Abstract Details

Title Grip Fatigability but not Strength Discriminates those with Pediatric Onset Multiple Sclerosis from Controls

Topic Multiple Sclerosis

Presentation(s) P4 - Poster Session 4 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-106

Objective

To objectively characterize motor fatigability, strength, and manual dexterity in pediatric-onset Multiple Sclerosis (POMS).

Background The onset of multiple sclerosis (MS) during childhood and adolescence presents unique clinical symptoms. Adult MS patients present with decreased strength in the hands and fingers and reductions in manual dexterity and higher hand fatigability. In comparison, less is known concerning motor fatigability and strength in POMS patients.

Design/Methods We evaluated hand grip fatigability and manual dexterity in both POMS and healthy control (HC) participants, who performed Lafayette Grooved Pegboard test (PEGs) and the hand grip fatigability test (using a digital grip dynamometer) that consisted of 30 consecutive contractions following by 30 seconds of sustained maximal contraction. Maximal grip strength, dynamic and static fatigue indexes, and age and gender adjusted z-scores for PEGs were analyzed for both dominant and non-dominant hand.

Results Forty-two POMS (median age 18.6) and 27 HC (median age 21.3) were included in this analysis. Quantitative measures of maximal strength during dynamic hand grip contractions showed no difference between POMS and HC (19.96 vs. 21.10 kg), as well as for the dynamic fatigue index. The static fatigue index was significantly higher in POMS for both the dominant and non-dominant hands: 41% vs. 28% (p<0.01) and 39% vs. 31% (p<0.01). A significant correlation was found between maximal hand grip strength and PEGs score for both the dominant (r=0.31, p<0.05) and non-dominant hand (r=0.35, p<0.05).

Conclusions Difference in fatigability between POMS and HC were found during sustained maximal hand grip contraction, but not during dynamic contractions. Dexterity seems to be only weakly associated with grip strength. As shown previously for adult MS, the static fatigue index detects differences in fatigability in POMS and could be a reliable indicator for disease progression.

Authors/Disclosures
Giuseppina Pilloni, PhD (NYU Grossman School of Medicine) PRESENTER	Dr. Pilloni has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Ceragem.
Michael Shaw	Mr. Shaw has nothing to disclose.
Raghav Malik (NYU Langone Medical Center)	No disclosure on file
Lauren B. Krupp, MD, FAAN (NYU Langone Medical Center)	Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Celgene. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medscape. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as a Consultant for EBIX. Dr. krupp 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. krupp has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Hoffman LaRoche. Dr. krupp has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for MMMK. Dr. krupp has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Patrick, Dolan, and Kaufman. Dr. krupp has received intellectual property interests from a discovery or technology relating to health care.
Leigh E. Charvet, PhD (NYU Langone)	Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Johnson & Johnson. Dr. Charvet has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Springer Healthcare. Dr. Charvet has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for YBrain. Dr. Charvet has stock in Johnson&Johnson.

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