scholarly journals Clinical, Neurophysiological, and MRI Markers of Fampridine Responsiveness in Multiple Sclerosis—An Explorative Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Sepehr Mamoei ◽  
Henrik Boye Jensen ◽  
Andreas Kristian Pedersen ◽  
Mikkel Karl Emil Nygaard ◽  
Simon Fristed Eskildsen ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Longitudinal Study ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Step Test ◽  
Conduction Time ◽  
Lesion Load ◽  
Clinical Trial Registration ◽  
Peripheral Motor

Objective: Persons with multiple sclerosis (PwMS), already established as responders or non-responders to Fampridine treatment, were compared in terms of disability measures, physical and cognitive performance tests, neurophysiology, and magnetic resonance imaging (MRI) outcomes in a 1-year explorative longitudinal study.Materials and Methods: Data from a 1-year longitudinal study were analyzed. Examinations consisted of the timed 25-foot walk test (T25FW), six spot step test (SSST), nine-hole peg test (9-HPT), five times sit-to-stand test (5-STS), symbol digit modalities test (SDMT), transcranial magnetic stimulation (TMS) elicited motor evoked potentials (MEP) examining central motor conduction times (CMCT), peripheral motor conduction times (PMCT) and their amplitudes, electroneuronography (ENG) of the lower extremities, and brain structural MRI measures.Results: Forty-one responders and eight non-responders to Fampridine treatment were examined. There were no intergroup differences except for the PMCT, where non-responders had prolonged conduction times compared to responders to Fampridine. Six spot step test was associated with CMCT throughout the study. After 1 year, CMCT was further prolonged and cortical MEP amplitudes decreased in both groups, while PMCT and ENG did not change. Throughout the study, CMCT was associated with the expanded disability status scale (EDSS) and 12-item multiple sclerosis walking scale (MSWS-12), while SDMT was associated with number of T2-weighted lesions, lesion load, and lesion load normalized to brain volume.Conclusions: Peripheral motor conduction time is prolonged in non-responders to Fampridine when compared to responders. Transcranial magnetic stimulation-elicited MEPs and SDMT can be used as markers of disability progression and lesion activity visualized by MRI, respectively.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03401307.

scholarly journals Adjunct Diagnostic Value of Transcranial Magnetic Stimulation in Mucopolysaccharidosis-Related Cervical Myelopathy: A Pilot Study

2019 ◽  
Vol 9 (8) ◽  
pp. 200 ◽  
Author(s):  
Mariagiovanna Cantone ◽  
Giuseppe Lanza ◽  
Alice Le Pira ◽  
Rita Barone ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Cervical Myelopathy ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Hot Spot ◽  
Diagnostic Value ◽  
Lower Limbs ◽  
Conduction Time ◽  
Variable Degree ◽  
Monitoring Methods

Background: Cervical myelopathy (CM) is a common cause of morbidity and disability in patients with mucopolysaccharidosis (MPS) and, therefore, early detection is crucial for the best surgical intervention and follow-up. Transcranial magnetic stimulation (TMS) non-invasively evaluates the conduction through the cortico-spinal tract, also allowing preclinical diagnosis and monitoring. Methods: Motor evoked potentials (MEPs) to TMS were recorded in a group of eight patients with MPS-related CM. Responses were obtained during mild tonic muscular activation by means of a circular coil held on the “hot spot” of the first dorsal interosseous and tibialis anterior muscles, bilaterally. The motor latency by cervical or lumbar magnetic stimulation was subtracted from the MEP cortical latency to obtain the central motor conduction time. The MEP amplitude from peak to peak to cortical stimulation and the interside difference of each measure were also calculated. Results: TMS revealed abnormal findings from both upper and lower limbs compatible with axonal damage and demyelination in six of them. Notably, a subclinical cervical spinal disease was detected before the occurrence of an overt CM in two patients, whereas TMS signs compatible with a CM of variable degree persisted despite surgery in all treated subjects. Conclusions: TMS can be viewed as an adjunct diagnostic test pending further rigorous investigations.

scholarly journals Transcranial Magnetic Stimulation as a Potential Biomarker in Multiple Sclerosis: A Systematic Review with Recommendations for Future Research

2019 ◽  
Vol 2019 ◽  
pp. 1-22 ◽  
Author(s):  
Nicholas J. Snow ◽  
Katie P. Wadden ◽  
Arthur R. Chaves ◽  
Michelle Ploughman
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Impairment ◽  
Transcranial Magnetic Stimulation ◽  
Disease Severity ◽  
Magnetic Stimulation ◽  
Motor Impairment ◽  
Risk Of Bias ◽  
Future Research ◽  
Conduction Time ◽  
Potential Biomarker

Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. Disease progression is variable and unpredictable, warranting the development of biomarkers of disease status. Transcranial magnetic stimulation (TMS) is a noninvasive method used to study the human motor system, which has shown potential in MS research. However, few reviews have summarized the use of TMS combined with clinical measures of MS and no work has comprehensively assessed study quality. This review explored the viability of TMS as a biomarker in studies of MS examining disease severity, cognitive impairment, motor impairment, or fatigue. Methodological quality and risk of bias were evaluated in studies meeting selection criteria. After screening 1603 records, 30 were included for review. All studies showed high risk of bias, attributed largely to issues surrounding sample size justification, experimenter blinding, and failure to account for key potential confounding variables. Central motor conduction time and motor-evoked potentials were the most commonly used TMS techniques and showed relationships with disease severity, motor impairment, and fatigue. Short-latency afferent inhibition was the only outcome related to cognitive impairment. Although there is insufficient evidence for TMS in clinical assessments of MS, this review serves as a template to inform future research.

scholarly journals Diagnostic and Prognostic Value of Transcranial Magnetic Stimulation in Mucopolysaccharidosis-Related Cervical Myelopathy

2019 ◽  
Author(s):  
Mariagiovanna Cantone ◽  
Giuseppe Lanza ◽  
Alice Le Pira ◽  
Rita Barone ◽  
Giovanni Pennisi ◽  
...  
Keyword(s):  
Transcranial Magnetic Stimulation ◽  
Cervical Myelopathy ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
Hot Spot ◽  
Lower Limbs ◽  
Conduction Time ◽  
Variable Degree ◽  
Monitoring Methods ◽  
The Difference

Background: Cervical myelopathy (CM) is a common cause of morbidity and disability in patients with mucopolysaccharidosis (MPS) and, therefore, early detection is crucial for best surgical intervention and follow-up. Transcranial Magnetic Stimulation (TMS) non-invasively evaluates the conductivity along the cortico-spinal tract, also allowing preclinical diagnosis and monitoring. Methods: motor evoked potentials (MEPs) to TMS were recorded in a group of 8 patients with MPS-related CM. Responses were obtained during mild tonic contraction through a circular coil applied over the “hot spot” of the first dorsal interosseous and tibialis anterior muscles, bilaterally. Central motor conduction time was estimated as the difference between MEP cortical latency and the peripheral motor conduction time by cervical or lumbar magnetic stimulation. Peak-to-peak MEP amplitude to cortical stimulation and right-to-left difference of each parameter were also measured. Results: TMS revealed abnormal findings from both upper and lower limbs compatible with axonal damage and demyelination in 6 of them. Notably, a subclinical cervical spinal disease was detected before the occurrence of an overt CM in two patients, whereas TMS signs compatible with a CM of variable degree persisted despite surgery in all treated subjects. Conclusions: TMS screening should be performed in MPS patients, before and after surgery.

CENTRAL MOTOR PATHWAYS IN CHILDREN WITH MULTIPLE SCLEROSIS

2013 ◽  
Vol 68 (11) ◽  
pp. 34-37
Author(s):  
V. B. Voitenkov ◽  
V. N. Komantsev ◽  
N. V. Skripchenko ◽  
G. P. Ivanova ◽  
A. V. Surovtseva ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Transcranial Magnetic Stimulation ◽  
Motor Neurons ◽  
Magnetic Stimulation ◽  
Motor Evoked Potentials ◽  
High Sensitivity ◽  
Membrane Excitability ◽  
Motor Pathways ◽  
Demyelinating Lesions ◽  
Multiple Sclerosis Patients

Aim: to evaluate motor pathways involvement in children with multiple sclerosis. Patients and methods: we used transcranial magnetic stimulation method. 9 children with relapsing-remitting multiple sclerosis (mean duration 1,68 years) and 20 controls were enrolled. Results: in most of the cases findings in multiple sclerosis group were abnormal. More often polyphasic changes of the motor evoked potentials (MEP) shape (78% of the cases) and elevation of MEP threshold (88%) were seen. Conclusions: transcranial magnetic stimulation demonstrated high sensitivity in children with multiple sclerosis. Main neurophysiologic findings in multiple sclerosis in children may reflect altering membrane excitability of motor neurons and demyelinating lesions. Axonal damage in children with multiple sclerosis are less apparent. 

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