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Ataxia in Multiple Sclerosis

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Essentials of Cerebellum and Cerebellar Disorders

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Abstract

It is well known that the cerebellum is commonly affected in patients with multiple sclerosis (MS), thus making everyday life activities such as walking or picking up objects extremely difficult for patients with advanced stages. Previous reports have discovered that as many as four out of five MS patients experience cerebellar ataxia, which is characterized by the inability to coordinate movements and maintain balance. Unfortunately, no treatment is currently available to effectively treat patient’s symptoms. What makes ataxia particularly challenging for rehabilitation experts is that it can cause widespread damage to both motor and sensory mechanisms of the central nervous system, thus the symptoms that patients exhibit vary tremendously from person to person. As a result of cerebellar damage, MS patients are also incapable of adjusting movements to the ever-changing environment, reflecting a damaged error-based motor learning mechanism that can impede rehabilitation interventions for gait, posture, and upper-limb movements. Here, we will provide a general overview of human cerebellar function and pathophysiology of ataxia and describe how this affects specific features of motor control and motor learning. Moreover, we will discuss clinical assessments of ataxia and detail how non-invasive brain stimulation can improve the symptoms of MS patients with concurrent rehabilitation therapy.

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Authors and Affiliations

  1. Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy

    Giacomo Koch

  2. Department of Clinical and Behavioral Neurology, IRCCS Santa Lucia Foundation, Rome, Italy

    Giacomo Koch & Danny Adrian Spampinato

Authors
  1. Giacomo Koch
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  2. Danny Adrian Spampinato
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Correspondence to Giacomo Koch .

Editor information

Editors and Affiliations

  1. Neuroscience Department, The Scripps Research Institute, La Jolla, CA, USA

    Donna L. Gruol

  2. Department of Integrative Physiology, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan

    Noriyuki Koibuchi

  3. Service de Neurologie, CHU-Charleroi, Charleroi, Belgium

    Mario Manto

  4. Clinical Translational Research, Santa Lucia Foundation, Rome, Italy

    Marco Molinari

  5. Ataxia Center, Cognitive Behavioral Neurology Unit, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Jeremy D. Schmahmann

  6. Department of Physiology, Zhejiang University School of Medicine, Hangzho, China

    Ying Shen

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Koch, G., Spampinato, D.A. (2023). Ataxia in Multiple Sclerosis. In: Gruol, D.L., Koibuchi, N., Manto, M., Molinari, M., Schmahmann, J.D., Shen, Y. (eds) Essentials of Cerebellum and Cerebellar Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-15070-8_102

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