Prospective clinical and electrophysiological follow-up on a multiple sclerosis population treated with interferon beta-1 a

Abstract

Objective To analyse transcranial magnetic stimulation (TMS) variables in a prospective six-month follow-up pilot study on patients suffering from relapsing-remitting multiple sclerosis (RRMS), satisfying inclusion criteria for interferon (IFN) beta-1a treatment.

Background So far, no predictive factors are available as to the course of RRMS treated with IFN beta-1 a.

Design/methods Fifteen RRMS patients were studied before (month 0 (M0)) and after IFN beta-1a onset (M3, M6). The parameters analysed were motor functional score (mFS), Expanded Disability Status Scale (EDSS), and TMS variables - central motor conduction time (CMCT) and amplitude ratio (AR).

Results Four of the six patients with no motor signs at inclusion, subsequently showed signs of pyramidal dysfunction. All had abnormal M0_TMS variables. The number of M0_TMS abnormalities per patient was greatest in the group that showed mFS worsening, and was significantly correlated with M6_EDSS. The M0_CMCT was significantly correlated with M6_EDSS. During follow-up, the number of patients with abnormal TMS variables decreased from 12/15 to 4/15, and the total number of abnormalities decreased from 33.3 to 16.7%.

Conclusions TMS variables might be predictive of disease progression. The improvement observed here in the TMS variables may reflect an improvement in MS patients undergoing IFN beta treatment. Multiple Sclerosis 2007; 13: 348-356. http://msj.sagepub.com

Keywords

evoked potentials humans interferon beta multiple sclerosis neurophysiology transcranial magnetic stimulation

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References

IFNB Multiple Sclerosis Study Group. Interfleron beta-1b is eflflective in relapsing-remitting multiple sclerosis. I. Clinical results ofl a multicenter, randomized, double-blind, placebo-controlled trial. IFNB Multiple Sclerosis Study Group . Neurology 1993; 43: 655-61 .

Jacobs LD , Cookfair DL , Rudick RA , Herndon RM , Richert JR , Salazar AM et al. Intramuscular interfleron beta-1a flor disease progression in relapsing multiple sclerosis. The Multiple Sclerosis Collaborative Research Group (MSCRG) . Ann Neurol 1996; 39: 285-94 .

Paty DW , Li DK Interfleron beta-1b is eflflective in relapsing-remitting multiple sclerosis. II. MRI analysis results ofl a multicenter, randomized, double-blind, placebo-controlled trial. UBC MS/MRI Study Group and the IFNB Multiple Sclerosis Study Group . Neurology 1993; 43: 662-67 .

Prisms. Randomised double-blind placebo-controlled study ofl interfleron beta-1a in relapsing/remitting multiple sclerosis. PRISMS (Prevention ofl Relapses and Disability by Interfleron beta-1a Subcutaneously in Multiple Sclerosis) Study Group . Lancet 1998; 352: 1498-504 .

Fuhr P. , Kappos L. Evoked potentials flor evaluation ofl multiple sclerosis . Clin Neurophysiol 2001; 112: 2185- 89 .

Kandler RH , Jarratt JA , Davies-Jones GA , Gumpert EJ , Venables GS , Sagar HJ et al. The role ofl magnetic stimulation as a quantifier ofl motor disability in patients with multiple sclerosis . J Neurol Sci 1991; 106: 31-34 .

Fuhr P. , Borggrefe-Chappuis A. , Schindler C. , Kappos L. Visual and motor evoked potentials in the course ofl multiple sclerosis . Brain 2001; 124: 2162-68 .

de Weerd AW. Variability ofl central conduction in the course ofl multiple sclerosis. Serial recordings ofl evoked potentials in the evaluation ofl therapy . Clin Neurol Neurosurg 1987; 89: 9- 15 .

Anlar O. , Kisli M. , Tombul T. , Ozbek H. Visual evoked potentials in multiple sclerosis beflore and aflter two years ofl interfleron therapy . Int J Neurosci 2003 ; 113: 483- 89 .

10.

Gerschlager W. , Beisteiner R. , Deecke L. , Dirnberger G. , Endl W. , Kollegger H. et al. Electrophysiological, neuropsychological and clinical findings in multiple sclerosis patients receiving interfleron beta-1b: a 1-year flollow-up . Eur Neurol 2000 ; 44: 205 -209 .

11.

Barker AT , Jalinous R. , Freeston IL Non-invasive magnetic stimulation ofl human motor cortex . Lancet 1985; 1: 1106-107 .

12.

Cruz-Martinez A. , Gonzalez-Orodea JI , Lopez Pajares R. , Arpa J. Disability in multiple sclerosis. The role ofl transcranial magnetic stimulation . Electromyogr Clin Neurophysiol 2000; 40: 441-47 .

13.

