Relation between spasticity in patients with multiple sclerosis with the degree of disability, neurofunctional and neuropsychological disorders

Abstract

Objective — to analyze the relationship between the level of spasticity in patients with MS with the degree of neurological deficit by the EDSS scale and the results of neurofunctional and neuropsychological research.Methods and subjects. We examined 100 patients with a clinical diagnosis of MS with spasticity symptoms. The Modified Ashwort Scale was used to quantify the severity of changes in muscle tone. The EDSS scale was used to assess the degree of disability. T25‑FW and 9‑HPT tests were performed to assess the functional status of the upper and lower extremities. Neuropsychological tests were performed to assess pain on the VAS scale, fatigue on the MFIS scale, and EuroQol‑5D quality of life.Results. The highest level of total spasticity score was in the group of patients with the highest degree of disability 5.5 — 7.0 points and was 6.29 ± 0.82 points. The correlation and regression analysis confirmed that the following factors have the greatest correlation with the total score of spasticity: the level of total EDSS (coefficient of determination D = 42.1 %), pyramidal disorders (D = 50.7 %) and pelvic dysfunction (D = 44.4 %).Conclusions. There was a significant strong correlation between total spasticity and the degree of disability of patients with MS on the EDSS scale (rs = 0.649; p < 0.05), primarily pyramidal (rs = 0.712; p < 0.05) and pelvic disorders. As spasticity increases, the quality of life decreases and the level of fatigue increases. Mean correlations with the level of total spasticity were found with the MFIS scales and 2 EuroQol scales (rs = 0.555, 0.53 and 0.583, respectively, p < 0.05).The sensation of pain in patients increases (rs = 0.192; p < 0.05) with increasing spasticity level.