title: Imbalance in multiple sclerosis and neuromyelitis optica: association with deep sensation disturbance.
abstract: Abnormality in balance is one of the most important causes of gait disturbance which has a direct impact to disability and medical cost in multiple sclerosis (MS) and neuromyelitis optica (NMO). However, characteristics of imbalance in these two diseases have not been fully elucidated. The aim of this study was to evaluate the degree and features of imbalance using stabilography, the degree of deep sensation disturbance using tibial nerve somatosensory evoked potentials (SEP), and their association with clinical impairment, in patients with MS and NMO. Seven NMO patients and seven MS patients with balance disturbance were examined. The relationship among stabilography measurements representing the degree and features of imbalance, height-adjusted P38 peak latency of SEP, and neurological functional disability, were analyzed. Stabilography evaluation showed a significantly severer degree of imbalance in NMO than in MS. Romberg quotient of the patients with brainstem lesions was significantly larger than those without them. In all patients, length of excursion per second significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. In all patients and in NMO, P38 peak latency adjusted by height significantly correlated positively with anterio-posterior-axis power spectra at intermediate frequency band. These findings suggest that the degree of imbalance of MS and NMO possibly correlate with deep sensation disturbance, which could be evaluated by anterio-posterior-axis power spectra at intermediate frequency band by stabilography. Severer imbalance in NMO than MS may be associated with the severe longitudinally extensive spinal cord lesions.
authors: Department of Clinical Laboratory, Utano National Hospital, National Hospital Organization, Kyoto, Japan.|Department of Clinical Laboratory, National Cerebral and Cardiovascular Center, Osaka, Japan.
authors: Yutaka
authors: Y
authors: Demura
authors: Department of Neurology, Utano National Hospital, National Hospital Organization, 8 Ondoyama-Cho, Narutaki, Ukyoku, Kyoto, 616-8255, Japan. machak@kuhp.kyoto-u.ac.jp.
authors: Masako
authors: M
authors: Kinoshita
authors: Department of Clinical Laboratory, Utano National Hospital, National Hospital Organization, Kyoto, Japan.
authors: Osamu
authors: O
authors: Fukuda
authors: Department of Clinical Laboratory, Utano National Hospital, National Hospital Organization, Kyoto, Japan.
authors: Shouzou
authors: S
authors: Nose
authors: Department of Neurology, Utano National Hospital, National Hospital Organization, 8 Ondoyama-Cho, Narutaki, Ukyoku, Kyoto, 616-8255, Japan.
authors: Hitoshi
authors: H
authors: Nakano
authors: Department of Clinical Laboratory, Utano National Hospital, National Hospital Organization, Kyoto, Japan.
authors: Akira
authors: A
authors: Juzu
authors: Department of Neurology, Kyoto Medical Center, National Hospital Organization, Kyoto, Japan.
authors: Nagako
authors: N
authors: Murase
authors: Department of Neurology, Utano National Hospital, National Hospital Organization, 8 Ondoyama-Cho, Narutaki, Ukyoku, Kyoto, 616-8255, Japan.
authors: Kenji
authors: K
authors: Yamamoto
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D004569:Electroencephalography; D004576:Electromyography; D005073:Evoked Potentials, Somatosensory / Q000502:physiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009471:Neuromyelitis Optica / Q000150:complications*; D004856:Postural Balance / Q000502:physiology*; D012678:Sensation Disorders / Q000209:etiology*; D013223:Statistics as Topic; D018709:Statistics, Nonparametric
keywords: Clinical Neurophysiology; Equilibrium; Multiple sclerosis; Neuromyelitis optica; Somatosensory evoked potentials; Stabilography