Abstract Details

Title Depression Symptoms Moderate Link Between Infratentorial and Cervical Cord T2 Lesions on Gait Speed in Relapsing-remitting Multiple Sclerosis

Topic Multiple Sclerosis

Presentation(s) P6 - Poster Session 6 (8:00 AM-9:00 AM)

Poster/Presentation
Number 6-017

Objective To examine relationships between gait speed/endurance and depressive symptoms in relapsing-remitting multiple sclerosis (RRMS), and evaluate whether depression symptoms moderate the relationship between infratentorial / cervical cord T2 lesion burden and gait.

Background Gait disturbance is common in RRMS and walking speed is an important outcome in clinical care and research; however, it is unclear whether depression affects gait performance.

Design/Methods A yes/no cutoff for at least mild depression symptoms was established with questionnaires (Beck Depression Inventory-Fast Screen or Hospital Anxiety and Depression Scale) in 404 persons with RRMS. Timed 25-Foot Walk (T25FW) and 2-Minute Walk Test (2MWT) were adjusted for age, sex, height, and weight. T2 lesions in the pons/medulla (0, 1, 2, 3+), cerebellum (0, 1, 2, 3+), and cervical cord (0, 1, 2, 3, 4+) were summed for total infratentorial / cervical cord T2 lesion burden (0-10). Multiple regressions predicted T25FW and 2MWT with depression (yes, no) and T2 lesion burden (continuous; step one), and a depression x T2 lesion burden interaction (step two).

Results Positive depression screen (yes n=113, 28.0%) was associated with slower T25FW (B=0.36s [0.21, 0.51], β=0.23, p<0.001) and shorter 2MWT (B=-47.0ft [-64.9, -29.1], β=-0.25, p<0.001), and moderated the link between lesion burden and gait whereby worse lesion burden was associated with slower gait in patients with at least mild depression (T25FW r= 0.34 , 2MWT r= -0.33; Ps<0.001) but not patients without depression (T25FW r= 0.09; 2MWT r= -0.08; Ps>0.10). T2 lesion burden was unrelated to depression (p>0.10).

Conclusions

Depression was linked to slower gait in RRMS, and was associated with much greater impact of infratentorial / cervical cord disease burden on gait function. Findings highlight even mild depression symptoms as a modifiable contributor to gait disturbance in clinical practice, and inform research (especially clinical trials) utilizing gait speed as a proxy of MS-related disability.

Authors/Disclosures
Hanaan Bing-Canar, PhD (Icahn School of Medicine at Mount Sinai) PRESENTER	Dr. Bing-Canar has nothing to disclose.
Marwa Baalbaki, MD (Rutgers New Jersey Medical School)	Dr. Baalbaki has nothing to disclose.
James F. Sumowski (Icahn School of Medicine At Mount Sinai)	Mr. Sumowski has nothing to disclose.

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