Contributions
Abstract: EP1529
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Introduction: Tremor is a disabling movement disorder in Multiple Sclerosis (MS) that has no effective treatment and poorly understood pathophysiology. Understanding the brain regions involved in MS tremor could advance treatment development.
Aim: To understand the functional brain abnormalities associated with upper limb tremor in MS.
Methods: Twenty-three MS patients with unilateral upper limb tremor (MST) and twenty MS patients without tremor (MSC) underwent 3T magnetic resonance imaging (MRI) (MPRAGE, DIR and task fMRI) and a clinical tremor assessment. Tremor was quantified using the Bain score (0 to 10) for overall severity, writing and Archimedes spiral drawing. Cerebellar function was quantified using the Scale for the assessment and rating of ataxia (SARA). The fMRI tasks included a 'brick-breaker' joystick game that aimed to isolate tremulous movement by contrasting two conditions: 'play' (playing the game) and ´move´ (rhythmic left/right movement of joystick without game). Task fMRI was analysed using FSL FEAT. Lesions were automatically segmented using LST toolbox version 2.0.15 for SPM. Regions of interest (ROI) were identified from FEAT analyses for correlation with tremor scores. Statistical analyses were performed in SPSS.
Results: MST (47.6±12.9y, Expanded Disability Status Scale (EDSS) 4.1±1.7) and MSC (46.2±11.0y, EDSS 3.4±1.6) groups were well matched. MST showed significantly higher activation in 'play´ vs ´watch' in the bilateral sensorimotor cortex compared to MSC. Furthermore, activation within bilateral sensorimotor cortex significantly correlated with Bain tremor severity (p< 0.001), handwriting (p< 0.000), Archimedes spiral (p< 0.000), and SARA (p< 0,005). Ipsilateral sensorimotor cortex activation correlated with lesion load (p< 0.010).
Conclusion: This study demonstrates a strong involvement of the sensorimotor cortex in the pathophysiology of upper-limb tremor in MS.
Disclosure:
Frederique Boonstra has nothing to declare
Gustavo Noffs has nothing to declare
Thushara Perera has nothing to declare
Camille Shanahan has nothing to declare
Adam Vogel has received consulting fees from Cogstate and Takeda.
Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis
Abstract: EP1529
Type: ePoster
Abstract Category: Pathology and pathogenesis of MS - 21 Imaging
Introduction: Tremor is a disabling movement disorder in Multiple Sclerosis (MS) that has no effective treatment and poorly understood pathophysiology. Understanding the brain regions involved in MS tremor could advance treatment development.
Aim: To understand the functional brain abnormalities associated with upper limb tremor in MS.
Methods: Twenty-three MS patients with unilateral upper limb tremor (MST) and twenty MS patients without tremor (MSC) underwent 3T magnetic resonance imaging (MRI) (MPRAGE, DIR and task fMRI) and a clinical tremor assessment. Tremor was quantified using the Bain score (0 to 10) for overall severity, writing and Archimedes spiral drawing. Cerebellar function was quantified using the Scale for the assessment and rating of ataxia (SARA). The fMRI tasks included a 'brick-breaker' joystick game that aimed to isolate tremulous movement by contrasting two conditions: 'play' (playing the game) and ´move´ (rhythmic left/right movement of joystick without game). Task fMRI was analysed using FSL FEAT. Lesions were automatically segmented using LST toolbox version 2.0.15 for SPM. Regions of interest (ROI) were identified from FEAT analyses for correlation with tremor scores. Statistical analyses were performed in SPSS.
Results: MST (47.6±12.9y, Expanded Disability Status Scale (EDSS) 4.1±1.7) and MSC (46.2±11.0y, EDSS 3.4±1.6) groups were well matched. MST showed significantly higher activation in 'play´ vs ´watch' in the bilateral sensorimotor cortex compared to MSC. Furthermore, activation within bilateral sensorimotor cortex significantly correlated with Bain tremor severity (p< 0.001), handwriting (p< 0.000), Archimedes spiral (p< 0.000), and SARA (p< 0,005). Ipsilateral sensorimotor cortex activation correlated with lesion load (p< 0.010).
Conclusion: This study demonstrates a strong involvement of the sensorimotor cortex in the pathophysiology of upper-limb tremor in MS.
Disclosure:
Frederique Boonstra has nothing to declare
Gustavo Noffs has nothing to declare
Thushara Perera has nothing to declare
Camille Shanahan has nothing to declare
Adam Vogel has received consulting fees from Cogstate and Takeda.
Andrew Evans has received honoraria from Novartis for giving presentations and providing consultancy services. He has participated in scientific advisory board meetings for Novartis, UCB Pharma, Allergan, and Boehringer Ingelheim. He has received conference travel support from Boehringer Ingelheim.
Helmut Butzkeuven has received consulting fees from Genzyme, Biogen, Novartis, Merck and Oxford PharmaGenesis and grant/research support from Biogen, Novartis, Merck and Genzyme
Anneke van der Walt has received travel support from Biogen Idec, Novartis, Teva, Merck and serves on several advisory boards
Scott Kolbe receives grant income from the National Health and Medical Research Council of Australia and has received honoraria from Novartis