A cross-sectional comparison of performance, neurophysiological and MRI outcomes of responders and non-responders to fampridine treatment in multiple sclerosis - An explorative study.

J Clin Neurosci

Department of Regional Health Research, University of Southern, Denmark; Department of Neurology, University Hospital of Southern Jutland, Sønderborg, Denmark; Neurological Research Unit, MS Clinics of Southern Jutland (Sønderborg, Esbjerg, Kolding), University Hospital of Southern Jutland, Denmark.

Published: December 2020

AI Article Synopsis

  • The study aimed to compare physical and cognitive performance, neurophysiological outcomes, and MRI results between participants with Multiple Sclerosis who responded or did not respond to Fampridine treatment.
  • Despite assessing 41 responders and 8 non-responders, no significant differences were found in any measured outcomes between the two groups.
  • However, certain associations were noted, such as the connection between central motor conduction time (CMCT) and various performance measures, as well as the relationship between the Symbol Digit Modalities Test (SDMT) and T2-weighted MRI lesions, highlighting potential markers for disability and walking impairment.

Article Abstract

Objective: To compare baseline physical and cognitive performance, neurophysiological, and magnetic resonance imaging (MRI) outcomes and examinetheir interrelationship inparticipants with Multiple Sclerosis (MS), already established aseither responder or non-responder to Fampridine treatment, andto examine associationswiththe expanded disability status scale (EDSS) and 12-item MS walking scale (MSWS-12).

Methods: Baseline data from an explorative longitudinal observational study were analyzed. Participants underwent the Timed 25-Foot Walk Test (T25FW), Six Spot Step Test (SSST), Nine-Hole Peg Test, Five Times Sit-to-Stand Test, Symbol Digit Modalities Test (SDMT), neurophysiological testing, including central motor conduction time (CMCT), peripheral motor conduction time (PMCT), motor evoked potential (MEP) amplitudesand electroneuronographyof the lower extremities, and brain MRI (brain volume, number and volume of T2-weighted lesions and lesion load normalized to brain volume).

Results: 41 responders and 8 non-responders were examined. There were no intergroup differences inphysical performance, cognitive, neurophysiological, andMRI outcomes (p > 0.05).CMCT was associated withT25FW, SSST, EDSS, and MSWS-12,(p < 0.05). SDMT was associated with the number and volume of T2-weighted lesions, and lesion load normalized to brain volume (p < 0.05).

Conclusion: No differences were identified between responders and non-responders to Fampridine treatment regarding physical and cognitive performance, neurophysiological or MRI outcomes. The results call for cautious interpretation and further large-scale studies are needed to expand ourunderstanding of underlying mechanisms discriminating Fampridine responders and non-responders.CMCT may be used as a marker of disability and walking impairment, while SDMT was associated with white matter lesions estimated by MRI. ClinicalTrials.gov identifier: NCT03401307.

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Source
http://dx.doi.org/10.1016/j.jocn.2020.10.034DOI Listing

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