Longitudinal assessment of hand function in individuals with multiple sclerosis

Area of Science:

• Neurology
• Rehabilitation Medicine
• Clinical Neurophysiology

Background:

• Hand dysfunction is a frequent but understudied complication in multiple sclerosis (MS).
• Understanding the progression and detection of hand impairment is crucial for managing MS.
• Current methods for assessing hand function in MS may lack sensitivity to detect subtle changes.

Purpose of the Study:

• To quantify the frequency and severity of hand dysfunction in individuals with MS.
• To evaluate the utility of quantitative hand function tests in detecting longitudinal changes.
• To explore the relationship between hand function, global disability measures, and identify predictors of hand impairment.

Main Methods:

• 147 individuals with MS and 35 healthy controls underwent quantitative hand function tests (grip strength, pinch strength, 9-hole peg test [9HPT], finger tapping).
• Leg strength, Expanded Disability Status Scale (EDSS), and timed 25-foot walk were also assessed.
• Statistical analyses included Spearman correlations, multivariate regression, and mixed-effects linear regression over a follow-up period of up to 5 years.

Main Results:

• Individuals with progressive MS (PMS) showed significant deficits in grip strength, pinch strength, 9HPT performance, and finger tapping compared to controls at baseline.
• Over two years, a substantial proportion of individuals with MS experienced over 20% worsening in 9HPT results and grip strength.
• Worsening in hand function measures was observed in both relapsing-remitting MS (RRMS) and PMS groups.

Conclusions:

• Quantitative hand function tests, including dynamometry and the 9HPT, are sensitive tools for detecting and monitoring hand dysfunction in MS.
• These measures may be more sensitive in identifying changes in progressive MS (PMS) and can serve as valuable outcome measures in clinical trials.
• The findings support the use of objective hand function assessments to improve precision in evaluating therapeutic interventions for MS.