Effect of Need to Void on Rectal Sensory Function in Multiple Sclerosis

Sensory disturbances are one of the most common findings in patients with multiple sclerosis (MS). However, they are usually assessed at the standard neurological examination only. Q uantitative Sensory Tests (Q STs) for temperature and vibratory sense allow a more objective evaluation. In a group of 19 clinically definite MS patients, we compared vibratory and temperatur e thresholds with sensory symptoms or signs at clinical neurological examination and somatosensory evoked potentials (SEPs) at the four limbs. The frequency of abnormalities of clinical symptoms/signs, vibration threshold and median SEPs were 69%, 33% and 55%, respectively. C orrelation between degree of abnormality of SEPs and clinically assessed vibration sense (V) was statistically significant (P B-0.007; Spearmann rank coefficient), as well as between SEPs and vibration perceptio n threshold (P B-0.02). C linical evaluation of thermal sense did not show false positive results compared to quantitative thermal threshold, but false negative findings (35%). This study suggests that the combined use of vibration threshold and SEPs allows a better objectivation of sensory function, allowing the detection of subclinical abnormalities and possibly reducing the number of false positive results introduced by clinical assessment. Moreover, Q STs are to be preferred to clinical evaluation in the assessment of thermal sense, due to their superior sensitivity.

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Association of Postural Sway with Disability Status and Cerebellar Dysfunction in People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2014-003 ◽

2015 ◽

Vol 17 (3) ◽

pp. 146-151 ◽

Cited By ~ 20

Author(s):

James McLoughlin ◽

Christopher Barr ◽

Maria Crotty ◽

Stephen R. Lord ◽

Daina L. Sturnieks

Keyword(s):

Multiple Sclerosis ◽

Postural Sway ◽

Balance Control ◽

Knee Extension ◽

Ankle Dorsiflexion ◽

Sensory Function ◽

Sensory Loss ◽

Cerebellar Dysfunction ◽

Exercise Interventions ◽

Disability Status

Background: The aims of this study were 1) to examine postural sway in the eyes open (EO) and eyes closed (EC) conditions in people with multiple sclerosis (MS) with moderate levels of disability compared with controls and 2) to examine relationships between postural sway and total Expanded Disability Status Scale (EDSS) scores, functional system subscores, and clinical measures of strength and spasticity in the MS group. Methods: Thirty-four people with moderate MS and ten matched controls completed measures of postural sway with EO and EC, knee extension and ankle dorsiflexion isometric strength, EDSS total score and subscores, and spasticity levels. Results: Participants with MS swayed significantly more with EO and EC and had reduced knee extension and ankle dorsiflexion strength compared with controls (P < .001). In the MS group, increased sway was associated with higher total EDSS scores and cerebellar function subscores, whereas increased sway ratio (EC/EO) was associated with reduced sensory function subscores. Postural sway was not significantly associated with strength or spasticity. Conclusions: Participants with MS swayed more and were significantly weaker than controls. Cerebellar dysfunction was identified as the EDSS domain most strongly associated with increased sway, and sensory loss was associated with a relatively greater dependence on vision for balance control. These findings suggest that exercise interventions targeting sensory integration and cerebellar ataxia may be beneficial for enhancing balance control in people with MS.

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Quality of life in patients with multiple sclerosis and their caregivers in Colombia: One-year follow-up

Biomédica ◽

10.7705/biomedica.4759 ◽

2020 ◽

Vol 40 (1) ◽

pp. 129-136

Author(s):

Elkin Beltrán ◽

Diana Díaz ◽

Cindy Díaz ◽

Luis Zarco

Keyword(s):

