定量测量可检测多发性硬化症中的感觉和运动障碍。
Quantitative measures detect sensory and motor impairments in multiple sclerosis.
机构信息
Department of Neurology, Johns Hopkins University, Baltimore, MD, USA.
出版信息
J Neurol Sci. 2011 Jun 15;305(1-2):103-11. doi: 10.1016/j.jns.2011.03.003. Epub 2011 Apr 1.
BACKGROUND
Sensory and motor dysfunction in multiple sclerosis (MS) is often assessed with rating scales which rely heavily on clinical judgment. Quantitative devices may be more precise than rating scales.
OBJECTIVE
To quantify lower extremity sensorimotor measures in individuals with MS, evaluate the extent to which they can detect functional systems impairments, and determine their relationship to global disability measures.
METHODS
We tested 145 MS subjects and 58 controls. Vibration thresholds were quantified using a Vibratron-II device. Strength was quantified by a hand-held dynamometer. We also recorded Expanded Disability Status Scale (EDSS) and Timed 25-Foot Walk (T25FW). t-tests and Wilcoxon-rank sum were used to compare group data. Spearman correlations were used to assess relationships between each measure. We also used a step-wise linear regression model to determine how much the quantitative measures explain the variance in the respective functional systems scores (FSS).
RESULTS
EDSS scores ranged from 0-7.5, mean disease duration was 10.4 ± 9.6 years, and 66% were female. In relapsing-remitting MS, but not progressive MS, poorer vibration sensation correlated with a worse EDSS score, whereas progressive groups' ankle/hip strength changed significantly with EDSS progression. Interestingly, not only did sensorimotor measures significantly correlate with global disability measures (i.e., EDSS), but they had improved sensitivity, as they detected impairments in up to 32% of MS subjects with normal sensory and pyramidal FSS.
CONCLUSIONS
Sensory and motor deficits in MS can be quantified using clinically accessible tools and distinguish differences among MS subtypes. We show that quantitative sensorimotor measures are more sensitive than FSS from the EDSS. These tools have the potential to be used as clinical outcome measures in practice and for future MS clinical trials of neurorehabilitative and neuroreparative interventions.
背景
多发性硬化症（MS）的感觉和运动功能障碍通常通过严重依赖临床判断的评分量表进行评估。定量设备可能比评分量表更精确。
目的
量化多发性硬化症患者的下肢感觉运动测量值，评估其检测功能系统损伤的程度，并确定它们与总体残疾测量值的关系。
方法
我们测试了 145 名 MS 患者和 58 名对照者。使用 Vibratron-II 设备量化振动阈值。使用手持式测力计量化强度。我们还记录了扩展残疾状况量表（EDSS）和定时 25 英尺步行（T25FW）。使用 t 检验和 Wilcoxon 秩和检验比较组间数据。使用 Spearman 相关分析评估各测量值之间的关系。我们还使用逐步线性回归模型来确定定量测量值在相应功能系统评分（FSS）中的方差解释程度。
结果
EDSS 评分范围为 0-7.5，平均病程为 10.4±9.6 年，66%为女性。在复发缓解型 MS 中，但在进行性 MS 中，较差的振动感觉与 EDSS 评分较差相关，而进展性组的踝关节/髋关节力量随着 EDSS 的进展显著变化。有趣的是，感觉运动测量值不仅与总体残疾测量值（即 EDSS）显著相关，而且具有更高的敏感性，因为它们可以检测到高达 32%的感觉和皮质脊髓束 FSS 正常的 MS 患者的损伤。
结论
可以使用临床可及的工具来量化 MS 中的感觉和运动缺陷，并区分 MS 亚型之间的差异。我们表明，定量感觉运动测量值比 EDSS 中的 FSS 更敏感。这些工具具有在实践中用作临床结局测量的潜力，并可用于未来多发性硬化症神经康复和神经修复干预的临床试验。
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