Evaluation of the effect of antispastic therapy in patients with multiple sclerosis based on the results of clinical and neurofunctional, neurophysiological and neuropsychological studies

Abstract

Objective: to conduct a comprehensive clinical and instrumental assessment of the effectiveness of antispastic therapy in multiple sclerosis patients. The observation of 68 patients with multiple sclerosis. The patients took three antispastic drugs — baclofen, thiocolchicoside (muscomed), tolperisone (midocalm). The degree of neurological deficit was assessed on the EDSS scale, the level of spasticity on the Ashworth scale, an electroneuromyographic study was performed using a stimulation non-invasive technique. Patients underwent a Timed-25-Footwalk test and a 9-Hole Peg Test. Patients completed questionnaires to assess quality of life (EuroQol-5D), fatigue (MFIS), pain (VAS). The assessment was carried out before treatment, after 10 days and after 2 months. In the group of patients who took thiocolchicoside, the total spasticity score was 12.87 ± 3.35, tolperisone — 14.17 ± 3.99, baclofen — 17.03 ± 3.74. 10 days after treatment, the total spasticity score decreased in all groups of patients. In the thiocolchicoside group the EDSS before treatment was 5.15 ± 0.88, tolperisone — 5.05 ± 0.63, baclofen — 5.68 ± 0.82. The effect size was strong in Cohen and Glass. After 10 days, the average EDSS score in the group of patients taking thiocolchicoside was 5.06 ± 0.85, tolperisone — 4.98 ± 0.56, baclofen — 5.55 ± 0.79 (p < 0.05). Ambulation scores were significantly improved in three groups of patients, which influenced the EDSS score. The studied drugs reliably reduce spasticity and improve the quality of life of patients, improve stroke rates, reduce fatigue and pain, test scores T25-FW, 9-HPT, the effect of treatment was stable during 2 months. Effect size measures were strong in total spasticity. When using thiocolchicoside, the M-amplitude indicator significantly increases in patients.