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author Bralić, Antonia
Pavelin, Sanda
Pleić, Nikolina
Šoda, Joško
Dolić, Krešimir
Markotić, Anita
Ćurković Katić, Ana
Mastelić, Angela
Režić Mužinić, Nikolina
Duranović, Jasna
Kljajić, Zlatko
Stipica Safić, Ivona
Đogaš, Zoran
Rogić Vidaković, Maja
author_facet Bralić, Antonia
Pavelin, Sanda
Pleić, Nikolina
Šoda, Joško
Dolić, Krešimir
Markotić, Anita
Ćurković Katić, Ana
Mastelić, Angela
Režić Mužinić, Nikolina
Duranović, Jasna
Kljajić, Zlatko
Stipica Safić, Ivona
Đogaš, Zoran
Rogić Vidaković, Maja
Bralić, Antonia
Pavelin, Sanda
Pleić, Nikolina
Šoda, Joško
Dolić, Krešimir
Markotić, Anita
Ćurković Katić, Ana
Mastelić, Angela
Režić Mužinić, Nikolina
Duranović, Jasna
Kljajić, Zlatko
Stipica Safić, Ivona
Đogaš, Zoran
Rogić Vidaković, Maja
collection PubMed - marine biology
contents Correspondence of MRI and nTMS With EDSS in Multiple Sclerosis: Longitudinal Follow-Up Study. Bralić, Antonia Pavelin, Sanda Pleić, Nikolina Šoda, Joško Dolić, Krešimir Markotić, Anita Ćurković Katić, Ana Mastelić, Angela Režić Mužinić, Nikolina Duranović, Jasna Kljajić, Zlatko Stipica Safić, Ivona Đogaš, Zoran Rogić Vidaković, Maja Adult Female Humans Male Middle Aged Disability Evaluation Evoked Potentials, Motor Follow-Up Studies Longitudinal Studies Magnetic Resonance Imaging Multiple Sclerosis, Relapsing-Remitting Pyramidal Tracts Severity of Illness Index Transcranial Magnetic Stimulation Considering the characteristics of multiple sclerosis (MS) disease and its impact on motor disability, this study aims to assess the functional integrity of the corticospinal tract by examining motor evoked potentials (MEPs), Expanded Disability Status Scale (EDSS) scores, magnetic resonance imaging (MRI) lesion counts, and psychological and physical status reported by patients with relapsing-remitting MS (RRMS). In 23 RRMS subjects (17 in the follow-up), the corticospinal tract for upper and lower extremity muscles was longitudinally studied over 2 years using navigated transcranial magnetic stimulation (nTMS) and MEP scoring. MRI parameters included lesion detection by applying McDonald's criteria and additional lesion detection of the corticospinal tract. EDSS scoring included evaluation of the EDSS general score, EDSS functional pyramidal score, and EDSS functional pyramidal score for each extremity. Longitudinal analyses of nTMS (MEP), EDSS, and MRI parameters were conducted using linear mixed models with time, sex, age, and disease duration as fixed effects and individual-specific random intercepts. The correspondence of MRI and nTMS scoring with the EDSS pyramidal scoring was tested using McNemar's or Fisher's exact test. RRMS patients with altered MEP latency had significantly higher general EDSS scores (β = -2.06, p = 0.006) and overall pyramid EDSS scores (β = -1.96, p = 0.002) compared to those with non-altered MEP latency. This difference was also observed in lower extremity pyramid EDSS scores, with higher scores in the right (β = -1.70, p = 0.001) and left leg (β = -1.50, p = 0.032) in the altered MEP latency group. RRMS patients with altered MEP latency had significantly more lesions in the corpus callosum (β = 2.38, p = 0.03) compared to subjects with non-altered MEP latency findings. The correspondence of MRI and nTMS (MEP latency) with EDSS scoring was confirmed. RRMS subjects with altered MEP latency findings (prolonged MEP latency or absent MEP response) compared to subjects with non-altered MEP latency findings, had higher EDSS scores in lower extremity muscles as well as a higher number of lesions in the corpus callosum. This is the first longitudinal nTMS study to perform four-limb cortical mapping of corticospinal tract integrity in RRMS. The study opens perspectives for the nTMS as an objective method for longitudinally assessing MS motor disability. ClinicalTrials.gov identifier: NCT04604041.
format Artículo científico
id pubmed_40244940
institution PubMed
language en
publishDate 2025
publisher Annals of clinical and translational neurology
record_format pubmed
spellingShingle Correspondence of MRI and nTMS With EDSS in Multiple Sclerosis: Longitudinal Follow-Up Study.
