Contributions
Abstract: P765
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Introduction: Gait impairment is the first and the most common symptom in the majority of primary progressive multiple sclerosis (PPMS) patients. The gait as a system has to be adapted in these patients to maintain its function of translation with an adequate control support during displacement. In previous studies we have demonstrated (by network analysis) that gait in PPMS is rearranged to maintain the maximum control of pelvic-femoral joints" movement (Gómez-Andrés et al. ECTRIMS 2015). Fampridine has been recently approved for symptomatic management of gait impairment in MS. Its efficacy has been demonstrated by clinical scales that measure changes in walking speed. However, gait impairment in PPMS is far more complex. Therefore, techniques that cope with that complexity are needed.
Objective: To compare the structure of gait system before and after 15 days of fampridine treatment in patients with PPMS by means of network analysis.
Methods: 43 left and 43 right spatiotemporal and kinematic gait parameters were collected from 12 healthy subjects and 10 PPMS patients (before and after treatment with fampridine) by means of instrumented gait analysis. Three networks (healthy subjects, pre-fampridine and post-fampridine) were built using gait parameters as nodes and bivariate Spearman"s rho correlation coefficient as edges. Integration, segregation, modularity, assortativity and centrality were assessed in each network.
Result: After the treatment with fampridine the network structure changes. Central parameters differ from pre-treatment to post-treatment network. In pre-fampridine network, the parameters that are more correlated with the rest of the network are spatiotemporal ones and those related with the range of knee flexion. However, in post-fampridine network these parameters are less correlated. The assortativity of the patients network decreases after treatment to become similar to the healthy subjects network (before 0.204; after 0.124; healthy 0.096). Integration, segregation and modularity are similar to normalcy and do not change with the treatment.
Conclusion: Fampridine modifies the interaction between gait parameters in PPMS patients. The flexibility of the gait structure improves after treatment with fampridine. Particularly, kinematic parameters seem to be less influent on gait spatiotemporal properties pointing out a not previously proposed mechanism for gait improvement after fampridine.
Disclosure:
Irene Pulido-Valdeolivas: Nothing to disclose
David Gómez-Andrés: Nothing to disclose
Estrella Rausell: Nothing to disclose
Juan Andres Martin Gonzalo: Nothing to disclose
Andrea Montero: Nothing to disclose
Irene Rodriguez: Nothing to disclose
Inés González-Suarez has received honoraria for speaking from Biogen and Merck
Celia Oreja-Guevara has received honoraria for speaking and/or consultancy from Biogen, Genzyme, Bayer, Merck-Sereno, Roche, Teva and Novartis.
Abstract: P765
Type: Poster
Abstract Category: Therapy - symptomatic - Treatment of specific symptoms
Introduction: Gait impairment is the first and the most common symptom in the majority of primary progressive multiple sclerosis (PPMS) patients. The gait as a system has to be adapted in these patients to maintain its function of translation with an adequate control support during displacement. In previous studies we have demonstrated (by network analysis) that gait in PPMS is rearranged to maintain the maximum control of pelvic-femoral joints" movement (Gómez-Andrés et al. ECTRIMS 2015). Fampridine has been recently approved for symptomatic management of gait impairment in MS. Its efficacy has been demonstrated by clinical scales that measure changes in walking speed. However, gait impairment in PPMS is far more complex. Therefore, techniques that cope with that complexity are needed.
Objective: To compare the structure of gait system before and after 15 days of fampridine treatment in patients with PPMS by means of network analysis.
Methods: 43 left and 43 right spatiotemporal and kinematic gait parameters were collected from 12 healthy subjects and 10 PPMS patients (before and after treatment with fampridine) by means of instrumented gait analysis. Three networks (healthy subjects, pre-fampridine and post-fampridine) were built using gait parameters as nodes and bivariate Spearman"s rho correlation coefficient as edges. Integration, segregation, modularity, assortativity and centrality were assessed in each network.
Result: After the treatment with fampridine the network structure changes. Central parameters differ from pre-treatment to post-treatment network. In pre-fampridine network, the parameters that are more correlated with the rest of the network are spatiotemporal ones and those related with the range of knee flexion. However, in post-fampridine network these parameters are less correlated. The assortativity of the patients network decreases after treatment to become similar to the healthy subjects network (before 0.204; after 0.124; healthy 0.096). Integration, segregation and modularity are similar to normalcy and do not change with the treatment.
Conclusion: Fampridine modifies the interaction between gait parameters in PPMS patients. The flexibility of the gait structure improves after treatment with fampridine. Particularly, kinematic parameters seem to be less influent on gait spatiotemporal properties pointing out a not previously proposed mechanism for gait improvement after fampridine.
Disclosure:
Irene Pulido-Valdeolivas: Nothing to disclose
David Gómez-Andrés: Nothing to disclose
Estrella Rausell: Nothing to disclose
Juan Andres Martin Gonzalo: Nothing to disclose
Andrea Montero: Nothing to disclose
Irene Rodriguez: Nothing to disclose
Inés González-Suarez has received honoraria for speaking from Biogen and Merck
Celia Oreja-Guevara has received honoraria for speaking and/or consultancy from Biogen, Genzyme, Bayer, Merck-Sereno, Roche, Teva and Novartis.