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Neurophysiological impairments in multiple sclerosis - central and peripheral motor pathways

Mamoei, S., Hvid, L. G., Boye Jensen, H., Zijdewind, I., Stenager, E. & Dalgas, U., 31-May-2020, In : Acta neurologica Scandinavica. 142, 5, p. 401-417 44 p.

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  • Neurophysiological impairments in multiple sclerosis – central and peripheral motor pathways

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DOI

  • Sepehr Mamoei
  • Lars G Hvid
  • Henrik Boye Jensen
  • Inge Zijdewind
  • Egon Stenager
  • Ulrik Dalgas

A systematic review of the literature was conducted comparing neurophysiological outcomes in persons with multiple sclerosis (PwMS) to healthy controls (HC), in studies of the central nervous system (CNS) function comprising motor evoked potentials (MEP) elicited by transcranial magnetic stimulation (TMS) and in studies of the peripheral nervous system (PNS) function comprising electroneuronography (ENG) outcomes elicited by peripheral nerve stimulation. Studies comparing neuromuscular function, assessed during maximal voluntary contraction (MVC) of muscle, were included if they reported muscle strength along with muscle activation by use of electromyography (EMG) and/or interpolated twitch technique (ITT). Studies investigating CNS function showed prolonged central motor conduction times, asymmetry of nerve conduction motor pathways, and prolonged latencies in PwMS when compared to HC. Resting motor threshold, amplitude, and cortical silent periods showed conflicting results. CNS findings generally correlated with disabilities. Studies of PNS function showed near significant prolongation in motor latency of the median nerve, reduced nerve conduction velocities in the tibial and peroneal nerves, and decreased compound muscle action potential amplitudes of the tibial nerve in PwMS. ENG findings did not correlate with clinical severity of disabilities. Studies of neuromuscular function showed lower voluntary muscle activation and increased central fatigue in PwMS, whereas EMG showed divergent muscle activation (ie, EMG amplitude) during MVC. When comparing the existing literature on neurophysiological motor examinations in PwMS and HC, consistent and substantial impairments of CNS function were seen in PwMS, whereas impairments of the PNS were less pronounced and inconsistent. In addition, impairments in muscle activation were observed in PwMS.

Original languageEnglish
Pages (from-to)401-417
Number of pages44
JournalActa neurologica Scandinavica
Volume142
Issue number5
Publication statusE-pub ahead of print - 31-May-2020

ID: 126806653