Quality Of Life ◽

Multiple Sclerosis ◽

Demyelinating Disease ◽

Chronic Fatigue ◽

Sensory Function ◽

Relapsing Remitting ◽

Remitting Multiple Sclerosis ◽

Relapsing Remitting Multiple Sclerosis

Introduction: Multiple sclerosis is a chronic inflammatory demyelinating disease associated with neurological disability. Clinical features include motor, cerebellar, visual, and sensory function alterations, as well as psychiatric comorbidities, such as depression, anxiety, and irritability. There is little literature available on the quality of life of patients and their caregivers.Objective: To assess the quality of life of patients with multiple sclerosis and their caregivers in Colombia given that there is no information on the subject in this particular population to establish comprehensive management plans.Materials and methods: We used the MusiQol and CareQol questionnaires and the Beck Depression Inventory. A prospective analytical observational protocol was designed to include patients aged 18 to 65 years with a diagnosis of relapsing-remitting multiple sclerosis between October, 2014, and October, 2015, at the Hospital Universitario San Ignacio. We evaluated quantitative variables and Spearman correlations. The data analysis was carried out with Student t and Mann-Whitney U tests.Results: A total of 55 patients with relapsing-remitting multiple sclerosis participated in the study. Chronic fatigue was the most common comorbidity in 27%. The MusiQol questionnaire revealed a good basal quality of life, which remained at similar levels in the follow-ups at six and 12 months. Quality of life was good during the study since there were no statistically significant differences between baseline and follow-up MusiQol scores. Good quality of life was also observed in caregivers.Conclusions: The quality of life of several Colombian patients diagnosed with multiple sclerosis was very good. This positive result was also observed in caregivers as evidenced by the results of the CareQol questionnaire. We also observed and indicated an inversely proportional correlation between the Expanded Disability Status Scale and the quality of life indexes.

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The Vibration Quantitation Scale (VQS): A Simple, Reproducible Bedside Measure of Sensory Function in Multiple Sclerosis

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100003681 ◽

2004 ◽

Vol 31 (4) ◽

pp. 490-493

Author(s):

J. Carter ◽

T. Wasser ◽

S. Statler ◽

A.D. Rae-Grant

Keyword(s):

Multiple Sclerosis ◽

Tuning Fork ◽

Neurological Diseases ◽

Statistical Significance ◽

Sensory Function ◽

Strongly Correlated ◽

Sensory Abnormalities ◽

Multiple Sclerosis Patients ◽

Disability Severity ◽

Normal Controls

Objectives:To assess the utility of a bedside measure of sensation (the Vibration Quantitation Scale (VQS)) in patients with multiple sclerosis (MS) and in normal controls. To correlate the VQS with the Kurtzke Expanded Disability Severity Score (EDSS) and sensory abnormalities in these patients.Methods:We developed the VQS and tested its performance in patients with MS of various ages, MS types, and EDSS scores. We compared this with controls (normal volunteers or patients with other neurological diseases) who did not have sensory symptoms. In a subgroup, two examiners measured VQS independently at the same patient visit. Astandard C-128 tuning fork was used for the VQS measurement.Results:The VQS had a good inter-observer reproducibility (r=0.920, p<0.001). The VQS fell with increasing age in normals consistent with declining sensory function. The VQS was significantly lower in the multiple sclerosis patients compared with age - matched controls (p<0.001). Abnormalities in VQS were present in patients with brief duration of MS (<5 years) and low EDSS scores, correlating with the presence of sensory abnormalities early in the disease course in some patients. There was a strong correlation between the VQS and EDSS (r=-0.509). The VQS correlated with abnormal sensation in the hands (r=0.310), but did not meet statistical significance for abnormal sensation in the feet or face. Asecond cohort of MS patients was studied using a modified VQS measure (single stimulation, omitting forehead measurement). This reconfirmed the correlation between the modified VQS and EDSS as well as with age. The modified VQS may be useful in clinical practice since it takes little time and is strongly correlated with the EDSS (r=0.578).Conclusion:The VQS provides a continuous sensory scale applicable in most patients with MS, which is measurable with standard bedside equipment, and which may avoid some of the pitfalls of sensory scoring in MS.

