scherpenhuijzen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Course ◽  
Nucleotide Polymorphisms ◽  
Expanded Disability Status Scale ◽  
Disability Progression ◽  
Single Nucleotide ◽  
Disability Status ◽  
Multiple Sclerosis Patients ◽  
The Impact ◽  
Lower Odds Ratio

ABSTRACT It is currently unknown how genetic factors may influence the clinical course of multiple sclerosis (MS). Objective: We examined the impact of CIITA polymorphisms −168A/G (rs3087456) and +1614G/C (rs4774) on the risk of disability progression, severity and on responses to first-line immunomodulator treatments. Methods: Genomic DNA was extracted from blood samples. We used ABI3730xl and GeneMapper v.4.0 software to identify genotype variations. All patients were followed up and clinically reassessed at three-month intervals. Disability progression was measured by the Expanded Disability Status Scale and disease severity by the Multiple Sclerosis Spasticity Scale (MSSS). Results: We included 37 men and 80 women. We found no evidence regarding the influence of the single nucleotide polymorphisms studied in the Expanded Disability Status Scale or therapeutic response of the evaluated drugs. We performed a logistic regression analysis with the MSSS and found that a less severe MS course was associated with wild type CIITA −168AA and CIITA +1614GG, as the chance of the patient progressing to MSSS2 and MSSS3 decreased in 61% and 75% with CIITA −168AA and 66% and 75% with CIITA +1614GG, respectively (p < 0.0001). Although less significant, the CIITA +1614 GC also pointed to a less severe MS course and the chance of the patient progressing to MSSS3 decreased 79% (p = 0.015). We also observed that the CIITA −168GG genotype was more frequent in MSSS2 and MSSS3 and had 40% lower odds ratio to becoming more severe MS. Conclusion: These data suggest that CIITA −168AA, CIITA +1614GG and CIITA +1614 GC polymorphisms may be associated with a better MS clinical course. This knowledge may be useful for a better understanding of MS and its therapeutic management.

Relevance of asymptomatic spinal MRI lesions in patients with multiple sclerosis

2015 ◽  
Vol 22 (6) ◽  
pp. 782-791 ◽  
Author(s):  
C Zecca ◽  
G Disanto ◽  
MP Sormani ◽  
GC Riccitelli ◽  
A Cianfoni ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disability Progression ◽  
Mri Brain ◽  
Relapsing Remitting ◽  
Spinal Mri ◽  
The Impact ◽  
Serial Mri ◽  
Clinical Stability ◽  
Median Interval

Background: The impact of new asymptomatic spinal cord lesions (a-SL) in multiple sclerosis (MS) course is poorly characterized. Objective: The objective of this research paper is to assess the prognostic value of a-SL in predicting MS course. Methods: Relapsing–remitting MS patients who received serial MRI (brain and spinal) at baseline (t1) and within 12 to 36 months (t2) during clinical stability, and had a follow-up (t2–t3) ⩾24 months were included. Relapses and disability progression were evaluated between t2 and t3. Results: Of 413 consecutive screened MS patients, 103 patients (65 females, median age 43 years) were included. After a median t1–t2 interval of 17 (IQR 13–26) months, 25.2% and 43.7% patients had ⩾1 new a-SL (a-SL+) and asymptomatic brain lesions (a-BL+), respectively. Relapse risk between t2 and t3 (median interval: 42 (IQR 32–57.5) months) was significantly increased in a-SL+ and/or a-BL+ vs a-BL– and a-SL– (HR = 2.31, 95% CI = 1.13–4.72, p = 0.02). No differences in the risk of disability progression were found in a-SL+ and/or a-BL+ vs a-SL- and a-BL–. Conclusion: a-SL occur in one-quarter of clinically stable RRMS, and combined with a-BL contribute significantly in predicting future disease course.

scholarly journals Pregnancy, sex and hormonal factors in multiple sclerosis

2014 ◽  
Vol 20 (5) ◽  
pp. 527-536 ◽  
Author(s):  
David H Miller ◽  
Franz Fazekas ◽  
Xavier Montalban ◽  
Stephen C Reingold ◽  
Maria Trojano
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Course ◽  
Future Research ◽  
Comprehensive Understanding ◽  
Hormonal Factors ◽  
Disease Mechanisms ◽  
Pubmed Search ◽  
Disease Modifying ◽  
The Impact

Background: Multiple sclerosis (MS) is influenced by pregnancy, sex and hormonal factors. Objectives: A comprehensive understanding of the role of pregnancy, sex and hormonal factors can provide insights into disease mechanisms, and new therapeutic developments and can provide improved patient care and treatment. Methods: Based on an international conference of experts and a comprehensive PubMed search for publications on these areas in MS, we provide a review of what is known about the impact of these factors on disease demographics, etiology, pathophysiology and clinical course and outcomes. Results and conclusions: Recommendations are provided for counseling and management of people with MS before conception, during pregnancy and after delivery. The use of disease-modifying and symptomatic therapies in pregnancy is problematic and such treatments are normally discontinued. Available knowledge about the impact of treatment on the mother, fetus and newborn is discussed. Recommendations for future research to fill knowledge gaps and clarify inconsistencies in available data are made.

Sign in / Sign up

Export Citation Format

Share Document