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Roman Schniepp, Ken Möhwald, Max Wuehr
During human locomotion, vestibular feedback control is fundamental for maintaining dynamic stability and adapting the gait pattern to external circumstances. Within the supraspinal locomotor network, the cerebellum represents the key site for the integration of vestibular feedback information. The cerebellum is further important for the fine-tuning and coordination of limb movements during walking. The aim of this review article is to highlight the shared structural and functional sensorimotor principles in vestibular and cerebellar locomotion control...
April 10, 2017: Journal of Neurology
Kate Behm, Prue Morgan
PURPOSE: To synthesise and critically appraise randomised controlled trials examining the effect of symptom-controlling medication on gait outcomes in people with multiple sclerosis (MS). METHOD: The literature search examined five databases (Medline, Embase, AMED, Cochrane (CENTRAL), and CINAHL until the end of November 2016. Eligible studies included medication to address symptoms associated with MS and an objective gait outcome measure. Two reviewers independently extracted data and assessed study quality using structured data extraction forms and the PEDro scale...
April 4, 2017: Disability and Rehabilitation
Tjalf Ziemssen, Christine Prosser, Jennifer Scarlet Haas, Andrew Lee, Sebastian Braun, Pamela Landsman-Blumberg, Angela Kempel, Erika Gleißner, Sarita Patel, Ming-Yi Huang
BACKGROUND: Multiple sclerosis (MS) patients often suffer from gait impairment and fampridine is indicated to medically improve walking ability in this population. Patient characteristics, healthcare resource use, and costs of MS patients on fampridine treatment for 12 months in Germany were analyzed. METHODS: A retrospective claims database analysis was conducted including MS patients who initiated fampridine treatment (index date) between July 2011 and December 2013...
March 27, 2017: BMC Neurology
Beatriz Mejuto, Paloma Castellano, Concepción Castro, Luis Manuel López
OBJECTIVE: Assessment of the efficacy and safety of fampridine for walking improvement in adult patients with multiple sclerosis. METHOD: A descriptive retrospective study of all patients who initiated treatment with fampridine between March, 2014 and February, 2015. Efficacy was assessed through the 25-foot walk test and the 12-item walking scale for multiple sclerosis. It was reviewed whether patients had suffered any of the most frequent adverse effects described in the pivotal clinical trial...
March 1, 2017: Farmacia Hospitalaria
Linard Filli, Björn Zörner, Sandra Kapitza, Katja Reuter, Lilla Lörincz, David Weller, Tabea Sutter, Tim Killeen, Philipp Gruber, Jens A Petersen, Michael Weller, Michael Linnebank
OBJECTIVE: To expand upon the limited knowledge of the long-term effects of prolonged-release (PR) fampridine in patients with multiple sclerosis (PwMS) regarding safety, walking improvements, and changes in drug responsiveness. METHODS: Fifty-three PwMS who completed the FAMPKIN core study were included in this extension trial. Drug efficacy was assessed in an open-label and randomized double-blind, placebo-controlled study design with regular baseline assessments over a period of 2 years using the Timed 25-Foot Walk (T25FW), 6-Minute Walk Test (6MWT), and 12-item MS Walking Scale (MSWS-12) as outcome measures...
February 28, 2017: Neurology
Susan E Bennett
No abstract text is available yet for this article.
February 28, 2017: Neurology
Sarah A Morrow, Heather Rosehart, Andrew M Johnson
BACKGROUND: Cognitive fatigue (CF) is a common complaint in persons with MS (PwMS). Fampridine-SR improves ambulation, fatigue and endurance, due to enhancing action potential formation by blocking potassium channels in demyelinated axons. Thus, through this same mechanism, it is hypothesized that Fampridine-SR could improve CF. OBJECTIVE: To determine if Fampridine-SR objectively improves CF in PwMS. METHODS: Sixty PwMS of any type with CF, defined as 3 or less correct responses when comparing the last third to the first third on the Paced Auditory Serial Addition Test (PASAT), were recruited from a tertiary care MS clinic in London (ON) Canada...
January 2017: Multiple Sclerosis and related Disorders
Miriam Álvarez Payero, Candelas Valeiras Muñoz, Susana Lion Vázquez, Guadalupe Piñeiro Corrales, Delicias Muñoz García, Luciana Midaglia
PURPOSE OF THE STUDY: Approximately 85% of patients with multiple sclerosis experience reduced mobility, which negatively affects quality of life. Fampridine is the first symptomatic treatment aimed at improving gait. We analyzed effectiveness and tolerance in clinical practice. We also sought a prevalent gait pattern in responders as a potential clinical response marker. MATERIAL AND METHODS: 6-month prospective study of fampridine in patients with multiple sclerosis...