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Dorsal Spinal Cord Stimulation in the Treatment of Multiple Sclerosis

Neurosurgery ◽

10.1227/00006123-197908000-00005 ◽

1979 ◽

Vol 5 (2) ◽

pp. 225-230 ◽

Cited By ~ 30

Author(s):

Ronald F. Young ◽

Stanley J. Stanley

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Spinal Cord Stimulation ◽

Symptomatic Treatment ◽

Symptomatic Improvement ◽

Sensory Function ◽

Dorsal Spinal Cord ◽

Sphincter Function ◽

Walking Velocity ◽

Dorsal Spinal

Abstract Previously published work indicated significant improvement in the symptoms of multiple sclerosis with dorsal spinal cord stimulation. In this study 23 patients with multiple sclerosis documented by history, examination, laboratory studies, and clinical course were treated with dorsal spinal cord stimulation and followed for 19 to 45 months (mean, 32 months). Preand postoperative clinical assessment was carried out using the Kurtzke Scale. Walking velocity, upper limb coordination, sphincter function, and sensory function were also evaluated quantitatively. No statistically significant objective improvement in any of these measures was demonstrated. Fifty per cent of the patients initially reported subjective symptomatic improvement, but this declined to 30% at last follow-up. Fifteen of 23 patients experienced complications related mainly to the hardware used and required a total of 21 subsequent operative procedures for correction of these complications. These results do not support the continued clinical use of dorsal spinal cord stimulation in the symptomatic treatment of multiple sclerosis.

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Relationship between desire to void and bladder capacity and rectal sensory function in patients with multiple sclerosis and anorectal disorders

Neurourology and Urodynamics ◽

10.1002/nau.24330 ◽

2020 ◽

Vol 39 (4) ◽

pp. 1129-1136

Author(s):

Camille Pouyau ◽

Matthieu Grasland ◽

Camille Leroux ◽

Camille Chesnel ◽

Nicolas Turmel ◽

...

Keyword(s):

Multiple Sclerosis ◽

Bladder Capacity ◽

Sensory Function ◽

Anorectal Disorders

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One Hundred Eleven Percutaneous Balloon Compressions for Trigeminal Neuralgia in a Cohort of 66 Patients with Multiple Sclerosis

Operative Neurosurgery ◽

10.1093/ons/opy402 ◽

2019 ◽

Vol 17 (5) ◽

pp. 452-459 ◽

Cited By ~ 1

Author(s):

Pär Asplund ◽

Bengt Linderoth ◽

Göran Lind ◽

Jaleh Winter ◽

A Tommy Bergenheim

Keyword(s):

Multiple Sclerosis ◽

Trigeminal Neuralgia ◽

Therapeutic Effect ◽

Sensory Function ◽

Resistant Disease ◽

Percutaneous Balloon ◽

Percutaneous Balloon Compression ◽

Number Of Patients ◽

Postoperative Time

Abstract BACKGROUND Trigeminal neuralgia associated with multiple sclerosis (MS–TN) is comparatively rare and larger series of percutaneous balloon compression (PBC) in such cases are few in the literature. OBJECTIVE To evaluate the results after PBC for MS–TN with regards to therapeutic effect, side effects, and complications. METHODS One hundred eleven procedures with PBC performed in 66 cases of MS–TN were analyzed. Therapeutic effect was measured as postoperative time to pain recurrence without medication. All complications were compiled and the sensory function was evaluated in a subgroup of cases. RESULTS The initial pain free rate was 67% and the median time to pain recurrence was 8 mo. Thirty-six patients were treated with PBC only, and among them, the results were worse if treated 3 to 4 times before, compared to first treatment (P = .009-.034). Patients who had several PBCs had worse results already after the first surgery (P < .001). A significant number of patients had impaired sensation to light touch directly after surgery, which was normalized at the late follow-up. Sensimetric testing showed raised thresholds for perception and pain directly after surgery (P = .004-.03), but these were also normalized at the late follow-up. CONCLUSION PBC is a treatment that can be effective for many patients with MS–TN. Repeated previous surgeries is a risk factor for an unsatisfactory outcome. However, the patients with multiple surgeries had less satisfactory results already at the first procedure, indicating that a therapy resistant disease can be predicted after the first two PBCs. Postoperative sensory deficits were common but not lasting.

