EDSS 0 is not normal: Multiple sclerosis disease burden below the clinical threshold
Stephen Krieger, Ali M. Antoine, James Sumowski
Abstract
Little to no above-threshold deficits may be evident in early multiple sclerosis (MS). The Expanded Disability Status Scale (EDSS) is a standard measure of neurologic function, with an EDSS score of 0 defined as "neurologically normal." The topographical model of MS proposes that sub-threshold disease is compensated for by functional reserve. In this short report, we found that physically high-challenge measures of balance and upper extremity coordination reveal sub-threshold deficits in patients with EDSS score of 0 compared with healthy controls. Challenge task performance was correlated with imaging markers of both lesional burden of disease and a volumetric measure of brain reserve.
Topics & Concepts
Multiple sclerosisExpanded Disability Status ScaleMedicinePhysical medicine and rehabilitationBalance (ability)DiseasePhysical therapyInternal medicinePsychiatryMultiple Sclerosis Research StudiesPeripheral Neuropathies and DisordersRheumatoid Arthritis Research and Therapies