Cerebellar volume measures may differentiate multiple sclerosis fallers from non-fallers.

Introduction: The cerebellum is a common lesion site in persons with multiple sclerosis (PwMS). Physiologic and anatomic studies have identified a topographic organization of the cerebellum including functionally distinct motor and cognitive areas. This study implemented a recent parcellation algorithm developed by Han et al.

Lessons learned from clinical trials of exercise and physical activity in people with MS - guidance for improving the quality of future research.

The body of research on exercise and physical activity among persons with multiple sclerosis(MS) has expanded rapidly in quantity, but not necessarily quality, over the past 20+ years. There is evidence for beneficial effects of exercise and physical activity on immune cells and neurotrophic factors, brain structure and function, walking and cognitive performance, fatigue, depression, and pain, and quality of life among persons with MS. Nevertheless, there is heterogeneity in the outcomes of exercise and physical activity, and a recognition of substantial challenges for improving the effectiveness of those behaviors in MS.

Cerebellar Contributions to Motor and Cognitive Control in Multiple Sclerosis.

Objective: To evaluate relationships between specific cerebellar regions and common clinical measures of motor and cognitive function in persons with multiple sclerosis (PwMS).

Design: Cross-sectional.

Setting: Laboratory.

Sensorimotor outcomes in adrenomyeloneuropathy show significant disease progression.

Current outcomes used to evaluate adrenomyeloneuropathy are limited by rater bias, not sensitive to preclinical changes, and require years to decades to detect disease progression. Quantitative outcomes are needed that detect meaningful change in a short time period over a broad range of disability. The study aim was to track sensorimotor outcomes in adults with adrenomyeloneuropathy and evaluate differences in progression between men and women.

Prioritizing progressive MS rehabilitation research: A call from the International Progressive MS Alliance.

Background: People with multiple sclerosis (MS) experience myriad symptoms that negatively affect their quality of life. Despite significant progress in rehabilitation strategies for people living with relapsing-remitting MS (RRMS), the development of similar strategies for people with progressive MS has received little attention.

Objective: To highlight key symptoms of importance to people with progressive MS and stimulate the design and implementation of high-quality studies focused on symptom management and rehabilitation.

Combining Magnetization Transfer Ratio MRI and Quantitative Measures of Walking Improves the Identification of Fallers in MS.

Multiple sclerosis (MS) impacts balance and walking function, resulting in accidental falls. History of falls and clinical assessment are commonly used for fall prediction, yet these measures have limited predictive validity. Falls are multifactorial; consideration of disease-specific pathology may be critical for improving fall prediction in MS.

Longitudinal assessment of hand function in individuals with multiple sclerosis.

Objective: Little is known about the frequency and severity of hand dysfunction in individuals with multiple sclerosis (MS). Hence, we sought to determine the extent that quantitative tests of hand function detect changes over time, evaluate their relationship to global disability measures, and identify predictors of hand function.

Methods: One-hundred and forty-seven individuals with MS were included (96 women, 84 relapsing-remitting MS [RRMS]) along with 35 age-and-sex matched controls.

Quantitative vibratory sensation measurement is related to sensory cortical thickness in MS.

Objective: Vibratory sensation is a quantifiable measure of physical dysfunction and is often related to spinal cord pathology; however, its association with relevant brain areas has not been fully explored. Our objective was to establish a cortical structural substrate for vibration sensation.

Methods: Eighty-four individuals with multiple sclerosis (MS) ( = 54 relapsing,  = 30 progressive) and 28 controls participated in vibratory sensation threshold quantification at the great toe and a 3T MRI evaluating volume of the thalamus and cortical thickness primary and secondary sensory cortices.

Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers.

Background: Fall rates among adults with multiple sclerosis are consistently greater than 50%, but near-falls (i.e. a trip or stumble) are often undocumented.

Quantitative measures of walking and strength provide insight into brain corticospinal tract pathology in multiple sclerosis.

At least 85% of individuals with multiple sclerosis report walking dysfunction as their primary complaint. Walking and strength measures are common clinical measures to mark increasing disability or improvement with rehabilitation. Previous studies have shown an association between strength or walking ability and spinal cord MRI measures, and strength measures with brainstem corticospinal tract magnetization transfer ratio.

Pain, cognition and quality of life associate with structural measures of brain volume loss in multiple sclerosis.

Background: Multiple sclerosis (MS) is characterized by physical and mental impairments that often result in pain and reduced quality of life.

Objective: To understand the relationship of pain, quality of life, and cognition to structural measures of brain volume.

Methods: Behavioral measures were assessed in a single session using standardized questionnaires and rating scales.

Gait and Balance Assessment.