January 5, 2017: International Journal of Neuroscience
H B Jensen, J L Nielsen, M Ravnborg, U Dalgas, P Aagaard, E Stenager
DESIGN: This study was conducted as a randomized, double blind, placebo-controlled parallel group trial preceded by open label enrichment phase. OBJECTIVES: The objectives of this study were 1) to examine the effect of SR-Fampridine treatment on muscle strength in terms of maximal voluntary contraction (MVC) and rate of force development (RFD) of the lower extremities and 2) to replicate previously published data on the effect of slow release-Fampridine (SR-Fampridine) on the functional capacity of the lower limbs, the upper limb and cognitive function, in persons with multiple sclerosis (pwMS)...
November 2016: Multiple Sclerosis and related Disorders
Christian Veauthier, Helge Hasselmann, Stefan M Gold, Friedemann Paul
More than 80% of multiple sclerosis (MS) patients suffer from fatigue. Despite this, there are few therapeutic options and evidence-based pharmacological treatments are lacking. The associated societal burden is substantial (MS fatigue is a major reason for part-time employment or early retirement), and at least one out of four MS patients view fatigue as the most burdensome symptom of their disease. The mechanisms underlying MS-related fatigue are poorly understood, and objective criteria for distinguishing and evaluating levels of fatigue and tiredness have not yet been developed...
2016: EPMA Journal
Hannah Pickering, Jenna Murray, Cindy S-Y Lin, Christine Cormack, Andrew Martin, Matthew C Kiernan, Arun V Krishnan
OBJECTIVE: To explore the benefits of modified-release fampridine on walking distance in MS. METHODS: This was a randomised double-blind, placebo-controlled crossover trial of fampridine in 25 MS patients. The primary outcome measure was the six minute walk test (6MWT). A p-value<10% led to rejection of the null hypothesis. RESULTS: The pre-specified criterion for statistical significance was met, with a 17m improvement in 6MWT in the treatment arm...
January 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Claudio Gasperini, Raymond Hupperts, Jan Lycke, Christine Short, Manjit McNeill, John Zhong, Lahar R Mehta
Prolonged-release (PR) fampridine is approved to treat walking impairment in persons with multiple sclerosis (MS); however, treatment benefits may extend beyond walking. MOBILE was a phase 2, 24-week, double-blind, placebo-controlled exploratory study to assess the impact of 10mg PR-fampridine twice daily versus placebo on several subject-assessed measures. This analysis evaluated the physical and psychological health outcomes of subjects with progressing or relapsing MS from individual items of the Multiple Sclerosis Impact Scale (MSIS-29)...
November 15, 2016: Journal of the Neurological Sciences
Mehri Christopher, Yoshimasa Sagawa, Céline Bernard, Thierry Moulin, Eloi Magnin, Pierre Decavel
OBJECTIVE: Fampridine is used as a symptomatic treatment in patients with multiple sclerosis (PwMS) gait disorders. Some clinical trials reported a positive effect on cognitive function especially on information-processing speed (IPS) or on fatigue. The aim of our clinical trial was to evaluate the effect of fampridine on IPS. MATERIAL/PATIENTS AND METHODS: 60 PwMS with an EDSS score between 4 and 7 were included in a prospective monocentric open label trial. Two identical measures were conducted a week apart before initiating treatment in order to take into account the test-retest effect...
September 2016: Annals of Physical and Rehabilitation Medicine
Jan-Patrick Stellmann, Midia Jlussi, Anneke Neuhaus, Christian Lederer, Martin Daumer, Christoph Heesen
BACKGROUND: Fampridine improves walking speed in patients with multiple sclerosis (MS) in performance-based tests. The impact on habitual mobility and its correlation with clinical tests has not been analysed. OBJECTIVE: To investigate the association between clinical response criteria and habitual mobility in MS patients starting a fampridine treatment. METHODS: During a four-week baseline-to-treatment study, we assessed in 28 patients (median EDSS 4...
