Resumen

Abstract

Introduction: Fampridine is a symptomatic treatment recently approved for patients with multiple sclerosis (MS) based on the improvement in walking speed as measured by 25FWT. Specifically, describing its effect on primary progressive MS is of great interest since gait abnormalities represent the main source of disability. Approaching this goal with instrumental gait analysis (IGA) provides an opportunity to understand the underlying mechanisms of the beneficial action of Fampridine on walking. Objectives: To study the spatio-temporal changes in walking in primary progressive multiple sclerosis (PPMS) patients after 15 days of treatment with fampridine (10mg TID). Material and Methods: 10 PPMS patients were studied by instrumental gait analysis (IGA). 12 left (L) and right (R) standard spatio-temporal parameters were recorded: normalized speed according leg length (NWS), cadence (C), total stance time ([percnt]ST) -[percnt] of gait cycle and its distribution among one leg ([percnt]SS) and first ([percnt]1DS) and second double support ([percnt]2DS). Results were compared to 12 healthy controls matched by age. Approximation to normal mean was considered as improvement and was calculated as the difference between the absolute values of Z-score pre-treatment and those obtained after 15 days of starting treatment with fampridine. The 95[percnt] confidence interval was calculated by bias-corrected accelerated bootstrap. Results: After 15 days of daily treatment with fampridine, most of the Z-score of all spatio-temporal variables statistically significantly improved except of R [percnt]-1DS and R-[percnt]SS. Mean approximation to normal in Z-score (L/R) were: NWS: 0.69/0.41, C: 1.21/0.83, [percnt]ST 1.30/1.34, [percnt]1DS 0.61/0.68, [percnt]SS 0.32/0.13 and [percnt]2DS 0.19/0.13. Conclusions: A normalization of single support and total stance time produced by treatment with fampridine may indicate a greater stability during gait that allows patients to improve cadence and walking speed. Further studies are need for better comprehension of fampridine effects on gait.

Disclosure: Dr. Gonzalez has received personal compensation for activities with Novartis and Merck. Dr. pulido-valdeolivas has nothing to disclose. Dr. Gomez-Andres has nothing to disclose. Dr. Orviz-Garcia has received personal compensation for activities with Novartis. Dr. Montero-Atalaya has nothing to disclose. Dr. martin-gonzalo has nothing to disclose. Dr. rodriguez-andonaegui has nothing to disclose. Dr. rausell has nothing to disclose. Dr. Oreja-Guevara has received research support from Biogen and Merck Serono.