Gait and balance deficits are commonly experienced by individuals with a variety of neurologic disorders. These deficits can be particularly frustrating because they often profoundly impact a person's quality of life. The author applies information about gait and balance based on the neurologic examination and summarizes important relationships among common impairment measures of gait and balance deficits.

Utility of the Six-Spot Step Test as a Measure of Walking Performance in Ambulatory Individuals With Multiple Sclerosis.

Objective: To examine the concurrent validity of the Six-Spot Step Test (SSST) with clinical measures of walking and spatiotemporal measures of gait in multiple sclerosis (MS), and to understand the utility of the SSST in individuals with both low and high levels of disability.

Design: Cross-sectional study.

Setting: Laboratory.

Longitudinal relationships among posturography and gait measures in multiple sclerosis.

Objective: Gait and balance dysfunction frequently occurs early in the multiple sclerosis (MS) disease course. Hence, we sought to determine the longitudinal relationships among quantitative measures of gait and balance in individuals with MS.

Methods: Fifty-seven ambulatory individuals with MS (28 relapsing-remitting, 29 progressive) were evaluated using posturography, quantitative sensorimotor and gait measures, and overall MS disability with the Expanded Disability Status Scale at each session.

Quantitative sensory and motor measures detect change overtime and correlate with walking speed in individuals with multiple sclerosis.

Background: Impairments of sensation, strength, and walking are common in multiple sclerosis (MS). The relationship among these abnormalities and how they change over time remains unclear.

Objective: To determine the extent that quantitative lower extremity sensory and motor measures detect abnormalities over time, relate to global disability, and to walking speed in individuals with MS.

The impact of dynamic balance measures on walking performance in multiple sclerosis.

Background: Static posture imbalance and gait dysfunction are common in individuals with multiple sclerosis (MS). Although the impact of strength and static balance on walking has been examined, the impact of dynamic standing balance on walking in MS remains unclear.

Objective: To determine the impact of dynamic balance, static balance, sensation, and strength measures on walking in individuals with MS.

2nd International Symposium on Gait and Balance in Multiple Sclerosis: interventions for gait and balance in MS.

Purpose: To provide a review of the 2nd International Symposium on Gait and Balance in Multiple Sclerosis (MS), emphasizing interventions in gait and balance for people with MS.

Method: Review of current research on interventions used with people having MS and with people having other disorders that may provide novel insights into improving gait and balance and preventing falls in people with MS (pwMS).

Results: Nine speakers provided evidence-based recommendations for interventions aimed at improving gait and balance dysfunction.

Development and validation of a falls-grading scale.

Background And Purpose: The recording of fall events is usually subjective and imprecise, which limits clinical practice and falls-related research. We sought to develop and validate a scale to grade near-fall and fall events on the basis of their severity represented by the use of health care resources, with the goal of standardizing fall reporting in the clinical and research settings.

Methods: Qualitative instrument development was based on a literature review and semistructured interviews to assess face and content validity.

Revisiting brain atrophy and its relationship to disability in multiple sclerosis.

Background: Brain atrophy is a well-accepted imaging biomarker of multiple sclerosis (MS) that partially correlates with both physical disability and cognitive impairment.

Methodology/principal Findings: Based on MRI scans of 60 MS cases and 37 healthy volunteers, we measured the volumes of white matter (WM) lesions, cortical gray matter (GM), cerebral WM, caudate nucleus, putamen, thalamus, ventricles, and brainstem using a validated and completely automated segmentation method. We correlated these volumes with the Expanded Disability Status Scale (EDSS), MS Severity Scale (MSSS), MS Functional Composite (MSFC), and quantitative measures of ankle strength and toe sensation.

Strength: a relevant link to functional performance in the neurodegenerative disease of adrenomyeloneuropathy.

Background: With progressive abnormalities in leg strength, tone, and sensation, adrenomyeloneuropathy (AMN) is a differential diagnosis for multiple sclerosis and hereditary spastic paraparesis. AMN pathology has been linked to weakness, making it a relevant model to evaluate the relationship between neurodegeneration and disability. Quantifying symptom severity in AMN is essential for treatment development in rehabilitative management.

Adrenoleukodystrophy in female heterozygotes: underrecognized and undertreated.

X-linked adrenoleukodystrophy (X-ALD) is a neurodegenerative disease resulting from mutations in the gene ABCD1 and alterations in peroxisomal beta-oxidation of long chain fatty acids. As it has been frequently discussed, it manifests a wide range of phenotypes in male, with progressive myelopathy being the most common. Even though the gene is localized to the X-chromosome and a region subject to X-inactivation, female carriers still are affected significantly by this condition.