Contributions
Abstract: P354
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Walking difficulties are among most limiting manifestations of multiple sclerosis (MS). Assessment tools that can evaluate walking disability are essential in management of MS patients. The Expanded Timed Up-and-Go (ETUG) test has been proposed as being more sensitive and clinically useful in assessing mobility. The relationship between walking impairment and brain MRI outcomes still remains unclear.
Objective: To determine if ETUG and/or its subcomponents are associated with changes in longitudinal MRI outcome measures over 5 years in MS patients. To compare ETUG association with MRI measures vs. other widely used ambulatory assessments.
Methods: The subjects are part of a prospective, ongoing Cardiovascular, Environmental and Genetic (CEG) study. We included 37 MS patients who were assessed at baseline and at follow-up using 3T MRI scanner that did not undergo major hardware or software upgrades. At both time points, an experienced neurologist applied Expanded Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25FW) test as part of full clinical examination. The ETUG test was introduced at the follow-up clinical visit. Correlation coefficients were calculated by Spearman"s rank order correlation. Results were considered statistically significant at P < 0.05.
Results: Three out of six individual components and total ETUG test showed a significant association with change in ventricular cerebrospinal fluid (vCSF) volume over the 5-year follow-up. These included: turn around (r=0.43, p=0.008), total ETUG (r=0.4, p=0.013), gait initiation (r=0.4, p=0.013) and second walk (r=0.35, p=0.034). ETUG demonstrated concurrent validity with T25FW and EDSS (p< 0.001). ETUG (p=0.013) showed a more significant relationship with change in vCSF volume over 5-years compared to T25FW test (p=0.024) and EDSS (p=0.08).
Conclusion: ETUG and its subcomponents showed greater associations with development of central atrophy compared to T25FW test and EDSS. ETUG should be added into the clinical routine to complement the assessment of MS patients. Larger sample size is needed to confirm our preliminary results.
Disclosure:
Dejan Jakimovski, Sirin Gandhi and Ahmed Sanai have nothing to disclose.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis, Acorda.
Channa Kolb has received personal compensation for activities with Teva Neuroscience, Biogen Idec and EMD Serono as a speaker and scientific advisory board member
Ralph Benedict has acted as a consultant or scientific advisory board member for Bayer, Biogen Idec, Actelion, and Novartis. He receives royalties from Psychological Assessment Resources, Inc. He has received financial support for research activities from Shire Pharmaceuticals, Accorda and Biogen Idec
Robert Zivadinov received personal compensation from Teva Pharmaceuticals, Biogen Idec, EMD Serono, Genzyme-Sanofi, Claret Medical, IMS Health and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.
Abstract: P354
Type: Poster
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Walking difficulties are among most limiting manifestations of multiple sclerosis (MS). Assessment tools that can evaluate walking disability are essential in management of MS patients. The Expanded Timed Up-and-Go (ETUG) test has been proposed as being more sensitive and clinically useful in assessing mobility. The relationship between walking impairment and brain MRI outcomes still remains unclear.
Objective: To determine if ETUG and/or its subcomponents are associated with changes in longitudinal MRI outcome measures over 5 years in MS patients. To compare ETUG association with MRI measures vs. other widely used ambulatory assessments.
Methods: The subjects are part of a prospective, ongoing Cardiovascular, Environmental and Genetic (CEG) study. We included 37 MS patients who were assessed at baseline and at follow-up using 3T MRI scanner that did not undergo major hardware or software upgrades. At both time points, an experienced neurologist applied Expanded Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25FW) test as part of full clinical examination. The ETUG test was introduced at the follow-up clinical visit. Correlation coefficients were calculated by Spearman"s rank order correlation. Results were considered statistically significant at P < 0.05.
Results: Three out of six individual components and total ETUG test showed a significant association with change in ventricular cerebrospinal fluid (vCSF) volume over the 5-year follow-up. These included: turn around (r=0.43, p=0.008), total ETUG (r=0.4, p=0.013), gait initiation (r=0.4, p=0.013) and second walk (r=0.35, p=0.034). ETUG demonstrated concurrent validity with T25FW and EDSS (p< 0.001). ETUG (p=0.013) showed a more significant relationship with change in vCSF volume over 5-years compared to T25FW test (p=0.024) and EDSS (p=0.08).
Conclusion: ETUG and its subcomponents showed greater associations with development of central atrophy compared to T25FW test and EDSS. ETUG should be added into the clinical routine to complement the assessment of MS patients. Larger sample size is needed to confirm our preliminary results.
Disclosure:
Dejan Jakimovski, Sirin Gandhi and Ahmed Sanai have nothing to disclose.
Bianca Weinstock-Guttman received honoraria as a speaker and as a consultant for Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis and Acorda. Dr Weinstock-Guttman received research funds from Biogen Idec, Teva Pharmaceuticals, EMD Serono, Genzyme&Sanofi, Novartis, Acorda.
Channa Kolb has received personal compensation for activities with Teva Neuroscience, Biogen Idec and EMD Serono as a speaker and scientific advisory board member
Ralph Benedict has acted as a consultant or scientific advisory board member for Bayer, Biogen Idec, Actelion, and Novartis. He receives royalties from Psychological Assessment Resources, Inc. He has received financial support for research activities from Shire Pharmaceuticals, Accorda and Biogen Idec
Robert Zivadinov received personal compensation from Teva Pharmaceuticals, Biogen Idec, EMD Serono, Genzyme-Sanofi, Claret Medical, IMS Health and Novartis for speaking and consultant fees. He received financial support for research activities from Teva Pharmaceuticals, Genzyme-Sanofi, Novartis, Claret Medical, Intekrin-Coherus and IMS Health.