Bralić, Antonia
Pavelin, Sanda
Pleić, Nikolina
Šoda, Joško
Dolić, Krešimir
Markotić, Anita
Ćurković Katić, Ana
Mastelić, Angela
Režić Mužinić, Nikolina
Duranović, Jasna
Kljajić, Zlatko
Stipica Safić, Ivona
Đogaš, Zoran
Rogić Vidaković, Maja
Adult
Female
Humans
Male
Middle Aged
Disability Evaluation
Evoked Potentials, Motor
Follow-Up Studies
Longitudinal Studies
Magnetic Resonance Imaging
Multiple Sclerosis, Relapsing-Remitting
Pyramidal Tracts
Severity of Illness Index
Transcranial Magnetic Stimulation
Correspondence of MRI and nTMS With EDSS in Multiple Sclerosis: Longitudinal Follow-Up Study. Bralić, Antonia Pavelin, Sanda Pleić, Nikolina Šoda, Joško Dolić, Krešimir Markotić, Anita Ćurković Katić, Ana Mastelić, Angela Režić Mužinić, Nikolina Duranović, Jasna Kljajić, Zlatko Stipica Safić, Ivona Đogaš, Zoran Rogić Vidaković, Maja Adult Female Humans Male Middle Aged Disability Evaluation Evoked Potentials, Motor Follow-Up Studies Longitudinal Studies Magnetic Resonance Imaging Multiple Sclerosis, Relapsing-Remitting Pyramidal Tracts Severity of Illness Index Transcranial Magnetic Stimulation Considering the characteristics of multiple sclerosis (MS) disease and its impact on motor disability, this study aims to assess the functional integrity of the corticospinal tract by examining motor evoked potentials (MEPs), Expanded Disability Status Scale (EDSS) scores, magnetic resonance imaging (MRI) lesion counts, and psychological and physical status reported by patients with relapsing-remitting MS (RRMS). In 23 RRMS subjects (17 in the follow-up), the corticospinal tract for upper and lower extremity muscles was longitudinally studied over 2 years using navigated transcranial magnetic stimulation (nTMS) and MEP scoring. MRI parameters included lesion detection by applying McDonald's criteria and additional lesion detection of the corticospinal tract. EDSS scoring included evaluation of the EDSS general score, EDSS functional pyramidal score, and EDSS functional pyramidal score for each extremity. Longitudinal analyses of nTMS (MEP), EDSS, and MRI parameters were conducted using linear mixed models with time, sex, age, and disease duration as fixed effects and individual-specific random intercepts. The correspondence of MRI and nTMS scoring with the EDSS pyramidal scoring was tested using McNemar's or Fisher's exact test. RRMS patients with altered MEP latency had significantly higher general EDSS scores (β = -2.06, p = 0.006) and overall pyramid EDSS scores (β = -1.96, p = 0.002) compared to those with non-altered MEP latency. This difference was also observed in lower extremity pyramid EDSS scores, with higher scores in the right (β = -1.70, p = 0.001) and left leg (β = -1.50, p = 0.032) in the altered MEP latency group. RRMS patients with altered MEP latency had significantly more lesions in the corpus callosum (β = 2.38, p = 0.03) compared to subjects with non-altered MEP latency findings. The correspondence of MRI and nTMS (MEP latency) with EDSS scoring was confirmed. RRMS subjects with altered MEP latency findings (prolonged MEP latency or absent MEP response) compared to subjects with non-altered MEP latency findings, had higher EDSS scores in lower extremity muscles as well as a higher number of lesions in the corpus callosum. This is the first longitudinal nTMS study to perform four-limb cortical mapping of corticospinal tract integrity in RRMS. The study opens perspectives for the nTMS as an objective method for longitudinally assessing MS motor disability. ClinicalTrials.gov identifier: NCT04604041.
title Correspondence of MRI and nTMS With EDSS in Multiple Sclerosis: Longitudinal Follow-Up Study.
topic Adult
Female
Humans
Male
Middle Aged
Disability Evaluation
Evoked Potentials, Motor
Follow-Up Studies
Longitudinal Studies
Magnetic Resonance Imaging
Multiple Sclerosis, Relapsing-Remitting
Pyramidal Tracts
Severity of Illness Index
Transcranial Magnetic Stimulation
url https://pubmed.ncbi.nlm.nih.gov/40244940/