Hess CW , Mills KR , Murray NM Responses in small hand muscles flrom magnetic stimulation ofl the human brain . J Physiol 1987; 388: 397- 419 .

14.

Hess CW , Mills KR , Murray NM , Schriefer TN Magnetic brain stimulation: central motor conduction studies in multiple sclerosis . Ann Neurol 1987; 22: 74452 .

15.

Ingram DA , Thompson AJ , Swash M. Central motor conduction in multiple sclerosis: evaluation ofl abnormalities revealed by transcutaneous magnetic stimulation ofl the brain . J Neurol Neurosurg Psychiatry 1988; 51: 48794 .

16.

Jones SM , Streletz LJ , Raab VE , Knobler RL , Lublin FD Lower extremity motor evoked potentials in multiple sclerosis . Arch Neurol 1991; 48: 944 - 48 .

17.

Beer S. , Rosler KM , Hess CW Diagnostic value ofl paraclinical tests in multiple sclerosis: relative sensitivities and specificities flor reclassification according to the Poser committee criteria . J Neurol Neurosurg Psychiatry 1995; 59: 152-59 .

18.

Caramia MD , Palmieri MG , Desiato MT , Boffa L. , Galizia P. , Rossini PM et al. Brain excitability changes in the relapsing and remitting phases ofl multiple sclerosis: a study with transcranial magnetic stimulation . Clin Neurophysiol 2004; 115: 956- 65 .

19.

Facchetti D. , Mai R. , Micheli A. , Marciano N. , Capra R. , Gasparotti R. et al. Motor evoked potentials and disability in secondary progressive multiple sclerosis . Can J Neurol Sci 1997; 24: 332 -37 .

20.

Humm AM , Magistris MR , Truffert A. , Hess CW , Rosler KM Central motor conduction diflflers between acute relapsing-remitting and chronic progressive multiple sclerosis . Clin Neurophysiol 2003; 114: 2196-203 .

21.

Emerson RG Evoked potentials in clinical trials flor multiple sclerosis . J Clin Neurophysiol 1998; 15: 109- 16 .

22.

Auer C. , Siebner HR , Dressnandt J. , Conrad B. Intrathecal bacloflen increases corticospinal output to hand muscles in multiple sclerosis . Neurology 1999; 52: 1298- 99 .

23.

Kinnman J. , Andersson T. , Andersson G. Eflflect ofl cooling suit treatment in patients with multiple sclerosis evaluated by evoked potentials . Scand J Rehabil Med 2000; 32: 16-19 .

24.

Mainero C. , Inghilleri M. , Pantano P. , Conte A. , Lenzi D. , Frasca V. et al. Enhanced brain motor activity in patients with MS aflter a single dose ofl 3,4-diaminopyridine . Neurology 2004 ; 62: 2044- 50 .

25.

Fierro B. , Salemi G. , Brighina F. , Buffa D. , Conte S. , La Bua V. et al. A transcranial magnetic stimulation study evaluating methylprednisolone treatment in multiple sclerosis . Acta Neurol Scand 2002; 105: 152-57 .

26.

Humm AM , Z'Graggen WJ , Buhler R. , Magistris MR , Rosler KM Quantification ofl central motor conduction deficits in multiple sclerosis patients beflore and aflter treatment ofl acute exacerbation by methylprednisolone . J Neurol Neurosurg Psychiatry 2006; 77: 345 -50 .

27.

Sorensen PS , Wanscher B. , Szpirt W. , Jensen CV , Ravnborg M. , Christiansen P. et al. Plasma exchange combined with azathioprine in multiple sclerosis using serial gadolinium-enhanced MRI to monitor disease activity: a randomized single-masked cross-over pilot study . Neurology 1996; 46: 1620- 25 .

28.

Manova MG , Kostadinova II , Chalakova-Atanasova NT , Temenlieva VK , Petrova NS Clinico-electrophysiological correlates in patients with relapsingremitting multiple sclerosis . Folia Med (Plovdiv) 2001; 43: 5-9 .

29.

White AT , Petajan JH Physiological measures ofl therapeutic response to interfleron beta-1a treatment in remitting-relapsing MS . Clin Neurophysiol 2004; 115: 2364- 71 .

30.

Kurtzke JF Rating neurologic impairment in multiple sclerosis: an Expanded Disability Status Scale (EDSS) . Neurology 1983; 33: 1444-52 .

31.

Attarian S. , Azulay JP , Lardillier D. , Verschueren A. , Pouget J. Transcranial magnetic stimulation in lower motor neuron diseases . Clin Neurophysiol 2005 ; 116: 35-42 .

32.

Rossini PM , Berardelli A. , Deuschl G. , Hallett M. , Maertens de Noordhout AM , Paulus W. et al. Applications ofl magnetic cortical stimulation. The International Federation ofl Clinical Neurophysiology . Electroencephalogr Clin Neurophysiol Suppl 1999; 52: 17185 .

