ECTRIMS eLearning

Elastography: a new diagnostic tool for the evaluation and quantification of multiple sclerosis spasticity
Author(s):
G. Illomei
G. Illomei
Affiliations:
ECTRIMS Learn. Illomei G. 09/15/16; 146187; P347
Giovanni Illomei
Giovanni Illomei
Contributions
Abstract

Abstract: P347

Type: Poster

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Purpose: The purpose of the study was to investigate the use of ultrasound (US) based elastography in evaluating the muscle fibers status and its changes after multiple sclerosis (MS) antispasticity treatment in order to assess its interest as a new imaging tool for the evaluation of spasticity.

Methods and materials: Two groups of patient were enrolled: GROUP A, 110 MS patients. In all these patients spasticity examination was performed with the modif. Ashworth scale by a neurologist. All patients also underwent US elastography tests in their both legs quadriceps muscle fibers and images scored with the 0-5 RTHE scale.

GROUP B, 50 MS patients starting Nabiximols (THC:CBD oromucosal spray) treatment for their resistant MS spasticity according to medical judgment and the Italian drugs agency (AIFA) criteria. All patients were non-responders to previous spasticity treatments. For each patient spasticity was evaluated by the 0-10 NRS scale at baseline and after 1 month (trial period). Participants" both legs quadriceps muscle fibers were examined through US elastography and images scored with the 0-5 RTHE scale.

The study was approved by the local Ethics committee.

Results:

GROUP A: there was full concordance between the Ashworth scale evaluation scores and the US elastography scores. However, patients classified as score “0” in the Ashworth scale could be further split by US elastography into “0a” (total normality of muscle fibers elasticity) and “0b” (initial compromising of muscle fibers elasticity).

GROUP B: Initial responders to Nabiximols (pre-defined as an improvement ≥20% in their 0-10 NRS spasticity score vs. baseline) after the 1 month trial period were 65% of sample. They had a mean -1.88 NRS score reduction and also a -1.95 change in their US elastography 0-5 mean RTHE score, while the 35% of patients not reaching the 20% NRS clinical initial response threshold improved their mean NRS score by -0.55 and their mean RTHE score by a -0.95, showing a correlation between these subjective and objective scales changes.

Conclusion: US elastography could be the new objective gold standard to evaluate MS muscle spasticity, in early or late periods and also to evaluate the efficacy of antispasticity therapy.

Disclosure: Nothing to disclose

Abstract: P347

Type: Poster

Abstract Category: Clinical aspects of MS - Clinical assessment tools

Purpose: The purpose of the study was to investigate the use of ultrasound (US) based elastography in evaluating the muscle fibers status and its changes after multiple sclerosis (MS) antispasticity treatment in order to assess its interest as a new imaging tool for the evaluation of spasticity.

Methods and materials: Two groups of patient were enrolled: GROUP A, 110 MS patients. In all these patients spasticity examination was performed with the modif. Ashworth scale by a neurologist. All patients also underwent US elastography tests in their both legs quadriceps muscle fibers and images scored with the 0-5 RTHE scale.

GROUP B, 50 MS patients starting Nabiximols (THC:CBD oromucosal spray) treatment for their resistant MS spasticity according to medical judgment and the Italian drugs agency (AIFA) criteria. All patients were non-responders to previous spasticity treatments. For each patient spasticity was evaluated by the 0-10 NRS scale at baseline and after 1 month (trial period). Participants" both legs quadriceps muscle fibers were examined through US elastography and images scored with the 0-5 RTHE scale.

The study was approved by the local Ethics committee.

Results:

GROUP A: there was full concordance between the Ashworth scale evaluation scores and the US elastography scores. However, patients classified as score “0” in the Ashworth scale could be further split by US elastography into “0a” (total normality of muscle fibers elasticity) and “0b” (initial compromising of muscle fibers elasticity).

GROUP B: Initial responders to Nabiximols (pre-defined as an improvement ≥20% in their 0-10 NRS spasticity score vs. baseline) after the 1 month trial period were 65% of sample. They had a mean -1.88 NRS score reduction and also a -1.95 change in their US elastography 0-5 mean RTHE score, while the 35% of patients not reaching the 20% NRS clinical initial response threshold improved their mean NRS score by -0.55 and their mean RTHE score by a -0.95, showing a correlation between these subjective and objective scales changes.

Conclusion: US elastography could be the new objective gold standard to evaluate MS muscle spasticity, in early or late periods and also to evaluate the efficacy of antispasticity therapy.

Disclosure: Nothing to disclose

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