Contributions
Abstract: P377
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Introduction: The timed-25 foot walk (T25FW) is an established measure of disability in multiple sclerosis (MS) A technology-enabled neuroperformance adaptation of the T25W, the walking speed test (WST) obtained via iPad® application has been implemented as part of routine clinical care at our center.
Objectives and aims: To determine the relationship of the WST and patient determined disease steps (PDDS) to other neuroperformance measures, patient reported outcomes (PROs) and quantitative MRI metrics in a large clinical cohort.
Methods: Demographics, MS disease history, iPad based neuroperformance tests, PROs, and quantitative MRI data were collected cross sectionally from the MS population at a single site between December 2015 and December 2017. Brain MRIs obtained +/- 90 days of a clinical encounter during which WST and PROs were collected were quantitatively analyzed via a semi-automated method to calculate T2 lesion volume (T2LV), normalized whole brain volume (BV), thalamic volume (TV), and cervical cord cross sectional area (CA). Spearman correlation coefficients were used to examine the relation of WST and PDDS with age, disease duration, PROs, neuroperformance measures and MRI metrics (significance set at p< 0.001). A linear regression model was designed to explore the contribution of disease measures and MRI measures to the WST and PDDS (significance set at p < 0.05).
Results: 944 patients (age 47.6 ± 11.4, disease duration 12.1 ± 9.4) underwent concurrent neuroperformance assessment and MRI. PDDS and WST showed a strong correlation (ρ= 0.69, p < 0.001). WST correlated with all PROs (strongest correlation were Neuro QoL lower extremity ρ= -0.70, p < 0.001). WST correlated with all MRI metrics (strongest correlations were T2LV (ρ=0.26), CA (ρ=-0.26), and BV (ρ=-0.25). PDDS had the same pattern of correlations. Linear regression model incorporating age, disease duration, sex, and MRI measures demonstrated that CA, T2LV, and BV were significant cross-sectional predictors of WST (p< 0.05). For PDDS, significant predictors were age, CA, and T2LV (p< 0.05).
Conclusions: WST and PDDS correlated best with PROs capturing lower extremity physical function in a large clinical cohort with routine technology-enabled administration. Gait dysfunction is likely related to spinal cord injury as evidenced by the strong correlation of WST and PDDS with cross sectional spinal cord area.
Disclosure: Marisa McGinley has served on scientific advisory boards for Genzyme and Genentech, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1506-04742)
Kunio Nakamura has received personal fees for consulting from NeuroRx Research, speaking from Sanofi Genzyme, and license from Biogen. He has received research support from NIH NINDS, NMSS, DOD, Biogen, Sanofi Genzyme, and Novartis.
Hong Li: Nothing to disclose
Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL.
Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Laura Baldassari has received personal fees for serving on a scientific advisory board for Teva, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1606-24540).
Ebtesam Alshehri: Nothing to disclose
Malory Weber: Nothing to disclose
Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.
Jeffrey Cohen has received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.
Abstract: P377
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Introduction: The timed-25 foot walk (T25FW) is an established measure of disability in multiple sclerosis (MS) A technology-enabled neuroperformance adaptation of the T25W, the walking speed test (WST) obtained via iPad® application has been implemented as part of routine clinical care at our center.
Objectives and aims: To determine the relationship of the WST and patient determined disease steps (PDDS) to other neuroperformance measures, patient reported outcomes (PROs) and quantitative MRI metrics in a large clinical cohort.
Methods: Demographics, MS disease history, iPad based neuroperformance tests, PROs, and quantitative MRI data were collected cross sectionally from the MS population at a single site between December 2015 and December 2017. Brain MRIs obtained +/- 90 days of a clinical encounter during which WST and PROs were collected were quantitatively analyzed via a semi-automated method to calculate T2 lesion volume (T2LV), normalized whole brain volume (BV), thalamic volume (TV), and cervical cord cross sectional area (CA). Spearman correlation coefficients were used to examine the relation of WST and PDDS with age, disease duration, PROs, neuroperformance measures and MRI metrics (significance set at p< 0.001). A linear regression model was designed to explore the contribution of disease measures and MRI measures to the WST and PDDS (significance set at p < 0.05).
Results: 944 patients (age 47.6 ± 11.4, disease duration 12.1 ± 9.4) underwent concurrent neuroperformance assessment and MRI. PDDS and WST showed a strong correlation (ρ= 0.69, p < 0.001). WST correlated with all PROs (strongest correlation were Neuro QoL lower extremity ρ= -0.70, p < 0.001). WST correlated with all MRI metrics (strongest correlations were T2LV (ρ=0.26), CA (ρ=-0.26), and BV (ρ=-0.25). PDDS had the same pattern of correlations. Linear regression model incorporating age, disease duration, sex, and MRI measures demonstrated that CA, T2LV, and BV were significant cross-sectional predictors of WST (p< 0.05). For PDDS, significant predictors were age, CA, and T2LV (p< 0.05).
Conclusions: WST and PDDS correlated best with PROs capturing lower extremity physical function in a large clinical cohort with routine technology-enabled administration. Gait dysfunction is likely related to spinal cord injury as evidenced by the strong correlation of WST and PDDS with cross sectional spinal cord area.
Disclosure: Marisa McGinley has served on scientific advisory boards for Genzyme and Genentech, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1506-04742)
Kunio Nakamura has received personal fees for consulting from NeuroRx Research, speaking from Sanofi Genzyme, and license from Biogen. He has received research support from NIH NINDS, NMSS, DOD, Biogen, Sanofi Genzyme, and Novartis.
Hong Li: Nothing to disclose
Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL.
Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Laura Baldassari has received personal fees for serving on a scientific advisory board for Teva, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1606-24540).
Ebtesam Alshehri: Nothing to disclose
Malory Weber: Nothing to disclose
Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.
Jeffrey Cohen has received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.