scholarly journals Diagnosing and quantifying a common deficit in multiple sclerosis

Neurology ◽  
2019 ◽  
Vol 92 (20) ◽  
pp. e2299-e2308 ◽  
Author(s):  
J.A. Nij Bijvank ◽  
L.J. van Rijn ◽  
L.J. Balk ◽  
H.S. Tan ◽  
B.M.J. Uitdehaag ◽  
...  

ObjectiveWe present an objective and quantitative approach for diagnosing internuclear ophthalmoplegia (INO) in multiple sclerosis (MS).MethodsA validated standardized infrared oculography protocol (DEMoNS [Demonstrate Eye Movement Networks with Saccades]) was used for quantifying prosaccades in patients with MS and healthy controls (HCs). The versional dysconjugacy index (VDI) was calculated, which describes the ratio between the abducting and adducting eye. The VDI was determined for peak velocity, peak acceleration, peak velocity divided by amplitude, and area under the curve (AUC) of the saccadic trajectory. We calculated the diagnostic accuracy for the several VDI parameters by a receiver operating characteristic analysis comparing HCs and patients with MS. The National Eye Institute Visual Function Questionnaire–25 was used to investigate vision-related quality of life of MS patients with INO.ResultsTwo hundred ten patients with MS and 58 HCs were included. The highest diagnostic accuracy was achieved by the VDI AUC of 15° horizontal prosaccades. Based on a combined VDI AUC and peak velocity divided by amplitude detection, the prevalence of an INO in MS calculated to 34%. In the INO group, 35.2% of the patients with MS reported any complaints of double vision, compared to 18.4% in the non-INO group (p = 0.010). MS patients with an INO had a lower overall vision-related quality of life (median 89.9, interquartile range 12.8) compared to patients without an INO (median 91.8, interquartile range 9.3, p = 0.011).ConclusionsThis study provides an accurate quantitative and clinically relevant definition of an INO in MS. This infrared oculography-based INO standard will require prospective validation. The high prevalence of INO in MS provides an anatomically well described and accurately quantifiable model for treatment trials in MS.

2021 ◽  
pp. 1-6
Author(s):  
Cihat Uzunköprü ◽  
Yesim Beckmann ◽  
Sabiha Türe

<b><i>Introduction:</i></b> The primary aim of the present study was to evaluate the long-term efficacy of fingolimod in patients with multiple sclerosis (MS); secondary aims were to describe the safety of fingolimod with the evaluation of treatment satisfaction and impact on the quality of life in real life. <b><i>Methods:</i></b> We collected clinical, demographical, neuroradiological, and treatment data, including pre- and posttreatment status health-related quality of life from 286 MS patients consecutively treated with fingolimod. Clinical assessment was based on the Expanded Disability Status Scale (EDSS), and quality of life assessment was performed with MS-related quality of life inventory (MSQOLI). The data were recorded at baseline and every 6 months for 2 years. <b><i>Results:</i></b> One hundred and fourteen males and 172 females were enrolled. The annualized relapse rate and EDSS showed a statistically significant reduction during the observation period (<i>p</i> &#x3c; 0.001). The patients also demonstrated substantial improvements in magnetic resonance imaging (MRI) outcomes (<i>p</i> &#x3c; 0.001). Health-related quality of life scores improved significantly between baseline and 24-month visit (<i>p</i> &#x3c; 0.001). No serious adverse events occurred. <b><i>Conclusion:</i></b> In our cohort, fingolimod treatment was associated with reduced relapse, MRI activity, and improved EDSS and MSQOLI scores. Additionally, fingolimod has been able to maintain its effectiveness over a considerable long period of treatment.


