Myelin status is associated with change in functional mobility following slope walking in people with multiple sclerosis

Background The level of myelin disruption in multiple sclerosis patients may impact the capacity for training-induced neuroplasticity and the magnitude of therapeutic response to rehabilitation interventions. Downslope walking has been shown to increase functional mobility in individuals with multiple sclerosis, but it is unclear if myelin status influences therapeutic response. Objective The current study aimed to examine the relationship between baseline myelin status and change in functional mobility after a walking intervention. Methods The Timed Up and Go test was used to measure functional mobility before and after completion of a repeated, six-session slope walking intervention in 16 participants with relapsing–remitting multiple sclerosis. Multi-component T2 relaxation imaging was used to index myelin water fraction of overall water content in brain tissue compartments. Results Results demonstrated that the ratio of the myelin water fraction in lesion to normal-appearing white matter (myelin water fraction ratio) significantly predicted 31% of the variance in change in Timed Up and Go score after the downslope walking intervention, where less myelin disruption was associated with greater intervention response. Conclusions Myelin water content fraction ratio may offer a neural biomarker of myelin to identify potential responders to interventions targeting functional impairments in multiple sclerosis.

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MRI myelin water fraction provides evidence of long-term neuro-recovery in alemtuzumab treated multiple sclerosis patients

10.26226/morressier.59a3eda5d462b8028d894c64 ◽

2017 ◽

Author(s):

Irene M. Vavasour

Keyword(s):

Multiple Sclerosis ◽

Water Fraction ◽

Myelin Water Fraction ◽

Multiple Sclerosis Patients

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Water content and myelin water fraction in multiple sclerosis

Journal of Neurology ◽

10.1007/s00415-004-0306-6 ◽

2004 ◽

Vol 251 (3) ◽

pp. 284-293 ◽

Cited By ~ 240

Author(s):

C. Laule ◽

I. M. Vavasour ◽

G. R. W. Moore ◽

J. Oger ◽

D. K. B. Li ◽

...

Keyword(s):

Multiple Sclerosis ◽

Water Content ◽

Water Fraction ◽

Myelin Water Fraction

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Water content changes in new multiple sclerosis lesions have a minimal effect on the determination of myelin water fraction values

Journal of Neuroimaging ◽

10.1111/jon.12908 ◽

2021 ◽

Author(s):

Irene M. Vavasour ◽

Kimberley L. Chang ◽

Anna J. E. Combes ◽

Sandra M. Meyers ◽

Shannon H. Kolind ◽

...

Keyword(s):

Multiple Sclerosis ◽

Water Content ◽

Minimal Effect ◽

Water Fraction ◽

Myelin Water Fraction

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A 24-month advanced magnetic resonance imaging study of multiple sclerosis patients treated with alemtuzumab

Multiple Sclerosis Journal ◽

10.1177/1352458518770085 ◽

2018 ◽

Vol 25 (6) ◽

pp. 811-818 ◽

Cited By ~ 8

Author(s):

Irene M Vavasour ◽

Roger Tam ◽

David KB Li ◽

Cornelia Laule ◽

Carolyn Taylor ◽

...

Keyword(s):

Multiple Sclerosis ◽

Magnetic Resonance ◽

Cortical Thickness ◽

Diffusion Tensor ◽

Imaging Study ◽

Water Fraction ◽

Normal Appearing White Matter ◽

Brain Parenchymal Fraction ◽

Brain Parenchymal ◽

Multiple Sclerosis Patients

Background: Tissue damage in both multiple sclerosis (MS) lesions and normal-appearing white matter (NAWM) are important contributors to disability and progression. Specific aspects of MS pathology can be measured using advanced imaging. Alemtuzumab is a humanised monoclonal antibody targeting CD52 developed for MS treatment. Objective: To investigate changes over 2 years of advanced magnetic resonance (MR) metrics in lesions and NAWM of MS patients treated with alemtuzumab. Methods: A total of 42 relapsing–remitting alemtuzumab-treated MS subjects were scanned for 2 years at 3 T. T1 relaxation, T2 relaxation, diffusion tensor, MR spectroscopy and volumetric sequences were performed. Mean T1 and myelin water fraction (MWF) were determined for stable lesions, new lesions and NAWM. Fractional anisotropy was calculated for the corpus callosum (CC) and N-acetylaspartate (NAA) concentration was determined from a large NAWM voxel. Brain parenchymal fraction (BPF), cortical thickness and CC area were also calculated. Results: No change in any MR measurement was found in lesions or NAWM over 24 months. BPF, cortical thickness and CC area all showed decreases in the first year followed by stability in the second year. Conclusion: Advanced MR biomarkers of myelin (MWF) and neuron/axons (NAA) show no change in NAWM over 24 months in alemtuzumab-treated MS participants.

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Lymphocyte subsets as biomarkers of therapeutic response in Fingolimod treated Relapsing Multiple Sclerosis patients

Journal of Neuroimmunology ◽

10.1016/j.jneuroim.2016.12.012 ◽

2017 ◽

Vol 303 ◽

pp. 75-80 ◽

Cited By ~ 10

Author(s):

D Paolicelli ◽

A Manni ◽

M D'Onghia ◽

V Direnzo ◽

P Iaffaldano ◽

...

