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进展性多发性硬化症中的感觉运动功能

Sensorimotor function in progressive multiple sclerosis.

作者信息

Miehm Jules D, Buonaccorsi John, Lim Jongil, Sato Sumire, Rajala Caitlin, Averill Julianna, Khalighinejad Farnaz, Ionete Carolina, Jones Stephanie L, Kent Jane A, van Emmerik Richard Ea

机构信息

Department of Kinesiology, University of Massachusetts Amherst, USA.

Department of Mathematics and Statistics, University of Massachusetts Amherst, USA.

出版信息

Mult Scler J Exp Transl Clin. 2020 Aug 31;6(3):2055217320934835. doi: 10.1177/2055217320934835. eCollection 2020 Jul-Sep.

Abstract

BACKGROUND

A sensitive test reflecting subtle sensorimotor changes throughout disease progression independent of mobility impairment is currently lacking in progressive multiple sclerosis.

OBJECTIVES

We examined non-ambulatory measures of upper and lower extremity sensorimotor function that may reveal differences between relapsing-remitting and progressive forms of multiple sclerosis.

METHODS

Cutaneous sensitivity, proprioception, central motor function and mobility were assessed in 32 relapsing-remitting and 31 progressive multiple sclerosis patients and 30 non-multiple sclerosis controls.

RESULTS

Cutaneous sensation differed between relapsing-remitting and progressive multiple sclerosis at the foot and to a lesser extent the hand. Proprioception function in the upper but not the lower extremity differed between relapsing-remitting and progressive multiple sclerosis, but was different for both upper and lower extremities between multiple sclerosis patients and non-multiple sclerosis controls. Foot-tap but not hand-tap speed was slower in progressive compared to relapsing-remitting multiple sclerosis, suggestive of greater central motor function impairment in the lower extremity in progressive multiple sclerosis. In addition, the non-ambulatory sensorimotor measures were more sensitive in detecting differences between relapsing-remitting and progressive multiple sclerosis than mobility assessed with the 25-foot walk test.

CONCLUSION

This study provides novel information about changes in sensorimotor function in progressive compared with relapsing-remitting forms of multiple sclerosis, and in particular the importance of assessing both upper and lower extremity function. Importantly, our findings showed loss of proprioceptive function in multiple sclerosis but also in progressive compared to relapsing-remitting multiple sclerosis.

摘要

背景

在进展型多发性硬化症中,目前缺乏一种能反映疾病进展过程中细微感觉运动变化且不受行动能力损害影响的敏感检测方法。

目的

我们研究了上肢和下肢感觉运动功能的非行走测量指标,这些指标可能揭示复发缓解型和进展型多发性硬化症之间的差异。

方法

对32例复发缓解型多发性硬化症患者、31例进展型多发性硬化症患者和30例非多发性硬化症对照者进行了皮肤敏感性、本体感觉、中枢运动功能和行动能力评估。

结果

复发缓解型和进展型多发性硬化症在足部的皮肤感觉存在差异,手部差异较小。复发缓解型和进展型多发性硬化症在上肢而非下肢的本体感觉功能存在差异,但多发性硬化症患者与非多发性硬化症对照者的上下肢本体感觉功能均不同。与复发缓解型多发性硬化症相比,进展型多发性硬化症的足部轻拍速度较慢,而手部轻拍速度无差异,这表明进展型多发性硬化症下肢的中枢运动功能损害更严重。此外,与通过25英尺步行测试评估的行动能力相比,非行走感觉运动测量指标在检测复发缓解型和进展型多发性硬化症之间的差异时更敏感。

结论

本研究提供了关于进展型与复发缓解型多发性硬化症感觉运动功能变化的新信息,特别是评估上下肢功能的重要性。重要的是,我们的研究结果表明,与复发缓解型多发性硬化症相比,多发性硬化症以及进展型多发性硬化症均存在本体感觉功能丧失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a25f/7466899/100f7a486b04/10.1177_2055217320934835-fig1.jpg

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