Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Multiple sclerosis – predicting treatment success

07.01.2014
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.

Contact

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

Gunnar Bartsch | idw
Further information:
http://www.uni-wuerzburg.de

More articles from Health and Medicine:

nachricht Correct connections are crucial
26.06.2017 | Charité - Universitätsmedizin Berlin

nachricht One gene closer to regenerative therapy for muscular disorders
01.06.2017 | Cincinnati Children's Hospital Medical Center

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: Can we see monkeys from space? Emerging technologies to map biodiversity

An international team of scientists has proposed a new multi-disciplinary approach in which an array of new technologies will allow us to map biodiversity and the risks that wildlife is facing at the scale of whole landscapes. The findings are published in Nature Ecology and Evolution. This international research is led by the Kunming Institute of Zoology from China, University of East Anglia, University of Leicester and the Leibniz Institute for Zoo and Wildlife Research.

Using a combination of satellite and ground data, the team proposes that it is now possible to map biodiversity with an accuracy that has not been previously...

Im Focus: Climate satellite: Tracking methane with robust laser technology

Heatwaves in the Arctic, longer periods of vegetation in Europe, severe floods in West Africa – starting in 2021, scientists want to explore the emissions of the greenhouse gas methane with the German-French satellite MERLIN. This is made possible by a new robust laser system of the Fraunhofer Institute for Laser Technology ILT in Aachen, which achieves unprecedented measurement accuracy.

Methane is primarily the result of the decomposition of organic matter. The gas has a 25 times greater warming potential than carbon dioxide, but is not as...

Im Focus: How protons move through a fuel cell

Hydrogen is regarded as the energy source of the future: It is produced with solar power and can be used to generate heat and electricity in fuel cells. Empa researchers have now succeeded in decoding the movement of hydrogen ions in crystals – a key step towards more efficient energy conversion in the hydrogen industry of tomorrow.

As charge carriers, electrons and ions play the leading role in electrochemical energy storage devices and converters such as batteries and fuel cells. Proton...

Im Focus: A unique data centre for cosmological simulations

Scientists from the Excellence Cluster Universe at the Ludwig-Maximilians-Universität Munich have establised "Cosmowebportal", a unique data centre for cosmological simulations located at the Leibniz Supercomputing Centre (LRZ) of the Bavarian Academy of Sciences. The complete results of a series of large hydrodynamical cosmological simulations are available, with data volumes typically exceeding several hundred terabytes. Scientists worldwide can interactively explore these complex simulations via a web interface and directly access the results.

With current telescopes, scientists can observe our Universe’s galaxies and galaxy clusters and their distribution along an invisible cosmic web. From the...

Im Focus: Scientists develop molecular thermometer for contactless measurement using infrared light

Temperature measurements possible even on the smallest scale / Molecular ruby for use in material sciences, biology, and medicine

Chemists at Johannes Gutenberg University Mainz (JGU) in cooperation with researchers of the German Federal Institute for Materials Research and Testing (BAM)...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Plants are networkers

19.06.2017 | Event News

Digital Survival Training for Executives

13.06.2017 | Event News

Global Learning Council Summit 2017

13.06.2017 | Event News

 
Latest News

Predicting eruptions using satellites and math

28.06.2017 | Earth Sciences

Extremely fine measurements of motion in orbiting supermassive black holes

28.06.2017 | Physics and Astronomy

Touch Displays WAY-AX and WAY-DX by WayCon

27.06.2017 | Power and Electrical Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>