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Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis

BACKGROUND: While magnetic resonance imaging contrast-enhancing lesions represent an excellent screening tool for disease-modifying treatments in relapsing–remitting multiple sclerosis (RRMS), this biomarker is insensitive for testing therapies against compartmentalized inflammation in progressive m...

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Autores principales: Tanigawa, Makoto, Stein, Jason, Park, John, Kosa, Peter, Cortese, Irene, Bielekova, Bibiana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480634/
https://www.ncbi.nlm.nih.gov/pubmed/28680701
http://dx.doi.org/10.1177/2055217316688930
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author Tanigawa, Makoto
Stein, Jason
Park, John
Kosa, Peter
Cortese, Irene
Bielekova, Bibiana
author_facet Tanigawa, Makoto
Stein, Jason
Park, John
Kosa, Peter
Cortese, Irene
Bielekova, Bibiana
author_sort Tanigawa, Makoto
collection PubMed
description BACKGROUND: While magnetic resonance imaging contrast-enhancing lesions represent an excellent screening tool for disease-modifying treatments in relapsing–remitting multiple sclerosis (RRMS), this biomarker is insensitive for testing therapies against compartmentalized inflammation in progressive multiple sclerosis (MS). Therefore, alternative sensitive outcomes are needed. Using machine learning, clinician-acquired disability scales can be combined with timed measures of neurological functions such as walking speed (e.g. 25-foot walk; 25FW) or fine finger movements (e.g. 9-hole peg test; 9HPT) into sensitive composite clinical scales, such as the recently developed combinatorial, weight-adjusted disability scale (CombiWISE). Ideally, these complementary simplified measurements of certain neurological functions could be performed regularly at patients’ homes using smartphones. OBJECTIVES: We asked whether tests amenable to adaptation to smartphone technology, such as finger and foot tapping have comparable sensitivity and specificity to current non-clinician-acquired disability measures. RESULTS: We observed that finger and foot tapping can differentiate RRMS and progressive MS in a cross-sectional study and can also measure yearly and two-year disease progression in the latter, with better power (based on z-scores) in comparison to currently utilized 9HPT and 25FW. CONCLUSIONS: Replacing the 9HPT and 25FW with simplified tests broadly adaptable to smartphone technology may enhance the power of composite scales for progressive MS.
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spelling pubmed-54806342017-07-05 Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis Tanigawa, Makoto Stein, Jason Park, John Kosa, Peter Cortese, Irene Bielekova, Bibiana Mult Scler J Exp Transl Clin Original Article BACKGROUND: While magnetic resonance imaging contrast-enhancing lesions represent an excellent screening tool for disease-modifying treatments in relapsing–remitting multiple sclerosis (RRMS), this biomarker is insensitive for testing therapies against compartmentalized inflammation in progressive multiple sclerosis (MS). Therefore, alternative sensitive outcomes are needed. Using machine learning, clinician-acquired disability scales can be combined with timed measures of neurological functions such as walking speed (e.g. 25-foot walk; 25FW) or fine finger movements (e.g. 9-hole peg test; 9HPT) into sensitive composite clinical scales, such as the recently developed combinatorial, weight-adjusted disability scale (CombiWISE). Ideally, these complementary simplified measurements of certain neurological functions could be performed regularly at patients’ homes using smartphones. OBJECTIVES: We asked whether tests amenable to adaptation to smartphone technology, such as finger and foot tapping have comparable sensitivity and specificity to current non-clinician-acquired disability measures. RESULTS: We observed that finger and foot tapping can differentiate RRMS and progressive MS in a cross-sectional study and can also measure yearly and two-year disease progression in the latter, with better power (based on z-scores) in comparison to currently utilized 9HPT and 25FW. CONCLUSIONS: Replacing the 9HPT and 25FW with simplified tests broadly adaptable to smartphone technology may enhance the power of composite scales for progressive MS. SAGE Publications 2017-01-01 /pmc/articles/PMC5480634/ /pubmed/28680701 http://dx.doi.org/10.1177/2055217316688930 Text en © The Author(s) 2017 http://creativecommons.org/licenses/by-nc/3.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Article
Tanigawa, Makoto
Stein, Jason
Park, John
Kosa, Peter
Cortese, Irene
Bielekova, Bibiana
Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title_full Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title_fullStr Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title_full_unstemmed Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title_short Finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
title_sort finger and foot tapping as alternative outcomes of upper and lower extremity function in multiple sclerosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5480634/
https://www.ncbi.nlm.nih.gov/pubmed/28680701
http://dx.doi.org/10.1177/2055217316688930
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