Abstract
Cerebellar impairment is frequent and predictive of disability in multiple sclerosis (MS). The Nine-Hole Peg Test (NHPT) is commonly used to assess cerebellar symptoms despite its lack of specificity for cerebellar ataxia. Eye-tracking is a reliable test for identifying subtle cerebellar symptoms and could be used in clinical trials, including those involving early MS patients. To evaluate, by the use of eye-tracking, the accuracy of the NHPT in detecting subtle cerebellar symptoms in patients with clinically isolated syndrome with a high risk of conversion to MS (HR-CIS). Twenty-nine patients and 13 matched healthy controls (HC) underwent an eye-tracking protocol. Cerebellar impairment was defined by registration of saccadic intrusions or at least 10 % dysmetria in a saccadic movement recording. These criteria were compared to NHPT performance. Sixteen patients fulfilled saccadic criteria for cerebellar impairment. NHPT performance was significantly increased in HR-CIS patients (p < 0.01) versus HC. However, NHPT performance did not differ between cerebellar and non-cerebellar groups. NHPT performance with the dominant hand could differentiate patients, particularly cerebellar patients, from HC, but it could not discriminate cerebellar from non-cerebellar patients who were classified according to saccadic criteria. These findings should be considered in future clinical trials involving HR-CIS patients.
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Acknowledgments
The authors thank Dr. JC Ouallet and Dr. P Louiset for referring patients to the study.
A. Moroso received research grant from the Fondation pour la Recherche Médicale (DEA20140630564).
This study was supported by ANR-10-LABX-57 Translational Research and Advanced Imaging Laboratory (TRAIL), laboratory of excellence and a grant from Teva. The sponsors did not participate in any aspect of the design or performance of the study, including data collection, management, analysis, and interpretation or the preparation, review, and approval of the manuscript.
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Each subject gave his or her written informed consent, and the study was approved by the local ethics committee.
Conflicts of Interest
Pr Brochet and Dr. Ruet or their institution received research grants and/or consulting fees from Actelion, Biogen-Idec, Bayer-Healthcare, Novartis, Genzyme, Roche, Medday, Merck-Serono, and Teva; A. Moroso, D. Hamel, M. Deloire, S. Cubizolle, J. Charré-Morin, and A. Saubusse have nothing to disclose.
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Moroso, A., Ruet, A., Deloire, M. et al. Cerebellar Assessment in Early Multiple Sclerosis. Cerebellum 16, 607–611 (2017). https://doi.org/10.1007/s12311-016-0831-8
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DOI: https://doi.org/10.1007/s12311-016-0831-8