TY - JOUR
T1 - Early effect of dalfampridine in patients with MS
T2 - A multi-instrumental approach to better investigate responsiveness
AU - Brambilla, L.
AU - Rossi Sebastiano, D.
AU - Aquino, D.
AU - Torri Clerici, V.
AU - Brenna, G.
AU - Moscatelli, M.
AU - Frangiamore, R.
AU - Giovannetti, A. M.
AU - Antozzi, C.
AU - Mantegazza, R.
AU - Franceschetti, S.
AU - Bruzzone, M. G.
AU - Erbetta, A.
AU - Confalonieri, P.
PY - 2016/9/15
Y1 - 2016/9/15
N2 - Background 4-aminopyridine (4-AP) is a potassium-channel blocker able to enhance walking speed in MS improving the action potentials of demyelinated axons on which internodal potassium channels are exposed. Objective to study early 4-AP effect with clinical, subjective, neurophysiological and neuroradiological tools. Methods Clinical (Timed 25-Foot Walk - T25FW, Timed Up-And-Go - TUG), subjective (MS Walking Scale-12 - MSWS-12), neurophysiological (Motor Evoked Potentials - MEPs) and imaging (Diffusion Tensor Imaging - DTI) evaluations were performed before (T0) and after (T1) 14 days of 4-AP treatment. MEPs were recorded from Abductor Hallucis of both legs. A Tract-Based-Spatial-Statistics (TBSS) was performed on DTI. Results We found a significant difference between T0 and T1 for T25FW, TUG, MSWS-12 (p ≤ 0.001) in the whole patients’ sample (23 subjects, median EDSS 6.0) and decrease of Central Motor Conduction Time and increase of mean Amplitude (Amp) at T1 (p = 0.008 and p = 0.006). We also recorded a significant difference of T25FW, TUG, MSWS-12 and Amp in clinical responder (CR) patients (CR: amelioration > 20% at T25FW). TBSS showed a significant Mean and Radial Diffusivity reduction in the corticospinal tracts (p
AB - Background 4-aminopyridine (4-AP) is a potassium-channel blocker able to enhance walking speed in MS improving the action potentials of demyelinated axons on which internodal potassium channels are exposed. Objective to study early 4-AP effect with clinical, subjective, neurophysiological and neuroradiological tools. Methods Clinical (Timed 25-Foot Walk - T25FW, Timed Up-And-Go - TUG), subjective (MS Walking Scale-12 - MSWS-12), neurophysiological (Motor Evoked Potentials - MEPs) and imaging (Diffusion Tensor Imaging - DTI) evaluations were performed before (T0) and after (T1) 14 days of 4-AP treatment. MEPs were recorded from Abductor Hallucis of both legs. A Tract-Based-Spatial-Statistics (TBSS) was performed on DTI. Results We found a significant difference between T0 and T1 for T25FW, TUG, MSWS-12 (p ≤ 0.001) in the whole patients’ sample (23 subjects, median EDSS 6.0) and decrease of Central Motor Conduction Time and increase of mean Amplitude (Amp) at T1 (p = 0.008 and p = 0.006). We also recorded a significant difference of T25FW, TUG, MSWS-12 and Amp in clinical responder (CR) patients (CR: amelioration > 20% at T25FW). TBSS showed a significant Mean and Radial Diffusivity reduction in the corticospinal tracts (p
KW - 4-Aminopyridine
KW - Dalfampridine
KW - Diffusion Tensor Imaging
KW - Fampridine
KW - Motor Evoked Potentials
KW - Multiple Sclerosis
KW - Subjective outcomes
KW - Walking ability
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U2 - 10.1016/j.jns.2016.06.019
DO - 10.1016/j.jns.2016.06.019
M3 - Article
AN - SCOPUS:84980351299
VL - 368
SP - 402
EP - 407
JO - Journal of the Neurological Sciences
JF - Journal of the Neurological Sciences
SN - 0022-510X
ER -