Comparison between the spastic paraplegia rating scale, Kurtzke scale, and Osame scale in the tropical spastic paraparesis/myelopathy associated with HTLV

Adry, Rodrigo Antonio Rocha da Cruz; Lins, Catarina Couras; Kruschewsky, Ramon de Almeida; Filho, Bernardo Galvão Castro

doi:10.1590/s0037-86822012000300006

Cited by 7 publications

(7 citation statements)

References 20 publications

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“…All subdomains were rated on a scale between 0 and 4 with a maximum total score of 52. 7,8 Ancillary investigations such as brain MRI, electrophysiologic tests, and metabolic studies were also evaluated. Patients with cerebellar signs were screened for mutations in FXN , SACS , and the common spinocerebellar ataxias (SCAs 1–8) prior to being included in the study.…”

Section: Methodsmentioning

confidence: 99%

Clinical and genetic study of hereditary spastic paraplegia in Canada

Chrestian¹,

Dupré²,

Gan‐Or

et al. 2017

Neurol Genet

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Objective:To describe the clinical, genetic, and epidemiologic features of hereditary spastic paraplegia (HSP) in Canada and to determine which clinical, radiologic, and genetic factors determine functional outcomes for patients with HSP.Methods:We conducted a multicenter observational study of patients who met clinical criteria for the diagnosis of HSP in the provinces of Alberta, Ontario, and Quebec from 2012 to 2015. Characteristics of the participants were analyzed using descriptive statistics. The main outcome measure for a subset of the cohort (n = 48) was the Spastic Paraplegia Rating Scale. We also used the SPATAX-EUROSPA disability stage (disability score) to assess disability (n = 65).Results:A total of 526 patients were identified with HSP across the country, and 150 patients had a confirmed genetic diagnosis. Mutations were identified in 15 different genes; the most common were SPAST (SPG4, 48%), ATL1 (SPG3A, 16%), SPG11 (8%), SPG7 (7%), and KIAA0196 (SPG8, 5%). The diagnosis of SPG4 was associated with older age at symptom onset (p = 0.0017). SPG4 and SPG3A were less associated with learning disabilities compared to other subtypes of HSP, and SPG11 was strongly associated with progressive cognitive deficits (odds ratio 87.75, 95% confidence interval 14.04–548.24, p < 0.0001). SPG3A was associated with better functional outcomes compared to other HSP subtypes (p = 0.04) on multivariate analysis. The strongest predictor of significant disability was abnormal brain MRI (p = 0.014).Conclusions:The most important predictors of disability in our HSP cohort were SPG11 mutations and abnormal brain MRI. Accurate molecular characterization of well-phenotyped cohorts and international collaboration are essential to establish the natural history of these rare neurodegenerative disorders.

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Section: Methodsmentioning

confidence: 99%

Clinical and genetic study of hereditary spastic paraplegia in Canada

Chrestian¹,

Dupré²,

Gan‐Or

et al. 2017

Neurol Genet

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“…A clinical rating scale that has been developed specifically for HSPs is the clinical Spastic Paraplegia Rating Scale (SPRS), which comprises 13 items to assess the level of spasticity and shows high internal consistency (24). Changes in SPRS (24, 25) were used as a secondary outcome in a clinical trial investigating the efficacy of botulinum toxin type-A for HSP (26). A subset of this SPRS scale has been used to generate a “spastic subscore,” which is the sum of point values for spasticity of hip adductor muscles, weakness of hip abduction, spasticity of knee flexion and weakness of foot dorsiflexion (27).…”