33.

Triggs WJ , Menkes D. , Onorato J. , Yan RS , Young MS , Newell K. et al. Transcranial magnetic stimulation identifies upper motor neuron involvement in motor neuron disease . Neurology 1999; 53: 605 -11 .

34.

Claus D. Central motor conduction: method and normal results . Muscle Nerve 1990; 13: 1125-32 .

35.

Rothwell JC , Hallett M. , Berardelli A. , Eisen A. , Rossini P. , Paulus W. Magnetic stimulation: motor evoked potentials. The International Federation ofl Clinical Neurophysiology . Electroencephalogr Clin Neurophysiol Suppl 1999; 52: 97-103 .

36.

Samii A. , Luciano CA , Dambrosia JM , Hallett M. Central motor conduction time: reproducibility and discomflort ofl diflflerent methods . Muscle Nerve 1998; 21: 1445-50 .

37.

de Carvalho M. , Miranda PC , Luis ML , Ducla-Soares E. Cortical muscle representation in amyotrophic lateral sclerosis patients: changes with disease evolution . Muscle Nerve 1999; 22: 1684-92 .

38.

Comi G. , Filippi M. , Rovaris M. , Leocani L. , Medaglini S. , Locatelli T. Clinical, neurophysiological, and magnetic resonance imaging correlations in multiple sclerosis . J Neurol Neurosurg Psychiatry 1998; 64: 21-25 .

39.

Stevenson VL , Leary SM , Losseff NA , Parker GJ , Barker GJ , Husmani Y. et al. Spinal cord atrophy and disability in MS: a longitudinal study . Neurology 1998 ; 51: 234- 38 .

40.

Mayr N. , Baumgartner C. , Zeitlhofer J. , Deecke L. The sensitivity ofl transcranial cortical magnetic stimulation in detecting pyramidal tract lesions in clinically definite multiple sclerosis . Neurology 1991; 41: 566-69 .

41.

Ravnborg M. , Liguori R. , Christiansen P. , Larsson H. , Sorensen PS The diagnostic reliability ofl magnetically evoked motor potentials in multiple sclerosis . Neurology 1992; 42: 1296-301 .

42.

Kandler RH , Jarratt JA , Gumpert EJ , Davies-Jones GA , Venables GS , Sagar HJ The role ofl magnetic stimulation in the diagnosis ofl multiple sclerosis . J Neurol Sci 1991; 106: 25-30 .

43.

Tataroglu C. , Genc A. , Idiman E. , Cakmur R. , Idiman F. Cortical silent period and motor evoked potentials in patients with multiple sclerosis . Clin Neurol Neurosurg 2003; 105: 105 -10 .

44.

Bednarik J. , Kadanka Z. Multimodal sensory and motor evoked potentials in a two-year flollow-up study

45.

ofl MS patients with relapsing course . Acta Neurol Scand 1992; 86: 15-18 .

46.

Hess CW , Mills KR , Murray NM Measurement ofl central motor conduction in multiple sclerosis by magnetic brain stimulation . Lancet 1986; 2: 355- 58 .

47.

Kidd D. , Thompson PD , Day BL , Rothwell JC , Kendall BE , Thompson AJ et al. Central motor conduction time in progressive multiple sclerosis. Correlations with MRI and disease activity . Brain 1998; 121: 1109-16 .

48.

Schmierer K. , Irlbacher K. , Grosse P. , Roricht S. , Meyer BU Correlates ofl disability in multiple sclerosis detected by transcranial magnetic stimulation . Neurology 2002; 59: 1218- 24 .

49.

Haug BA , Kukowski B. Latency and duration ofl the muscle silent period flollowing transcranial magnetic stimulation in multiple sclerosis, cerebral ischemia, and

50.

other upper motoneuron lesions . Neurology 1994; 44: 936-40 .

51.

Kornek B. , Lassmann H. Neuropathology ofl multiple sclerosis-new concepts . Brain Res Bull 2003; 61: 321- 26 .

52.

Trapp BD , Peterson J. , Ransohoff RM , Rudick R. , Mork S. , Bo L. Axonal transection in the lesions ofl multiple sclerosis . N Engl J Med 1998; 338: 278- 85 .

53.

Magistris MR , Rosler KM , Truffert A. , Myers JP Transcranial stimulation excites virtually all motor neurons supplying the target muscle. A demonstration and a method improving the study ofl motor evoked potentials . Brain 1998; 121: 437- 50 .

54.

Magistris MR , Rosler KM , Truffert A. , Landis T. , Hess CW A clinical study ofl motor evoked potentials using a triple stimulation technique . Brain 1999; 122: 265- 79 .