Santinelli Felipe Balistieri, Sebastião Emerson, Simieli Lucas, Antunes Barbara Moura, Vieira Luiz Henrique Palucci, Kalron Alon, Barbieri Fabio Augusto
REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium; São Paulo State University (Unesp), School of Sciences, Graduate Program in Movement Sciences, Department of Physical Education, Human Movement Research Laboratory (MOVI-LAB), Bauru, SP, Brazil.
Northern Illinois University, Department of Kinesiology and Physical Education, United States.
Mult Scler Relat Disord. 2022 Oct;66:104064. doi: 10.1016/j.msard.2022.104064. Epub 2022 Jul 22.
It has been suggested that the protein Brain-derived Neurotrophic Factor (BDNF) plays a neuroprotective role in people with multiple sclerosis (pwMS). Also, BDNF seems to play a role in cognition performance. In the same line, gait in pwMS requires a higher cognitive resource, mainly during complex walking. Thus, maybe BDNF could be related to gait in pwMS.
To investigate the relationship between BDNF and gait spatial-temporal parameters during unobstructed and obstructed conditions and the Timed Up and Go (TUG) in pwMS and healthy controls (HC).
The study included 20 pwMS (11F/9M, 33.1±7.5 years, Expanded Disability Status Scale- EDSS 2.2±1.2) and 18 HC (13F/5M, 35.5±5.9 years). Both groups performed 20 gait attempts in two conditions: unobstructed walking (10 trials) and avoiding an obstacle. The obstacle was 15 cm in height and made of foam material. The BDNF serum concentration was collected with participants in fasting and completed before the clinical, gait, and mobility assessments. Clinical variables included the Symbol Digit Modality Test (SDMT), the Fatigue Severity Scale (FSS), and the International Physical Activity Questionnaire (IPAQ- short version). Associations between BDNF and spatial-temporal gait parameters, clinical variables, and TUG were determined by Pearson/Spearman correlations with Bonferroni's correction being applied (p<0.0013). Gait was compared by a two-way, repeated-measures ANOVA (group and condition) to characterize our cohort.
Reduced BDNF was observed for pwMS (41.66±4.45 ng/ml) in comparison with HC (61.67±7.07, p<0.001). However, although some correlations presented a moderate correlation between BDNF with gait variables, the correlations didn't reach a significant p-value after Bonferroni's correction. Lastly, pwMS presented shorter step length and slower step velocity for both gait conditions, with more evidence for obstacle conditions. Only pwMS changed gait behavior from unobstructed walking to obstacle avoidance conditions (i.e., reduced step length and velocity and increased step duration).
BDNF is not related to either clinical (i.e., EDSS, SDMT, FSS, or IPAQ) or gait parameters in pwMS and HC, even in a condition involving higher cognitive demand. These results may suggest that BDNF does not play a role in these parameters' performance.
有人提出，脑源性神经营养因子（BDNF）蛋白在多发性硬化症患者（pwMS）中发挥神经保护作用。此外，BDNF似乎在认知表现中也发挥作用。同样，pwMS的步态需要更高的认知资源，主要是在复杂行走过程中。因此，也许BDNF可能与pwMS的步态有关。
研究BDNF与pwMS和健康对照者（HC）在无障碍和有障碍条件下的步态时空参数以及定时起立行走测试（TUG）之间的关系。
该研究纳入了20名pwMS患者（11名女性/9名男性，33.1±7.5岁，扩展残疾状态量表 - EDSS 2.2±1.2）和18名HC（13名女性/5名男性，35.5±5.9岁）。两组在两种条件下进行20次步态尝试：无障碍行走（10次试验）和避开障碍物。障碍物高15厘米，由泡沫材料制成。在参与者空腹时采集BDNF血清浓度，并在临床、步态和运动能力评估之前完成。临床变量包括符号数字模态测试（SDMT）、疲劳严重程度量表（FSS）和国际体力活动问卷（IPAQ - 简版）。通过Pearson/Spearman相关性分析确定BDNF与步态时空参数、临床变量和TUG之间的关联，并应用Bonferroni校正（p<0.0013）。通过双向重复测量方差分析（组和条件）比较步态，以描述我们的队列特征。
与HC（61.67±7.07，p<0.001）相比，观察到pwMS患者的BDNF降低（41.66±4.45 ng/ml）。然而，尽管一些相关性显示BDNF与步态变量之间存在中等相关性，但在Bonferroni校正后，这些相关性未达到显著的p值。最后，pwMS患者在两种步态条件下的步长较短，步速较慢，在有障碍条件下证据更明显。只有pwMS患者的步态行为从无障碍行走变为避开障碍物条件（即步长和速度降低，步幅持续时间增加）。
BDNF与pwMS和HC的临床（即EDSS、SDMT、FSS或IPAQ）或步态参数均无关，即使在涉及更高认知需求的条件下也是如此。这些结果可能表明BDNF在这些参数的表现中不起作用。
