Abstract Details

Title NIH Toolbox Standing Balance Test as a new method to detect subtle balance impairment in patients with multiple sclerosis

Topic Multiple Sclerosis

Presentation(s) MS and CNS Inflammatory Disease Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 035

Objective

To assess balance impairment in patients with Multiple Sclerosis (MS) with NIH Toolbox Standing Balance Test (SBT).

Background Attempts to measure balance deficits in MS in clinical practice have mostly relied on EDSS, but its scarce capability to detect subtle deficits is an important limitation.

Design/Methods 128 consecutive MS patients and 36 age and sex-matched healthy controls (HCs) underwent NIH Toolbox SBT at the MS Center of the University of Genoa. Patients underwent clinical evaluation with EDSS recording and 3T brain MRI. Theta scores were derived and corrected for age,sex,height and weight. T2 and T1 lesion volumes (LV) were obtained for the cerebellum and the total brain separately. A linear logistic regression model was performed to evaluate the relative contribution of cerebellar, sensory and brainstem impairment on balance performance.

Results

92(73.9%) MS patients were females, mean (SD) age was 41.2(11.6) years; 108(84.4%) patients had relapsing-remitting(RRMS). Mean disease duration was 10.6(9.3) years, median (IQR) baseline EDSS was 2.5(1-4). According to their functional systems, 73(53.0%), 57(44.5%) and 79(61.7%) patients had no evidence of cerebellar, sensory and brainstem dysfunction respectively. On brain MRI, 95(74.2%) patients exhibited cerebellar lesions [mean T2LV 0.31(0.44) mL; mean T1LV 0.20(0.31) mL]. Patients had significantly lower theta scores than HCs (-0.27vs0.91;p=0.003). RRMS performed better than PMS patients (-0.05vs-1.45;p=0.006). Patients without clinically evident impairment in sensory and brainstem FS had worse performance than HCs (0.08vs0.91;p=0.046 and 0.12vs0.91;p=0.048, respectively). Each 1 point increase in cerebellar FS independently determined a -0.50 decrease in theta scores(95%CI:-0.91-0.09; p=0.017). Theta scores correlated with cerebellar T2 and T1LV (r=-0.29,p=0.001 and r=-0.28,p=0.001 respectively) but not with global T2 and T1LV.

Conclusions NIH Toolbox SBT is able to detect subtle balance impairment in MS patients, not detected by clinical examination. Cerebellar involvement seem to be specifically related to NIH Toolbox SBT metric.

Authors/Disclosures
Giacomo Boffa (Department of Neuroscience, University of Genova) PRESENTER	Mr. Boffa has nothing to disclose.
Caterina Lapucci, MD (DINOGMI, University of Genoa)	Dr. Lapucci has nothing to disclose.
	No disclosure on file
	No disclosure on file
	No disclosure on file
Nicolo Bruschi	Mr. Bruschi has nothing to disclose.
Maria Cellerino, MD (University of Genoa)	Maria Cellerino has nothing to disclose.
Matilde Inglese, MD, PhD (University of Genoa)	Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SANOFI GENZYME. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BIOGEN. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for NOVARTIS. Dr. Inglese has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for MERCK-SERONO. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for ROCHE. Dr. Inglese has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MS Journal.

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