Self-reported scores on the Numeric Rating Scale (NRS) from patients with neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) were correlated with physicians’ scores on the Modified Ashworth Scale (MAS) (r =.934; P <.001), as published in Multiple Sclerosis and Related Disorders.

“Patients’ self-reported NRS score had a good correlation with clinician-evaluated MAS score for spasticity assessment in NMOSD and CNSIDD [central nervous system inflammatory demyelinating disease] patients overall,” the authors said.

They found that spasticity was much more common among patients with NMOSD than patients with MS (34% vs 8%; P =.016), and patients with NMOSD scored higher on both the NRS (1.6 vs 0.5; P =.022) and MAS (0.5 vs 0.1; P =.037) than patients with MS.


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When considering only NMOSD and MS patients with spasticity, however, the scores were not significantly different. “Spasticity in NMOSD had a higher prevalence and were more severe compared to MS,” the authors said.

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When all patients were combined together, those with spasticity also had higher rates of transverse myelitis (TM) attacks (P <.001), severe TM attacks (P <.001), and longitudinally extensive TM attacks (P <.001) compared to patients without spasticity. This trend was also observed among the subgroup of patients with NMOSD.

Patients with spasticity also had a longer disease duration than patients without (113 vs 97 months, P =.025) and also had more severe disability reported through the Expanded Disability Status Scale (EDSS; P <.001). Only half of the patients with spasticity (55%) had EDSS scores less than 3 compared to 93.2% of patients without spasticity.

“Our results showed that NRS could be used as a screening tool for the presence of spasticity in CNSIDD patients including MS and NMOSD. The tool required minimal time and training, thus suitable for a routine clinical encounter,” the authors said.

A total of 79 patients included in the study comprised 25 with MS, 53 with NMOSD, and 1 with myelin oligodendrocyte glycoprotein antibody disorder. Of these patients, 20 patients reported spasticity (2 with MS and 18 with NMOSD). No difference was found between the groups with NMOSD or MS in terms of age, sex, the total number of attacks, concomitant diseases, disease duration, and relapse-free time interval.

Reference

Jinkarn N, Tisavipat N, Jitprapaikulsan J, Prayoonwiwat N, Rattanathamsakul N, Siritho S. A comparison between subjective and objective measurements of spasticity in neuromyelitis optica spectrum disorder patients. Mult Scler Relat Disord. Published online January 10, 2022. doi:10.1016/j.msard.2022.103517