Keyword(s):

Multiple Sclerosis ◽

Therapeutic Response ◽

Lymphocyte Subsets ◽

Multiple Sclerosis Patients ◽

Relapsing Multiple Sclerosis

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‘Timed up and go’ and brain atrophy: a preliminary MRI study to assess functional mobility performance in multiple sclerosis

Journal of Neurology ◽

10.1007/s00415-017-8612-y ◽

2017 ◽

Vol 264 (11) ◽

pp. 2201-2204 ◽

Cited By ~ 6

Author(s):

Lorena Lorefice ◽

G. Coghe ◽

G. Fenu ◽

M. Porta ◽

G. Pilloni ◽

...

Keyword(s):

Multiple Sclerosis ◽

Brain Atrophy ◽

Functional Mobility ◽

Timed Up And Go ◽

Mobility Performance ◽

Mri Study

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Associations Between Fatigue and Disability, Functional Mobility, Depression, and Quality of Life in People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2015-013 ◽

2016 ◽

Vol 18 (2) ◽

pp. 71-77 ◽

Cited By ~ 27

Author(s):

Hina Garg ◽

Steffani Bush ◽

Eduard Gappmaier

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Functional Mobility ◽

Common Symptom ◽

Timed Up And Go ◽

Predominant Symptom ◽

Impact Scale ◽

Scale Scores ◽

Study Participants

Background: Fatigue is a common symptom in people with multiple sclerosis (MS), but its associations with disability, functional mobility, depression, and quality of life (QOL) remain unclear. We aimed to determine the associations between different levels of fatigue and disability, functional mobility, depression, and physical and mental QOL in people with MS. Methods: Eighty-nine individuals with MS (mean [SD] disease duration = 13.6 [9.8] years, mean [SD] Expanded Disability Status Scale [EDSS] score = 5.3 [1.5]) and no concurrent relapses were retrospectively analyzed. Participants were divided into two groups based on five-item Modified Fatigue Impact Scale (MFIS-5) scores: group LF (n = 32, MFIS-5 score ≤10 [low levels of fatigue]) and group HF (n = 57, MFIS-5 score >10 [high levels of fatigue]). Results: Sixty-four percent of the sample reported high levels of fatigue. Compared with group LF, group HF demonstrated significantly (P < .05) greater impairments in the Timed Up and Go test, Activities-specific Balance Confidence scale, and 12-item Multiple Sclerosis Walking Scale scores; depression; and QOL but not in the EDSS scores, which were not significantly different between groups. Conclusions: Fatigue was found to be a predominant symptom in the study participants. Individuals reporting higher levels of fatigue concomitantly exhibited greater impairments in functional mobility, depression, and physical and mental QOL. Disability was not found to be related to level of fatigue. These findings can be important for appropriate assessment and management of individuals with MS with fatigue.

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Effects of Maximal Strength Training on Perceived-Fatigue and Functional Mobility in Persons with Relapsing-Remitting Multiple Sclerosis

Medicina ◽

10.3390/medicina56120718 ◽

2020 ◽

Vol 56 (12) ◽

pp. 718

Author(s):

Ramon Gomez-Illan ◽

Raul Reina ◽

David Barbado ◽

Rafael Sabido ◽

Pedro Moreno-Navarro ◽

...

Keyword(s):

Multiple Sclerosis ◽

Strength Training ◽

Functional Mobility ◽

Control Group ◽

Maximal Strength ◽

Timed Up And Go ◽

Strength Performance ◽

Daily Life Activities ◽

Fatigue Severity ◽

Relapsing Remitting Multiple Sclerosis

Background and objectives: Fatigue is one of the most disabling symptoms that limit daily life activities in persons with multiple sclerosis (pwMS). This study aimed to evaluate the effects of maximal strength training (MST) on perceived-fatigue and functional mobility in pwMS. Materials and Methods: 26 participants with MS were balanced according to their pre-intervention fatigue scores and distributed into an MST group (n = 13) and a control group (CG; n = 13). The MST group completed eight weeks using high loads, evaluating detraining after ten weeks. Quadriceps and hamstring isokinetic (QPTIK; HPTIK) and isometric (QPTIM; HPTIM) peak torques were assessed using an isokinetic dynamometer. Effect size differences were estimated with the Hedges’ g index (dg). Fatigue was evaluated through the Fatigue Severity Scale (FSS), while functional mobility was assessed via the Timed Up and Go Test (TUG). Results: The MST significantly improved all the strength measurements after the intervention (Δ6.43–29.55%; p < 0.05) compared to the control group. FSS showed a significant reduction (59.97%, dg = 5.41, large). The MST group also reduced the TUG time (19.69%; dg = 0.93, large) compared to the control group. Improvements caused by the intervention did not remain after a 10-week follow-up, with decreases in strength performance from 4.40% to 13.86% (dg = 0.24–0.56, small to moderate), 112.08% in the FSS (dg = −3.88, large), and 16.93% in TUG (dg = −1.07, large). Conclusions: MST (up to 90% 1RM) seems to be a feasible and useful way to obtain clinically relevant improvements in the perceived-fatigue symptoms and functional mobility. Still, symptom improvements decrease after a 10-week detraining period.

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