The MS Neuromotor Test: A Nonambulatory Measure of Sensorimotor Function to Identify and Track Progressive MS
Abstract
Progressive multiple sclerosis (MS), a chronic disorder that currently affects more than one million people worldwide, is characterized by steadily worsening function of the nervous system ultimately leading to profound disability. Despite the fact that almost half of individuals with MS presently exhibit a progressive course, effective methods to treat and provide a timely diagnosis have been elusive. Two critical needs currently impede our ability to understand and treat progressive MS effectively; specifically, clinical tests that can (1) accurately assess the onset of progression in an individual and (2) quantify progression of dysfunction in a sensitive and reliable way. These tests are vitally important tools needed to evaluate the effectiveness of potential treatments aimed at slowing disability progression and maintaining or improving quality of life. The goal of this proposal is to develop the MS Neuromotor Test to: (1) accurately track disease progression, (2) discriminate between individuals who have progressive and non-progressive MS, (3) test individuals who can and cannot walk independently, and (4) be administered by clinicians or researchers. The test will be applicable to those with MS that can walk independently as well as those who are wheelchair bound. Many individuals with MS have sensory loss and difficulty with sensing body position that impairs balance and motor function. Our research team and others have demonstrated that sensation of the feet and the speed with which you can tap your feet rapidly can discriminate between individuals with progressive and non-progressive MS. In the proposed study, we will determine which measures of sensation, body position sense, and motor function best discriminate between progressive and non-progressive forms of MS. To achieve this goal, we will perform the following experiments that have been divided into two parts. In Part I, we will determine which measures of sensation (skin sensation, body awareness) and motor function (rapid foot tapping) best differentiate between individuals with progressive and non-progressive MS and create the MS Neuromotor Test. In Part II, we will follow participants for 2 years using the sensorimotor measures from Part I to determine how sensation and motor function change in those with progressive MS by repeating these measurements every 6 months. Three study groups (with 30 participants each) will be recruited: one with individuals who have progressive MS, one with individuals who have non-progressive MS, and one with individuals who do not have MS. Participants will perform tests of foot sensation, leg position awareness, rapid foot tapping, and walking ability. Participants will complete questionnaires assessing their walking ability, their confidence in their balance, and their usual fatigue levels, and report their medications. Currently measures of walking ability and expensive imaging tests (MRI) are used to determine whether individuals with MS are worsening. Walking ability tests require that the individual can walk independently, and MRI tests often do not show changes that relate to changes in body functions. The MS Neuromotor Test is novel because it includes tests of the underlying body functions (sensation, motor function) that contribute to disability, and can be performed by individuals who can walk and those who cannot. We anticipate that this test will be more sensitive than either the walking ability tests or MRI because it measures changes in specific body functions that may occur before changes in walking ability are measurable. Ultimately, we aim to create a measure that can accurately detect small changes in sensation and motor function so that clinicians and researchers can develop effective treatments to slow disability progression in those with MS. We expect that within 1 year after completion of the proposed study, articles reporting on the effectiveness of the MS Neuromotor Test at
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Jan 31, 2017
- Source ID
- W81XWH1610351
Entities
People
- Richard van Emmerik
Organizations
- United States Army
- University of Massachusetts Amherst