Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Multiple sclerosis – predicting treatment success

People with multiple sclerosis often have problems with their gait. A drug that can help them is unfortunately only effective in fewer than half of patients. Now medics from the Department of Neurology at the University of Würzburg have developed a method for predicting the success of this treatment.

People who suffer from multiple sclerosis (MS) have centers of inflammation in the brain and spinal cord, which cause symptoms that range in severity depending on their site and size. Many patients have gait problems that seriously impede them in everyday life.

The medicine of choice in this case is the agent fampridine, which has been approved in Germany since 2011. It blocks potassium channels on the surface of nerve axons and, in so doing, can improve the conductivity of nerve fibers. After taking fampridine, many sufferers are able to walk more quickly again; they also report that they feel steadier walking.

However, studies even before the approval of fampridine have shown that fewer than half of patients with MS actually benefit from taking the drug. The rest experience no change in their ability to walk. For this reason, physicians can currently only give the medication to their patients for two weeks initially as a trial. Only if the ability to walk has improved markedly after this time are they permitted to prescribe the drug on a permanent basis.

Magnetic stimulation to predict treatment success

A method for predicting treatment success has now been developed by scientists from the University of Würzburg. The team, led by medics Dr. Daniel Zeller and Dr. Mathias Buttmann, turned to a painless examination technique known as transcranial magnetic stimulation, which works without the use of harmful rays and has been used in clinical routine measurements for many years. The researchers have now published the results of their work in the Journal of Neurology, Neurosurgery and Psychiatry.

“We have taken a closer look at the correlation between the conduction velocity of motor pathways in the central nervous system and the response of gait disturbance to fampridine in patients with MS,” is how Daniel Zeller describes the study. Their findings are unequivocal: “With the help of magnetic stimulation it is possible to say in advance whether fampridine will improve a particular patient’s ability to walk,” says the medic.

The study

Twenty MS patients were examined by the scientists in this study. Prior to treatment with fampridine, they used transcranial magnetic stimulation to determine the so-called central motor conduction time (CMCT). This is the time that an electrical impulse takes to travel from the cerebral cortex to the nerve root level with the spine. “The central motor conduction time primarily reflects the degree of damage to motor pathways as a result of inflammatory demyelinating lesions,” explains Zeller.

The scientists also measured the walking speed of their study participants prior to beginning treatment as well as on day 14 of taking fampridine. Only if the speed increased by at least 20 percent over two different distances did they interpret this as a successful response to treatment.

The findings

The study revealed a significant correlation between the CMCT and the changes in walking speed while taking fampridine: the longer the CMCT was prior to treatment, the better the patients responded to the medication. In addition, the average CMCT prior to treatment in the group of treatment responders was significantly higher than in patients who did not respond to fampridine (the non-responders). The same result was also found when the scientists relaxed the response criterion to include a ten-percent improvement over both walking distances.

In summary, the study demonstrated that taking fampridine brought no improvements in walking speed for any patient with a normal CMCT. All the participants for whom the drug was effective had a longer CMCT prior to starting treatment. And only in some patients with a longer CMCT did fampridine treatment remain unsuccessful.

“This finding is consistent with what we presume is fampridine’s mode of action,” says Daniel Zeller. The agent ultimately improves impulse conduction in central pathways and their conduction velocity.

In particular, however, the study indicated that MS patients with a normal central conduction time are extremely unlikely to benefit from fampridine, whereas a longer CMCT prior to treatment increases the possibility of a response. If these results are confirmed by a larger study, magnetic stimulation could help neurologists in clinical practice to estimate the likely success of treatment with fampridine in advance, thereby avoiding unnecessary fampridine treatment trials.

About Transcranial Magnetic Stimulation

In Transcranial Magnetic Stimulation, physicians place a ring-shaped magnetic coil near the skull. This coil produces a rapidly changing magnetic field that sends magnetic impulses through the skullcap into the brain. There it triggers an action potential in the neurons and the nerve cell transmits an impulse, which in turn can be measured from outside. Even though the technology is only a few decades old, it is now routinely used in research and diagnostics.

Central motor conduction time may predict response to fampridine in multiple sclerosis patients. Daniel Zeller, Karlheinz Reiners, Stefan Bräuninger, Mathias Buttmann. J Neurol Neurosurg Psychiatry doi:10.1136/jnnp-2013-306860.


Dr. Daniel Zeller, Department of Neurology at the University of Würzburg
T: +49 (0)931 201-23766, e-mail: or
Dr. Mathias Buttmann, Department of Neurology at the University of Würzburg
T.: +49 (0)931 201-24617, e-mail:

Gunnar Bartsch | idw
Further information:

More articles from Health and Medicine:

nachricht UofL scientists identify critical pathway to improve muscle repair
01.12.2015 | University of Louisville

nachricht University of California Scientists Create Malaria-Blocking Mosquitoes
30.11.2015 | University of California, Irvine

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: How do Landslides control the weathering of rocks?

Chemical weathering in mountains depends on the process of erosion.

Chemical weathering of rocks over geological time scales is an important control on the stability of the climate. This weathering is, in turn, highly dependent...

Im Focus: How Cells in the Developing Ear ‘Practice’ Hearing

Before the fluid of the middle ear drains and sound waves penetrate for the first time, the inner ear cells of newborn rodents practice for their big debut. Researchers at Johns Hopkins report they have figured out the molecular chain of events that enables the cells to make “sounds” on their own, essentially “practicing” their ability to process sounds in the world around them.

The researchers, who describe their experiments in the Dec. 3 edition of the journal Cell, show how hair cells in the inner ear can be activated in the absence...

Im Focus: Climate study finds evidence of global shift in the 1980s

Planet Earth experienced a global climate shift in the late 1980s on an unprecedented scale, fuelled by anthropogenic warming and a volcanic eruption, according to new research published this week.

Scientists say that a major step change, or ‘regime shift’, in the Earth’s biophysical systems, from the upper atmosphere to the depths of the ocean and from...

Im Focus: Innovative Photovoltaics – from the Lab to the Façade

Fraunhofer ISE Demonstrates New Cell and Module Technologies on its Outer Building Façade

The Fraunhofer Institute for Solar Energy Systems ISE has installed 70 photovoltaic modules on the outer façade of one of its lab buildings. The modules were...

Im Focus: Lactate for Brain Energy

Nerve cells cover their high energy demand with glucose and lactate. Scientists of the University of Zurich now provide new support for this. They show for the first time in the intact mouse brain evidence for an exchange of lactate between different brain cells. With this study they were able to confirm a 20-year old hypothesis.

In comparison to other organs, the human brain has the highest energy requirements. The supply of energy for nerve cells and the particular role of lactic acid...

All Focus news of the innovation-report >>>



Event News

European Geosciences Union meeting: Media registration now open (EGU 2016 media advisory 1)

01.12.2015 | Event News

Urbanisation and migration from rural areas challenging agriculture in Eastern Europe

30.11.2015 | Event News

Fraunhofer’s Urban Futures Conference: 2 days in the city of the future

25.11.2015 | Event News

Latest News

USGS projects large loss of Alaska permafrost by 2100

01.12.2015 | Earth Sciences

New study reveals what's behind a tarantula's blue hue

01.12.2015 | Life Sciences

Climate Can Grind Mountains Faster Than They Can Be Rebuilt

01.12.2015 | Earth Sciences

More VideoLinks >>>