Wednesday, 12 June 2013

Finger test to monitor change

MSers with EDSS=0 have subtle deficits of fine motor movements. #MSBlog #MSResearch

Bonzano et al. Quantitative assessment of finger motor impairment in multiple sclerosis. PLoS One. 2013 May 31;8(5):e65225. 

OBJECTIVE: To address the disability impact on fine hand motor functions in MSers by quantitatively measuring finger opposition movements, with the aim of providing a new "score" integrating current methods for disability assessment.

METHODS: 40 MSers (Expanded Disability Status Scale (EDSS): 0-7) and 80 healthy controls (HC) performed a repetitive finger-to-thumb opposition sequence with their dominant hand at spontaneous and maximal velocity, and uni- and bi-manually metronome-paced. A sensor-engineered glove was used to measure finger motor performance. Twenty-seven HC were tested twice, one month apart, to assess test-retest reliability.

RESULTS: The motor parameters showed a good reproducibility in HC and demonstrated significantly worse performance in MSers with respect to HC. A multivariate model revealed that rate of movement in the spontaneous velocity condition and inter-hand interval (IHI), indicating bimanual coordination, contributed independently to differentiate the two groups. A finger motor impairment score based on these two parameters was able to discriminate HC from MSers with very low EDSS scores (p<0.001): a significant difference was already evident for MSers with EDSS = 0. Further, in the MS group, some motor performance parameters correlated with the clinical scores. In particular, significant correlations were found between IHI and EDSS (r = 0.56; p<0.0001), MS Functional Composite (r = -0.40; p = 0.01), Paced Auditory Serial Addition (r = -0.38; p = 0.02). No motor performance parameter correlated with Timed 25-Foot Walk.

CONCLUSIONS: A simple, quantitative, objective method measuring finger motor performance could be used to define a score discriminating healthy controls and MSers, even with very low disability. This sensitivity might be of crucial importance for monitoring the disease course and the treatment effects in early MS patients, when changes in the EDSS are small or absent.


"Wow, even in MSers with very low disability (EDSS = 0), this test can pick-up abnormalities of fine motor control. It reminds me of the cognitive impairment rates in people presenting with CIS; even at the earliest stages of the disease there are subtle signs of damage. As always the brain is very good at compensating so that MSers won't realise they have a problem unless they need these fine motor skills for specialist functions, e.g. playing the piano."

"Will this study be validated? I have been working on a tapping test for Parkinson's disease since 1992 and it is still not validated enough to be included in routine clinical practice and trials."

1 comment:

  1. I'd love to see more tests available for MSers who have low EDSS scores and to all intents and purposes "appear" to be as healthy as those without the condition.

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