Cerebellar Assessment in Early Multiple Sclerosis.

Area of Science:

• Neurology
• Neuroscience
• Clinical Trials

Background:

• Cerebellar impairment is common in multiple sclerosis (MS) and predicts disability.
• The Nine-Hole Peg Test (NHPT) is widely used for cerebellar symptoms but lacks specificity for ataxia.
• Eye-tracking shows promise for detecting subtle cerebellar signs in early MS and clinical trials.

Purpose of the Study:

• To assess the accuracy of the NHPT in detecting subtle cerebellar symptoms using eye-tracking in high-risk clinically isolated syndrome (HR-CIS) patients.
• To compare eye-tracking derived cerebellar impairment criteria with NHPT performance in HR-CIS patients.

Main Methods:

• Twenty-nine HR-CIS patients and 13 healthy controls (HC) underwent an eye-tracking protocol.
• Cerebellar impairment was defined by saccadic intrusions or ≥10% dysmetria.
• NHPT performance was compared between patient groups and controls.

Main Results:

• Sixteen HR-CIS patients met saccadic criteria for cerebellar impairment.
• NHPT performance was significantly worse in HR-CIS patients compared to HC (p < 0.01).
• NHPT performance did not differ between cerebellar and non-cerebellar patient groups, failing to discriminate based on saccadic criteria.

Conclusions:

• The NHPT is not sensitive enough to detect subtle cerebellar impairment in HR-CIS patients.
• Eye-tracking provides a more precise measure of cerebellar function in early MS.
• Findings suggest eye-tracking should be considered for future clinical trials in HR-CIS patients.