@article{70ec3c6351ef40f09f66f8606f32c3d4,
title = "Gait stability reflects motor tracts damage at early stages of multiple sclerosis",
abstract = "Background: Gait in people with multiple sclerosis (PwMS) is affected even when no changes can be observed on clinical examination. A sensitive measure of gait deterioration is stability; however, its correlation with motor tract damage has not yet been established. Objective: To compare stability between PwMS and healthy controls (HCs) and determine associations between stability and diffusion magnetic resonance image (MRI) measures of axonal damage in selected sensorimotor tracts. Methods: Twenty-five PwMS (Expanded Disability Status Scale (EDSS) < 2.5) and 15 HCs walked on a treadmill. Stability from sacrum (LDE SAC), shoulder (LDE SHO) and cervical (LDE CER) was calculated using the local divergence exponent (LDE). Participants underwent a 7T-MRI brain scan to obtain fibre-specific measures of axonal loss within the corticospinal tract (CST), interhemispheric sensorimotor tract (IHST) and cerebellothalamic tract (CTT). Correlation analyses between LDE and fibre density (FD) within tracts, fibre cross-section (FC) and FD modulated by FC (FDC) were conducted. Between-groups LDE differences were analysed using analysis of variance (ANOVA). Results: Correlations between all stability measures with CST FD, between CST FDC with LDE SAC and LDE CER, and LDE CER with IHST FD and IHST FDC were significant yet moderate (R < −0.4). Stability was significantly different between groups. Conclusions: Poorer gait stability is associated with corticospinal tract (CST) axonal loss in PwMS with no-to-low disability and is a sensitive indicator of neurodegeneration. ",
keywords = "7T-MRI, Lyapunov, Stability, balance, tractography, walking",
author = "{Cofr{\'e} Lizama}, {L. Eduardo} and Myrte Strik and {van der Walt}, Anneke and Kilpatrick, {Trevor J.} and Kolbe, {Scott C.} and Galea, {Mary P.}",
note = "Funding Information: The authors acknowledge the Traditional Owners of the land on which this study was carried out, and pay respect to elders past and present. They would like to thank all participants for their time. They also acknowledge the facilities, scientific and technical assistance from the National Imaging Facility, a National Collaborative Research Infrastructure Strategy (NCRIS) capability, at the Melbourne Brain Centre Imaging Unit, the University of Melbourne. They would also like to specifically thank Rebecca Glarin and Dr Camille Shanahan for their assistance in setting up the MRI protocol and recruiting and testing participants, and Dr Andisheh Bastani for her assistance with gait assessments. Imaging analysis was supported by the MASSIVE HPC facility ( www.massive.org.au ). Kilpatrick T.J. is an NHMRC Leadership Fellow. Funding Information: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: L. Eduardo Cofr{\'e} Lizama, Myrte Strik and Mary P. Galea have received no financial support for the research, authorship and/or publication of this article. Anneke van der Walt served on advisory boards for Novartis, Biogen, Merck and Roche and NervGen. She received unrestricted research grants from Novartis, Biogen, Merck and Roche. She is a co-principal investigator on a co-sponsored observational study with Roche, evaluating a Roche-developed smartphone app, Floodlight-MS. She has received speaker{\textquoteright}s honoraria and travel support from Novartis, Roche, Biogen and Merck. She serves as the Chief operating Officer of the MSBase Foundation (not for profit). Her primary research support is from the National Health and Medical Research Council of Australia and MS Research Australia. Scott Kolbe has received grant funding from Biogen, Ipsen and the Trish Foundation. Trevor Kilpatrick receives support from Novartis in the form of consultancy fees, honoraria for giving lectures and funding for a pre-clinical Investigator-Initiated Study (IIS). Publisher Copyright: {\textcopyright} The Author(s), 2022.",
year = "2022",
month = oct,
doi = "https://doi.org/10.1177/13524585221094464",
language = "English",
volume = "28",
pages = "1773--1782",
journal = "MULTIPLE SCLEROSIS JOURNAL",
issn = "1352-4585",
publisher = "SAGE Publications Ltd",
number = "11",
}