Ten-year disease progression in multiple sclerosis: walking declines more rapidly than arm and hand function

Area of Science:

• Neurology
• Clinical Research
• Rehabilitation Science

Background:

• Multiple Sclerosis (MS) presents with differential decline in motor functions.
• Understanding the temporal progression of walking versus upper limb function is crucial for patient management.

Purpose of the Study:

• To investigate the longitudinal course of walking and arm/hand function in patients with MS over 10 years post-diagnosis.
• To determine if walking or upper limb function declines earlier or at a faster rate.

Main Methods:

• A prospective follow-up of 156 patients with definite MS (relapse or non-relapse onset).
• Systematic assessments at diagnosis, 6 months, and 1, 2, 3, 6, and 10 years.
• Evaluations included the 10-meter timed walk test (10mTWT) for walking and the Action Research Arm test (ARAT) and nine-hole peg test (9HPT) for arm/hand function.

Main Results:

• Arm and leg function z-scores began to diverge from 3 years post-diagnosis, with significance trending by 6 years.
• At 10 years, the 10mTWT z-score was significantly higher than the 9HPT, indicating faster walking decline.
• This pattern was more pronounced in non-relapse onset MS but present in both onset types.

Conclusions:

• This study is the first to demonstrate that walking declines earlier and more rapidly than arm and hand function in MS patients.
• Findings offer insights into the pathophysiological progression of MS, suggesting an ascending order of functional deterioration.