Clinical evaluation of patients with multiple sclerosis Review article
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Published:
Sep 30, 2012
Keywords:
methods of evaluation, EDSS, MSFC, multiple sclerosis
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Abstract
Multiple sclerosis (MS) is a chronic disease causing disability and decreasing the quality of life. Heterogenity of the clinical symptoms makes assessment of activity of nervous system a complex issue. Some of the frequent symptoms of the MS (visual disturbances, fatigue, pain or decline of cognitive functions) are extremely difficult to assess with standard clinical tests. Commonly used Expanded Disability Status Scale (EDSS) does not fulfill all the requirements. That is why National MS Society in the USA recommended the MS Functional Composite (MSFC). MS Society suggested to utilize a sensitive test of contrast discrimination with the Pelli-Robson method (Low-Contrast Sloan Letter Chart Testing-Binocular) and Symbol Digit Modalities Test (SDMT) – a test measuring the cognitive functions. All new clinical methods serve the objectification of assessment of MS patients and show correlation with results in EDSS scale and NMR test. They can also be performed by average medical staff, while EDSS requires supervision of an experienced doctor.
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References
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2. Granger C.V., Cotter A.C., Hamilton B.B. et al.: Functional assessment scales: a study of persons with multiple sclerosis. Arch. Phys. Med. Rehabil. 1990; 71: 870-875.
3. Whitaker J.N., McFarland H.F., Rudge P.: Outcomes assessment in multiple sclerosis clinical trials: a critical analysis. Mult. Scler. 1995; 1: 37-47.
4. Kurtzke J.F.: A new scale for evaluating disability in multiple sclerosis. Neurology 1955; 5: 580-583.
5. Kurtzke J.F.: Neurologic impairment in multiple sclerosis and the disability status scale. Acta Neurol. Scand. 1970; 46: 493-512.
6. Kurtzke J.F.: Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444-1452.
7. Walczak A.: Skale kliniczne oceny niesprawności – znaczenie praktyczne. Pol. Przegl. Neurol. 2008; 4, supl. A: 70.
8. Opara J.: Klinimetria w stwardnieniu rozsianym. Farmakoterapia w Psychiatrii i Neurologii 2005; 3: 219-226.
9. Wender M.: Próba optymalizacji liczbowej oceny stanu klinicznego chorych na stwardnienie rozsiane. Akt. Neurol. 2002; 2: 128-130.
10. Hobart J., Freeman J., Thompson A.: Kurtzke scales revisited: the application of psychometric methods to clinical intuition. Brain 2000; 123: 1027-1040.
11. Haber A., LaRocca N.G.: Minimal Record of Disability for multiple sclerosis. National Multiple Sclerosis Society, New York 1985.
12. Rudick R.A., Fischer J., Antel J. et al.: Clinical outcomes assessment in multiple sclerosis. Ann. Neurol. 1996; 40: 469-479.
13. Sharrack B., Hughes R.A.C., Soudain S. et al.: The psychometric properties of clinical rating scales used in multiple sclerosis. Brain 1999; 122: 141-159.
14. Willoughby E.W., Paty D.W.: Scales for rating impairment in multiple sclerosis: a critique. Neurology 1988; 38: 1793.
15. Rudick R.A. et al.: Use of the Multiple Sclerosis Functional Composite to predict disability in relapsing MS. Neurology 2000; 56: 1324-1330.
16. Cutter G.R. et al.: Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain 1999; 122: 871-882.
17. Rudick R.A., Antel J., Confavreux C. et al.: Recommendations from the National Multiple Sclerosis Society Clinical Outcomes Assessment Task Force. Ann. Neurol. 1997; 42: 379-382.
18. Hauser S.L., Dawson D.M., Lehrich J.R. et al.: Intensive immunosuppression in progressive multiple sclerosis. A randomized, threearm study of high-dose intravenous cyclophosphamide, plasma exchange, and ACTH. N. Engl. J. Med. 1983; 308: 173-80.
19. Gronwall D.M.: Paced auditory serial-addition task: a measure of recovery from concussion. Percept. Mot. Skills 1977; 44: 367-373.
