Sensorimotor function in progressive multiple sclerosis

Abstract

Background A sensitive test reflecting subtle sensorimotor changes throughout disease progression independent of mobility impairment is currently lacking in progressive multiple sclerosis. Objectives We examined non-ambulatory measures of upper and lower extremity sensorimotor function that may reveal differences between relapsing–remitting and progressive forms of multiple sclerosis. Methods Cutaneous sensitivity, proprioception, central motor function and mobility were assessed in 32 relapsing–remitting and 31 progressive multiple sclerosis patients and 30 non-multiple sclerosis controls. Results Cutaneous sensation differed between relapsing–remitting and progressive multiple sclerosis at the foot and to a lesser extent the hand. Proprioception function in the upper but not the lower extremity differed between relapsing–remitting and progressive multiple sclerosis, but was different for both upper and lower extremities between multiple sclerosis patients and non-multiple sclerosis controls. Foot-tap but not hand-tap speed was slower in progressive compared to relapsing–remitting multiple sclerosis, suggestive of greater central motor function impairment in the lower extremity in progressive multiple sclerosis. In addition, the non-ambulatory sensorimotor measures were more sensitive in detecting differences between relapsing–remitting and progressive multiple sclerosis than mobility assessed with the 25-foot walk test. Conclusion This study provides novel information about changes in sensorimotor function in progressive compared with relapsing–remitting forms of multiple sclerosis, and in particular the importance of assessing both upper and lower extremity function. Importantly, our findings showed loss of proprioceptive function in multiple sclerosis but also in progressive compared to relapsing–remitting multiple sclerosis.

Assessing proprioceptive acuity in people with multiple sclerosis

“…Recently, differences in proprioceptive acuity have been reported in PwMS based on clinical course, such that people with primary progressive MS have demonstrated lower vibration sensitivity, poorer elbow matching, and overall reduced position sense across ULs when compared to people with relapsing-remitting MS. 5 Moreover, a small percentage of PwMS (i.e. approximately 20%) demonstrate greater matching errors compared to control participants.…”

“…8/43 participants) performed worse than control participants. Miehm and colleagues 5 further demonstrated that PwMS diagnosed with primary progressive MS had greater matching errors compared to control participants and individuals with relapsing-remitting MS. In general, these studies discuss their findings of poor proprioceptive function in light of MS disease progression, such that they emphasize differences between clinical courses 5 or correlations with such clinical measures as performance on the nine-hole peg test (9-HPT).…”

“…Miehm and colleagues 5 further demonstrated that PwMS diagnosed with primary progressive MS had greater matching errors compared to control participants and individuals with relapsing-remitting MS. In general, these studies discuss their findings of poor proprioceptive function in light of MS disease progression, such that they emphasize differences between clinical courses 5 or correlations with such clinical measures as performance on the nine-hole peg test (9-HPT). 1 Unfortunately, these studies either do not report 1 or assess 5 endpoint errors, which most studies utilize to quantitatively evaluate proprioceptive acuity in people without MS. 6 , 7 Furthermore, these studies do not assess proprioceptive acuity in PwMS via an ipsilateral matching task, in which participants match the sensed position of their reference hand using the same hand, and hence information does not need to be relayed between the two brain hemispheres.…”

“…In general, these studies discuss their findings of poor proprioceptive function in light of MS disease progression, such that they emphasize differences between clinical courses 5 or correlations with such clinical measures as performance on the nine-hole peg test (9-HPT). 1 Unfortunately, these studies either do not report 1 or assess 5 endpoint errors, which most studies utilize to quantitatively evaluate proprioceptive acuity in people without MS. 6 , 7 Furthermore, these studies do not assess proprioceptive acuity in PwMS via an ipsilateral matching task, in which participants match the sensed position of their reference hand using the same hand, and hence information does not need to be relayed between the two brain hemispheres. 6 Finally, a detailed investigation into how PwMS plan and execute their movements to a proprioceptive target has not been undertaken in previous studies utilizing proprioceptive matching tasks.…”

Comparative Profiling of TG2 and Its Effectors in Human Relapsing Remitting and Progressive Multiple Sclerosis

“…Multiple Sclerosis (MS) is a debilitating and chronic autoimmune neurodegenerative disease of the central nervous system (CNS) that exhibits inflammation mediated demyelination [ 1 , 2 ]. MS leads to diverse neurological deficits, progressive loss of sensorimotor function, and clinical disability [ 3 , 4 ]. The etiology underlying MS pathogenesis has been proposed to involve environmental factors, particularly exposure to the Epstein–Barr virus (EBV) and vitamin D insufficiencies as well as ultraviolet light exposure, smoking, and stress.…”