September 15, 2016: Journal of the Neurological Sciences
Yoshimasa Sagawa, Eloi Magnin, Laura Paillot, Thierry Moulin, Pierre Decavel
BACKGROUND: Fampridine improves walking in patients with multiple sclerosis (pwMS). However, little is known about its impact on the quality of life (QoL) of pwMS. OBJECTIVES: This study aimed to evaluate the contribution of fampridine on the QoL of pwMS and to determine if improvements in QoL are best associated with walk respondents. METHODS: Fifty pwMS were included in this study. The PERSEPP scale and the GaitRite system were used to evaluate QoL and gait respectively...
2016: SpringerPlus
C Veauthier, F Paul
BACKGROUND: Fatigue is one of the most frequent symptoms of multiple sclerosis (MS) and one of the main reasons for underemployment and early retirement. The mechanisms of MS-related fatigue are unknown but comorbid disorders play a major role. Anemia, diabetes, side effects of medication and depression should be ruled out. Moreover, excessive daytime sleepiness (EDS) should be differentiated from fatigue. No approved medicinal therapy of MS fatigue is currently available. OBJECTIVE: Presentation of current treatment strategies with a particular focus on secondary fatigue due to sleep disorders...
December 2016: Der Nervenarzt
Yara Dadalti Fragoso, Tarso Adoni, Soniza Vieira Alves-Leon, Samira Luisa Apostolos-Pereira, Amilton Antunes Barreira, Joseph Bruno Bidin Brooks, Rinaldo Claudino, Eber Castro Correa, Maria Lucia Brito Ferreira, Alessandro Finkelsztejn, Juliana Finkelsztejn, Paulo Diniz da Gama, Marcus Vinicius Magno Goncalves, Carlos Tostes Guerreiro, Andre Palma da Cunha Matta, Vanessa Daccach Marques, Rogerio Rizo Morales, Monica Fiuza Koncke Parolin, Marlise de Castro Ribeiro, Taysa Alexandrino Gonsalves Jube Ribeiro, Heloisa Helena Ruocco, Henry Sato, Simone Scherpenhuijzen, Fabio Siquineli, Nise Alessandra de Carvalho Sousa, Daniel Lima Varela, Carlos Bernardo Tauil, Thereza Cristina Winckler
BACKGROUND: Fampridine is a broad-spectrum voltage-dependent potassium channel blocker that enhances synaptic transmission. The drug has been shown to be able to ameliorate conduction in demyelinated axons, thereby leading to improved gait in patients with multiple sclerosis (MS). OBJECTIVE: To assess the "real-life" efficacy and safety of fampridine prescribed for gait disorders in MS. This was an observational and prospective study carried out at MS Units participating in the Brazilian Multiple Sclerosis Study Group...
June 30, 2016: NeuroRehabilitation
William Huynh, Hannah Pickering, James Howells, Jenna Murray, Christine Cormack, Cindy S-Y Lin, Steve Vucic, Matthew C Kiernan, Arun V Krishnan
OBJECTIVE: To investigate the effects of fampridine on nerve excitability, the present study utilized peripheral axonal excitability techniques in 18 MS patients receiving treatment with fampridine. METHODS: Studies were performed at baseline and repeated 3months after institution of fampridine at standard dosing. RESULTS: Following treatment with fampridine there were significant changes in axonal excitability for those parameters associated with fast K(+) channels that shifted towards normal control values...
July 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
H B Jensen, Sepehr Mamoei, M Ravnborg, U Dalgas, E Stenager
OBJECTIVE: To provide distribution-based estimates of the minimal clinical important difference (MCID) after slow release fampridine treatment on cognition and functional capacity in people with MS (PwMS). METHOD: MCID values were determined after SR-Fampridine treatment in 105 PwMS. Testing included the Timed 25 Foot Walk (T25FW), the Symbol Digit Modalities Test (SDMT), the Six Spot Step Test (SSST), the 9-Hole-Peg-Test (9-HPT), and the 5-Time-Sit-To-Stand test (5-STS)...
May 2016: Multiple Sclerosis and related Disorders
Eva Costa-Arpín, Antonio Pato, Ana Rodríguez-Regal, Luciana Midaglia, Rosa Yáñez, Delicias Muñoz, José R Lorenzo, Campo Amigo, José M Prieto
BACKGROUND: Gait disorder is very prevalent in multiple sclerosis. After 15 years of disease progression, 50% of patients need assistive devices for walking. MATERIALS & METHODS: We performed a multicenter observational study, including multiple sclerosis patients with an Expanded Disability Status Scale score between 4.0 and 7.0, normal kidney function and no previous history of seizures. RESULTS: The study sample comprised 138 patients with average age of 50...
April 2016: Neurodegenerative Disease Management
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