20. Rao S.M., Leo G.J., Haughton V.M. et al.: Correlation of magnetic resonance imaging with neuropsychological testing in multiple sclerosis. Neurology 1989; 39: 161-166.
21. Wiens A.N., Fuller K.H., Crossen J.R.: Paced Auditory Serial Addition Test: adult norms and moderator variables. J. Clin. Exp. Neuropsychol. 1997; 19: 473-483.
22. Cohen J.A., Fischer J.S., Bolibrush D.M. et al.: Intrarater and interrater reliability of the MS functional composite outcome measure. Neurology 2000; 54: 802-806.
23. Polman C.H., Rudick R.A.: The multiple sclerosis functional composite: a clinically meaningful measure of disability. Neurology 2010; 74(supl. 3): 8-15.
24. Nijeholt G.J., Van Walderveen M.A., Castelijns J.A. et al.: Brain and spinal cord abnormalities in multiple sclerosis. Correlation between MRI parameters, clinical subtypes and symptoms. Brain 1998; 121: 687-697.
25. Kalkers N.F., Bergers E., Castelijns J.A. et al.: Optimizing the association between disability and biological markers in MS. Neurology 2001; 57: 1253-1258.
26. Balcer L.J., Baier M.L., Cohen J.A. et al.: Contrast letter acuity as a visual component for the Multiple Sclerosis Functional Composite. Neurology 2003; 61: 1367-1373.
27. Pelli D.G., Robson J.G., Wilkins A.J.: Designing a new letter chart for measuring contrast sensivity. Clin. Vision Sci. 1988; 2: 187-199.
28. Pelli-Robson contrast sensitivity chart. Instruction for use. Clement Clarke International Ltd. Harlow, Essex 1989.
29. Wender M.: Wartość badań wzroku metodą dyskryminacji kontrastu według Pelli-Robson do oceny stanu chorych na stwardnienie rozsiane. Neurol. Neurochir. Pol. 2007; 41: 141-143.
30. Brochet B., Deloire M.S.A., Bonnet M. et al.: Should SDMT substitute for PASAT in MSFC? A 5-year longitudinal study. Mult. Scler. 2008; 14: 1242-1249.
31. Drake A.S., Weinstock-Guttman B., Morrow S.A. et al.: Psychometrics and normative data for the Multiple Sclerosis Functional Composite: replacing the PASAT with the Symbol Digit Modalities Test. Mult. Scler. 2010; 16: 228-237.
32. Smith A.: Dominant and nondominant hemispherectomy. W: Drugs, development and cerebral function. W.L. Smith (red.). Charles C. Thomas, Springfield, IL 1972.
33. Smith A., Centofanti C.C.: Two economic tests of cognitive and somatosensory functions for the detection of cerebral dysfunction. Neurosciences Abstracts 1975; 1: 510.
34. Smith A.: Symbol Digit Modalities Test. Manual. Western Psychological Services, Los Angeles 2007.
35. Bogen J.E.: The other side of the brain. Bulletin of the Los Angeles Neurological Society 1969; 34: 73-105.
36. Bogen J.E., Gazzaniga S.N.: Cerebral commisures in man. Journal of Neurosurgery 1965; 23: 394-399.
37. Campbell A.L., Bogen J.E., Smith A.: Disorganization and reorganization of cognitive and sensorimotor functions in cerebral commissurotomy. Brain 1981; 104: 493-511.
38. Sperry R.W.: Lateral specialization in the surgically separated hemisphere. W: Neurosciences third study program. F.O. Schmitt, F.G. Worden (red.). MIT Press, Cambridge 1974.
39. Teuber H.L.: Why two brains? W: Neurosciences third study program. F.O. Schmitt, F.G. Worden (red.). MIT Press, Cambridge 1974.
40. van Waesberghe J.H., van Buchem M.A., Filippi M. et al.: MR outcome parameters in multiple sclerosis: comparison of surface based thresholding segmentation and magnetization transfer ratio histographic analysis in relation to disability (a preliminary note). Am. J. Neuroradiol. 1998; 19: 1857-1862.
41. van Buchem M.A., Grossman R.I., Armstrong C. et al.: Correlation of volumetric magnetization transfer imaging with clinical data in MS. Neurology 1998; 50: 1609-1617.