Early effect of dalfampridine in patients with MS: A multi-instrumental approach to better investigate responsiveness

L. Brambilla, D. Rossi Sebastiano, D. Aquino, V. Torri Clerici, G. Brenna, M. Moscatelli, R. Frangiamore, A. M. Giovannetti, C. Antozzi, R. Mantegazza, S. Franceschetti, M. G. Bruzzone, A. Erbetta, P. Confalonieri

Research output: Contribution to journalArticlepeer-review

Abstract

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 

Original languageEnglish
Pages (from-to)402-407
Number of pages6
JournalJournal of the Neurological Sciences
Volume368
DOIs
Publication statusPublished - Sep 15 2016

Keywords

  • 4-Aminopyridine
  • Dalfampridine
  • Diffusion Tensor Imaging
  • Fampridine
  • Motor Evoked Potentials
  • Multiple Sclerosis
  • Subjective outcomes
  • Walking ability

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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