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Serum and Saliva Myelin Basic Protein as Multiple Sclerosis Biomarker

Basic and Clinical Neuroscience Journal ◽

10.32598/bcn.2021.950.2 ◽

2021 ◽

Author(s):

Mohammad-Hosein Mirzaii-Dizgah ◽

◽

Mohammad-Reza Mirzaii-Dizgah ◽

Iraj Mirzaii-Dizgah ◽

◽

...

Keyword(s):

Multiple Sclerosis ◽

Myelin Basic Protein ◽

Basic Protein ◽

Sensory Function ◽

Characteristic Analysis ◽

Potential Biomarker ◽

Whole Saliva ◽

Unstimulated Saliva ◽

Unstimulated Whole Saliva ◽

Saliva Level

Objective: Multiple sclerosis (MS) is considered as motor and sensory function loss, which results from demyelination and following axonal lesion. As Myelin basic protein (MBP) is one of the key elements of the myelin cover, we examined the level of MBP in serum, stimulated and unstimulated saliva as a suitable biomarker for detecting of MS. Methods: A case–control study was performed in 29 healthy women and 32 definitive relapsing-remitting MS patients who were hospitalized in Imam Reza hospital, Tehran, Iran. MBP level was assayed in serum and stimulated and unstimulated whole saliva. Results: MBP was expressed at a lower level in serum and stimulated saliva of MS patients compared to control groups. The serum MBP level had a considerable correlation with its stimulated saliva level. The receiver operating characteristic analysis showed significantly diagnostic abilities for MBP to discrimination MS patients with serum and stimulated saliva from controls. Conclusions: Serum and saliva level of MBP is lower in MS and it may be considered as a potential biomarker in Multiple sclerosis.

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Unilateral and bilateral upper limb dysfunction at body functions, activity and participation levels in people with multiple sclerosis

Multiple Sclerosis Journal ◽

10.1177/1352458514567553 ◽

2015 ◽

Vol 21 (12) ◽

pp. 1566-1574 ◽

Cited By ~ 44

Author(s):

Rita Bertoni ◽

Ilse Lamers ◽

Christine C Chen ◽

Peter Feys ◽

Davide Cattaneo

Keyword(s):

Multiple Sclerosis ◽

Upper Limb ◽

Community Integration ◽

Cross Sectional Study ◽

Activity Level ◽

Sensory Function ◽

International Classification Of Functioning ◽

Cross Sectional ◽

Rehabilitation Centers ◽

Upper Limb Dysfunction

Background: There has been limited research on upper limb dysfunction in people with multiple sclerosis (PwMS). Objective: The objective of this paper is to study unilateral and bilateral upper limb dysfunction at different International Classification of Functioning (ICF) levels according to overall disability in PwMS. Methods: A total of 105 PwMS (16 with EDSS<4 (mild); 17 with EDSS 4–5.5 (moderate); 37 with EDSS 6–6.5 (severe); 35 with EDSS>6.5 (severe non-ambulant)) were recruited from two rehabilitation centers and assessed in a cross-sectional study. Results: The whole sample showed a diminished sensory function (median (first/third interquartile)) score of 3 (2/3) on the Monofilament Test and a reduced strength 91 (76/100) points on the Motricity Index (Body-Function level). Sensory dysfunction did not increase with higher EDSS while strength decreased from 100 (86/100) in the mild subgroups to 91 (80/100) points in the severe subgroup. All showed diminished dexterity, scoring 0.28 peg/s (0.17/0.35) on the Nine-Hole Peg Test (NHPT) (activity level). Score was better for the mild (0.38 (0.35/0.46)) peg/s compared to the severe subgroup (0.28 (0.17/0.35)). Sixty-eight percent, 44% and 75% of PwMS showed bilateral disorders in sensation, strength and dexterity, respectively. The Community Integration Questionnaire (participation level) showed a 35% reduction in home activities, even among PwMS with EDSS<4. Conclusion: This study showed uni-/bilateral upper limb abnormalities at all ICF levels increasing with the overall disability.

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