De Blasiis Paolo, Massimiani Andrea, Inglese Cristina, Bianchini Edoardo, Fullin Allegra, De Girolamo Ciro Ivan, Giovannelli Morena, Pau Massimiliano, Cocco Eleonora, Salvetti Marco, Lus Giacomo
Department of Health Sciences, University of Basilicata, 85100, Potenza, Italy.
Department of Advanced Medical and Surgery Science, Multiple Sclerosis Center, II Division of Neurology, University of Campania "L. Vanvitelli", 80131, Naples, Italy.
J Neurol. 2024 Dec 12;272(1):34. doi: 10.1007/s00415-024-12750-1.
Spasticity and muscle weakness are the most disabling symptoms in people with Multiple Sclerosis (pwMS), frequently affecting lower limbs and causing motor impairments, fatigue and increased risk of falls. Previous epidemiological studies on pwMS reported prevalence of spasticity and other symptoms but scarce information is available about combined patterns of muscle weakness and spasticity, symmetry and regional localization.
To describe the prevalent combined patterns of muscle weakness and spasticity in pwMS in order to focus attention on their functional balance before spasticity treatment.
pwMS with lower limb spasticity, 3.5 ≤ Expanded-Disability-Status Scale (EDSS) ≤ 6.5 were recruited. Data regarding muscle weakness and spasticity, symmetry and involvement of other functional systems were collected. Prevalence analysis was performed.
Three-hundred pwMS were included. Muscle weakness and spasticity occurred mostly asymmetrically with a prevalence of paraparesis. Incidence of both symptoms increase with higher EDSS, particularly of muscle weakness. Twelve prevalent combined patterns were identified, with highest incidence of combinations characterized by "distal-intermediate spasticity and diffuse weakness" (29.3%), "diffuse spasticity and weakness" (13.7%), "distal spasticity and diffuse weakness" (11.7%).
This study highlighted the most prevalent combined patterns of weakness and spasticity, useful in clinical practice for pwMS' assessment by supporting optimal planning of specific pharmacologic and rehabilitative treatments.
痉挛和肌肉无力是多发性硬化症患者（pwMS）中最致残的症状，经常影响下肢并导致运动障碍、疲劳和跌倒风险增加。先前关于pwMS的流行病学研究报告了痉挛和其他症状的患病率，但关于肌肉无力和痉挛的联合模式、对称性和区域定位的信息却很少。
描述pwMS中肌肉无力和痉挛的普遍联合模式，以便在痉挛治疗前关注其功能平衡。
招募下肢痉挛且扩展残疾状态量表（EDSS）为3.5≤EDSS≤6.5的pwMS。收集有关肌肉无力和痉挛、对称性以及其他功能系统受累的数据。进行患病率分析。
纳入300例pwMS。肌肉无力和痉挛大多不对称出现，截瘫患病率较高。两种症状的发生率均随EDSS升高而增加，尤其是肌肉无力。确定了12种普遍的联合模式，其中“远端-中间痉挛和弥漫性无力”（29.3%）、“弥漫性痉挛和无力”（13.7%）、“远端痉挛和弥漫性无力”（11.7%）组合的发生率最高。
本研究突出了最普遍的无力和痉挛联合模式，通过支持特定药物和康复治疗的优化规划，对临床实践中pwMS的评估很有用。
