Contributions
Abstract: P408
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the main acquired demyelinating diseases. Movement disorders are not rare among them and previous studies have estimated tremor prevalence in MS between 25-58%. Tonic spasms or paroxysmal dystonia might be common in NMOSD, but whether they are more prevalent in NMOSD or MS is uncertain.
Purpose: To describe the prevalence and characteristics of movement disorders in MS and NMOSD and investigate the association of tonic spasms and NMOSD.
Methods: From June 2015 to September 2016 patients aged 18 years or older, without dementia and with diagnosis of MS or NMOSD (with positive anti-aquaporin-4 antibody) were consecutively evaluated using standard questionnaire and scales for movement disorders diagnosis. Fahn-Tolosa-Marin (FTM) scale was used for tremor evaluation. Patients with others defined or possible causes of movement disorders were excluded. Data from personal interview, neurological examination and medical files were collected. We used a logistic regression model to investigate whether tonic spasms or tremor was predicted by NMOSD (having MS as reference), controlling for sex, age, and disease duration.
Results: Two hundred and fifty-three patients were evaluated (MS=208; NMOSD=45). Sixty-six patients (26%) have reported or presented with movement disorders. Paroxysmal dystonia (n=32) was the most common movement disorder, followed by tremor (n=27). Overall, the prevalence of tremor in MS was 12,5% while intention tremor was the most common type of tremor (82%). MS was the most prevalent among patients with tremor (26 out of 27). We found a positive linear correlation between scores of the FTM scale (parts A, B, C) and the cerebellar functional system score of the Expanded Disability Status Scale (EDSS) (ρ= 0,73-0,83 p-value< 0,01). The prevalence of paroxysmal dystonia was 35,5% in NMOSD and 7,7% in MS. Having NMOSD (as compared to MS) increases 22 times the chance of tonic spasms (OR=22.07, 95%CI=2.56 to 189.78; p-value=0.005).
Conclusions: Our findings suggest that paroxysmal dystonia is strongly associated with NMOSD and tremor with MS. Intention tremor is the most common type of tremor in MS patients and the greater the cerebellar impairment the more severe the tremor.
Disclosure:
Carolina Candeias da Silva has resgistration on 7th joint ECTRIMS - ACTRIMS meeting sponsored by Roche.
Denis Bernardi Bichuetti has received speaking/consulting honoraria from Bayer Health Care, Biogen Idec, Merck Serono, Genzyme-Sanofi, TEVA and Roche and had travel expenses to scientific meetings sponsored by Bayer Health Care, Merck Serono, TEVA and Roche.
Sonia Maria Cesar de Azevedo Silva: nothing to disclose.
Henrique Balalai Ferraz: nothing to disclose.
Enedina Maria Lobato de Oliveira has received speaker fee from Teva, Biogen, Genzyme
Vanderci Borges has participation of 20th International Congress of Parkinson´s disease and Movement Disorders sponsored by Roche.
Abstract: P408
Type: Poster
Abstract Category: Clinical aspects of MS - 11 Comorbidity
Background: Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are the main acquired demyelinating diseases. Movement disorders are not rare among them and previous studies have estimated tremor prevalence in MS between 25-58%. Tonic spasms or paroxysmal dystonia might be common in NMOSD, but whether they are more prevalent in NMOSD or MS is uncertain.
Purpose: To describe the prevalence and characteristics of movement disorders in MS and NMOSD and investigate the association of tonic spasms and NMOSD.
Methods: From June 2015 to September 2016 patients aged 18 years or older, without dementia and with diagnosis of MS or NMOSD (with positive anti-aquaporin-4 antibody) were consecutively evaluated using standard questionnaire and scales for movement disorders diagnosis. Fahn-Tolosa-Marin (FTM) scale was used for tremor evaluation. Patients with others defined or possible causes of movement disorders were excluded. Data from personal interview, neurological examination and medical files were collected. We used a logistic regression model to investigate whether tonic spasms or tremor was predicted by NMOSD (having MS as reference), controlling for sex, age, and disease duration.
Results: Two hundred and fifty-three patients were evaluated (MS=208; NMOSD=45). Sixty-six patients (26%) have reported or presented with movement disorders. Paroxysmal dystonia (n=32) was the most common movement disorder, followed by tremor (n=27). Overall, the prevalence of tremor in MS was 12,5% while intention tremor was the most common type of tremor (82%). MS was the most prevalent among patients with tremor (26 out of 27). We found a positive linear correlation between scores of the FTM scale (parts A, B, C) and the cerebellar functional system score of the Expanded Disability Status Scale (EDSS) (ρ= 0,73-0,83 p-value< 0,01). The prevalence of paroxysmal dystonia was 35,5% in NMOSD and 7,7% in MS. Having NMOSD (as compared to MS) increases 22 times the chance of tonic spasms (OR=22.07, 95%CI=2.56 to 189.78; p-value=0.005).
Conclusions: Our findings suggest that paroxysmal dystonia is strongly associated with NMOSD and tremor with MS. Intention tremor is the most common type of tremor in MS patients and the greater the cerebellar impairment the more severe the tremor.
Disclosure:
Carolina Candeias da Silva has resgistration on 7th joint ECTRIMS - ACTRIMS meeting sponsored by Roche.
Denis Bernardi Bichuetti has received speaking/consulting honoraria from Bayer Health Care, Biogen Idec, Merck Serono, Genzyme-Sanofi, TEVA and Roche and had travel expenses to scientific meetings sponsored by Bayer Health Care, Merck Serono, TEVA and Roche.
Sonia Maria Cesar de Azevedo Silva: nothing to disclose.
Henrique Balalai Ferraz: nothing to disclose.
Enedina Maria Lobato de Oliveira has received speaker fee from Teva, Biogen, Genzyme
Vanderci Borges has participation of 20th International Congress of Parkinson´s disease and Movement Disorders sponsored by Roche.