Work ◽  
2021 ◽  
pp. 1-10
Author(s):  
Emília Martins ◽  
Rosina Fernandes ◽  
Francisco Mendes ◽  
Cátia Magalhães ◽  
Patrícia Araújo

BACKGROUND: The health-related quality of life construct (QoL) implies a relationship with eating habits (EA) and physical activity (PA). Sociodemographic and anthropometric variables (gender, age and Body Mass Index - BMI) are highlighted in the definition of healthy lifestyle habits promotion strategies. OBJECTIVE: We aim to characterize and relate PA, EA and QoL in children/youth and explore gender, age and BMI influences. METHODS: It is a non-experimental study, with 337 children/youth, ages between 8 and 17 years (12.61±2.96), mostly from the rural inland of Portugal. In data collection we used a sociodemographic and anthropometric questionnaire, a weekly register table of EA and Kid-Kindl (QoL). Statistical analysis (p <  0.05) were performed in SPSS-IBM 25. RESULTS: Lower BMI was associated with better EA (p <  0.001), PA (p <  0.05) and self-esteem (p <  0.01) and worse scores on family subscale of QoL. Female showed higher fruit intake (p <  0.05). The older has shown better results. PA is positively correlated with QoL (p <  0.01) and EA (p <  0.05). CONCLUSIONS: It is important to explore other relevant social and family dimensions, to promote intervention programs with parents, school and community, as well as healthy practices policies. The intervention in these age groups is critical for a longer-term impact in improving healthy life habits.


2013 ◽  
Vol 20 (2) ◽  
pp. 253-257 ◽  
Author(s):  
Mariko Kita ◽  
Robert J Fox ◽  
J Theodore Phillips ◽  
Michael Hutchinson ◽  
Eva Havrdova ◽  
...  

Multiple sclerosis (MS) has a significant impact on health-related quality of life (HRQoL) with symptoms adversely affecting many aspects of everyday living. BG-12 (dimethyl fumarate) demonstrated significant efficacy in the phase III studies DEFINE and CONFIRM in patients with relapsing–remitting MS. In CONFIRM, HRQoL was worse in patients with greater disability at baseline, and who relapsed during the study, and improved with BG-12 treatment. Mean Short Form-36 Physical Component Summary scores for BG-12 increased over 2 years and scores for placebo decreased. Coupled with clinical and neuroradiological benefits, these HRQoL results further support BG-12 as an effective oral treatment for relapsing MS.


Physiotherapy ◽  
2016 ◽  
Vol 102 ◽  
pp. e226-e227
Author(s):  
S.-J. Ryan ◽  
A. Marcar ◽  
P. Stone ◽  
K. Garikipati ◽  
R. Kuisma ◽  
...  

1995 ◽  
Vol 4 (3) ◽  
pp. 187-206 ◽  
Author(s):  
B. G. Vickrey ◽  
R. D. Hays ◽  
R. Harooni ◽  
L. W. Myers ◽  
G. W. Ellison

Author(s):  
Joanna Dymecka ◽  
Mariola Bidzan

The aim of this research was to assess the level of adaptation to multiple sclerosis (Sclerosis multiplex; MS) and health-related quality of life (HRQoL) of the study population as well as to determine the relationship between biomedical factors related to the course of multiple sclerosis, adaptation to the disease, and HRQoL. Analysis of medical records, clinical and psychological interviews, the Extended Disability Status Scale (EDSS), Guy’s Neurological Disability Scale (GNDS), the Acceptance of Illness Scale (AIS), and the Multiple Sclerosis Impact Scale 29 (MSIS-29) were collected from 137 patients with MS. It was found that there was a relation between motor impairment, neurological disability, adaptation to illness, and HRQoL; it was also found that there were negative correlations between adaptation to illness and the severity of lower-limb disability, fatigue, mood disorders, other problems related to MS, and upper-limb disability. Of all the symptoms, lower-limb disability, fatigue, and mood disorders had the strongest relation with adaptation. All of the analysed symptoms were found to correlate with HRQoL. Of all the symptoms, HRQoL was most affected by lower- and upper-limb disability, fatigue, other MS problems, and mood disorders.


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