Section: Resultsmentioning

confidence: 99%

Clinical Trial Designs and Measures in Hereditary Spastic Paraplegias

2018

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Hereditary spastic paraplegias (HSPs) are a large group of genetically-diverse neurologic disorders characterized clinically by a common feature of lower extremity spasticity and gait difficulties. Current therapies are predominantly symptomatic, and even then usually provide inadequate relief of symptoms. Going forward, HSP therapeutics development requires a systematic analysis of quantifiable measures and tools to assess treatment response. This review summarizes promising therapeutic targets, assessment measures, and previous clinical trials for the HSPs. Oxidative stress, signaling pathways, microtubule dynamics, and gene rescue/replacement have been proposed as potential treatment targets or modalities. Quantitative evaluation of pre-clinical rodent HSP models emphasize rotarod performance, foot base angle, grip strength, stride length, beam walking, critical speed, and body weight. Clinical measures of HSP in humans include 10-m gait velocity, the Spastic Paraplegia Rating Scale (SPRS), Ashworth Spasticity Scale, Fugl-Meyer Scale, timed up-and-go, and the Gillette Functional Assessment Questionnaire. We conducted a broad search for past clinical trials in HSPs and identified trials that investigated pharmacological agents including atorvastatin, gabapentin, L-threonine, botulinum toxin, dalfampridine, methylphenidate, and baclofen. We provide recommendations for future HSP treatment directions based on these prior research experiences as well as regulatory insight.

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“… 15 , 16 Others are specific, and skilled professionals from certain areas are more likely to use them with greater precision. 17 , 18 As they are specific, only a few individuals with certain diseases or dysfunctions may benefit from their use. Due to the imprecision of assessment tools, the biological variability of affected individuals, and the intrinsic subjectivity of the human being, 19 , 20 it is important to know the best resources to assess and treat each condition.…”

Section: Physiotherapeutic Assessment Of Individuals With Htlv-1mentioning

confidence: 99%

“… 41 Despite the fact that the use of the Berg Scale is not reported in patients with HAM/TSP, a recent study demonstrated that at baseline they present much lower grades than those found in elderly patients with Parkinson’s disease and stroke. 42 The use of other scales has also been suggested, such as the adaptation of the scale used in paraplegia 18 and the Functional Independence Measure (FIM), 35 which can extend the functionality evaluation. The use of more precise measures such as a three-dimensional kinematic dispositive, isokinetic dynamometry, and stabilometry can improve the accuracy of kinetic functional diagnosis, 17 , 39 but involve more extensive assessments and more expensive resources.…”

Section: Physiotherapeutic Assessment Of Individuals With Htlv-1mentioning

confidence: 99%

Physiotherapy for human T-lymphotropic virus 1-associated myelopathy: review of the literature and future perspectives

Sá¹,

Macêdo²,

Andrade³

et al. 2015

JMDH

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Human T-lymphotropic virus 1 (HTLV-1) infection may be associated with damage to the spinal cord – HTLV-associated myelopathy/tropical spastic paraparesis – and other neurological symptoms that compromise everyday life activities. There is no cure for this disease, but recent evidence suggests that physiotherapy may help individuals with the infection, although, as far as we are aware, no systematic review has approached this topic. Therefore, the objective of this review is to address the core problems associated with HTLV-1 infection that can be detected and treated by physiotherapy, present the results of clinical trials, and discuss perspectives on the development of knowledge in this area. Major problems for individuals with HTLV-1 are pain, sensory-motor dysfunction, and urinary symptoms. All of these have high impact on quality of life, and recent clinical trials involving exercises, electrotherapeutic modalities, and massage have shown promising effects. Although not influencing the basic pathologic disturbances, a physiotherapeutic approach seems to be useful to detect specific problems related to body structures, activity, and participation related to movement in HTLV-1 infection, as well as to treat these conditions.

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Comparison between the spastic paraplegia rating scale, Kurtzke scale, and Osame scale in the tropical spastic paraparesis/myelopathy associated with HTLV

Cited by 7 publications

References 20 publications

Clinical and genetic study of hereditary spastic paraplegia in Canada

Clinical and genetic study of hereditary spastic paraplegia in Canada

Clinical Trial Designs and Measures in Hereditary Spastic Paraplegias

Physiotherapy for human T-lymphotropic virus 1-associated myelopathy: review of the literature and future perspectives

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