Contributions
Abstract: P1024
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Introduction: Upper limb dysfunction, that is highly prevalent in persons with MS (pwMS), is not well captured by the EDSS. Measures obtained by an engineered glove (Hand Test System, HTS) have been previously shown to correlate with EDSS and cognitive impairment in RRMS. Magnetic resonance imaging (MRI) and optical coherence tomography (OCT) give objective measures of brain and retinal nerve fiber layer (RNFL) damage.
Objectives: To correlate the finger motor parameters obtained by the HTS glove system to the objective parameters given by MRI and OCT in a cohort of pwMS.
Methods: 65 pwMS (47 females; mean age: 43.4±11.1 y; median EDSS=2 (range:0-6.5); 46 RR, 13 PP and 3 SP), enrolled in the European ERACoSysMed study, performed a repetitive finger-to-thumb opposition sequence with their dominant hand at their maximal velocity, and bimanually metronome-paced (2Hz). All subjects had clinical examination (EDSS and 9HPT) and underwent conventional MRI (T2 lesion volume (LV) and T1LV) and OCT. The RNFL was obtained as the average of the 2 eyes. Movement RATE in the maximal velocity condition measured on correct sequences and Inter Hand Interval (IHI) for the bimanual trial were measured. Correlations were assessed by the Pearson or Spearman correlation coefficients. A multivariate model was run to assess independent predictors of RNFL, T2LV and T1LV.
Results: RNFL thickness was not correlated to T2LV o T1LV. EDSS was correlated to MRI T2LV (r=0.39;p=0.003), T1LV (r=0.30;p=0.018) and RNFL (r=-0.43;p< 0.001). Both the glove RATE and the IHI were significantly correlated to EDSS (r=-0.54;p< 0.001 and r=0.32;p=0.03). The RATE correlated to T2LV (r=-0.34;p=0.012) and with T1LV (r=-0.36;p=0.004); the IHI correlated to T1LV (r=0.38;p=0.01) and with RNFL (r=-0.39;p=0.01). The 9HPT correlated to MRI lesion volumes (T2LV r=0.54;p< 0.001, T1LV r=0.37;p=0.003) but it was not associated to RNFL (r=-0.11;p=0.39). At multivariate analysis the factors independently associated to RNFL were EDSS (p=0.046) and IHI (p=0.039); the factor associated to T2LV was EDSS (p=0.022) and to T1LV was IHI (p=0.008).
Conclusions: The glove parameters (RATE and IHI) correlated with objective measures of neuronal damage as measured by RNFL thickness on OCT and lesion volumes on MRI. The IHI, assessing bimanual coordination, was correlated to RNFL independently from EDSS. This result indicates that the IHI glove parameter adds clinically relevant information to the disability assessment given by EDSS.
Disclosure: This study received an award from Merck Serono and funding within the European ERACoSysMed "Personalizing health care in Multiple Sclerosis using systems medicine tools ("Sys4MS") study
AS has received teaching honoraria from Novartis
LC, CL, LN, MC, EG, ES, LF, RM, GB, NP have nothing to disclose
AL has received personal compensation from Novartis, Genzyme, Biogen, Merck, and Teva for public speaking and advisory boards.
MP received research support from Novartis.
MI received research grants from NIH, DOD, NMSS, FISM and Teva Neuroscience
GLM has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from Bayer Schering, Biogen Idec, Genzyme,Merck Serono, Novartis, Sanofi-Aventis, and Teva P harmaceuticals.
AU has received grants/research supports and honoraria or consultation fees from Biogen, Novartis, Teva, Roche and Merck-Serono.
MPS received consulting fees from TEVA, Biogen, Merck Serono, Genzyme, Roche, GeNeuro, Novartis, Medday.
Abstract: P1024
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Introduction: Upper limb dysfunction, that is highly prevalent in persons with MS (pwMS), is not well captured by the EDSS. Measures obtained by an engineered glove (Hand Test System, HTS) have been previously shown to correlate with EDSS and cognitive impairment in RRMS. Magnetic resonance imaging (MRI) and optical coherence tomography (OCT) give objective measures of brain and retinal nerve fiber layer (RNFL) damage.
Objectives: To correlate the finger motor parameters obtained by the HTS glove system to the objective parameters given by MRI and OCT in a cohort of pwMS.
Methods: 65 pwMS (47 females; mean age: 43.4±11.1 y; median EDSS=2 (range:0-6.5); 46 RR, 13 PP and 3 SP), enrolled in the European ERACoSysMed study, performed a repetitive finger-to-thumb opposition sequence with their dominant hand at their maximal velocity, and bimanually metronome-paced (2Hz). All subjects had clinical examination (EDSS and 9HPT) and underwent conventional MRI (T2 lesion volume (LV) and T1LV) and OCT. The RNFL was obtained as the average of the 2 eyes. Movement RATE in the maximal velocity condition measured on correct sequences and Inter Hand Interval (IHI) for the bimanual trial were measured. Correlations were assessed by the Pearson or Spearman correlation coefficients. A multivariate model was run to assess independent predictors of RNFL, T2LV and T1LV.
Results: RNFL thickness was not correlated to T2LV o T1LV. EDSS was correlated to MRI T2LV (r=0.39;p=0.003), T1LV (r=0.30;p=0.018) and RNFL (r=-0.43;p< 0.001). Both the glove RATE and the IHI were significantly correlated to EDSS (r=-0.54;p< 0.001 and r=0.32;p=0.03). The RATE correlated to T2LV (r=-0.34;p=0.012) and with T1LV (r=-0.36;p=0.004); the IHI correlated to T1LV (r=0.38;p=0.01) and with RNFL (r=-0.39;p=0.01). The 9HPT correlated to MRI lesion volumes (T2LV r=0.54;p< 0.001, T1LV r=0.37;p=0.003) but it was not associated to RNFL (r=-0.11;p=0.39). At multivariate analysis the factors independently associated to RNFL were EDSS (p=0.046) and IHI (p=0.039); the factor associated to T2LV was EDSS (p=0.022) and to T1LV was IHI (p=0.008).
Conclusions: The glove parameters (RATE and IHI) correlated with objective measures of neuronal damage as measured by RNFL thickness on OCT and lesion volumes on MRI. The IHI, assessing bimanual coordination, was correlated to RNFL independently from EDSS. This result indicates that the IHI glove parameter adds clinically relevant information to the disability assessment given by EDSS.
Disclosure: This study received an award from Merck Serono and funding within the European ERACoSysMed "Personalizing health care in Multiple Sclerosis using systems medicine tools ("Sys4MS") study
AS has received teaching honoraria from Novartis
LC, CL, LN, MC, EG, ES, LF, RM, GB, NP have nothing to disclose
AL has received personal compensation from Novartis, Genzyme, Biogen, Merck, and Teva for public speaking and advisory boards.
MP received research support from Novartis.
MI received research grants from NIH, DOD, NMSS, FISM and Teva Neuroscience
GLM has received honoraria for lecturing, travel expenses for attending meetings, and financial support for research from Bayer Schering, Biogen Idec, Genzyme,Merck Serono, Novartis, Sanofi-Aventis, and Teva P harmaceuticals.
AU has received grants/research supports and honoraria or consultation fees from Biogen, Novartis, Teva, Roche and Merck-Serono.
MPS received consulting fees from TEVA, Biogen, Merck Serono, Genzyme, Roche, GeNeuro, Novartis, Medday.