Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel Institute of Motor Functions, Sheba Medical Center, Tel Hashomer, Israel.
NeuroRehabilitation. 2012;31(2):147-55. doi: 10.3233/NRE-2012-0784.
To evaluate the frequency of motor impairments in patients with recently diagnosed clinically isolated syndrome (CIS) suggestive of MS.
Following a neurological examination, patients with CIS were subdivided into two groups according to the number of functional systems involved at onset. Groups consisted of monosymptomatic (n=35, mean EDSS=1.3 ± 0.2) and polysymptomatic (n=17, mean EDSS=2.6 ± 0.1) patients. Motor assessment included peak isometric torque and fatigue index (FI) measured at the knee and ankle bilaterally and spatiotemporal parameters of gait and postural control. Lesion load and atrophy were measured on a 3.0T brain MRI using MSAnalyze computerized software. Twenty eight age- and gender-matched healthy subjects served as controls for motor assessment.
Polysymptomatic patients demonstrated reduced peak strength and FI, slower gait velocity, narrower base of support and increased sway rate compared to healthy subjects and mono-symptomatic patients. Furthermore, polysymptomatic and monosymptomatic patient median score in T2-weighted volume lesions (mm
Evidence of two subtypes of CIS was established in context with MRI findings and motor deficits. Differentiating between these groups can potentially improve management of MS patients at the initial stages of the disease process.
评估新诊断的临床孤立综合征（CIS）患者中符合 MS 表现的运动障碍的频率。
在进行神经系统检查后，根据发病时受累的功能系统数量，将 CIS 患者分为两组。两组分别为单症状组（n=35，平均 EDSS=1.3±0.2）和多症状组（n=17，平均 EDSS=2.6±0.1）。运动评估包括双侧膝关节和踝关节的等长峰值扭矩和疲劳指数（FI）以及步态和姿势控制的时空参数。使用 MSAnalyze 计算机软件在 3.0T 脑 MRI 上测量病变负荷和萎缩。28 名年龄和性别匹配的健康受试者作为运动评估的对照组。
多症状组患者与健康对照组和单症状组患者相比，表现出峰值力量和 FI 降低、步态速度较慢、支撑基础较窄和摆动率增加。此外，多症状组和单症状组患者 T2 加权容积病变（mm
在 MRI 发现和运动缺陷的背景下，确立了两种 CIS 亚型的存在。区分这些组可能有助于改善疾病过程初始阶段 MS 患者的管理。
