The Efficacy of Fampridine on Upper Extremity Functions in Individuals with Multiple Sclerosis: Is There a Difference between Cerebellar and Pyramidal Dysfunction?

INTRODUCTION: Similar to its positive effect on the lower extremities, fampridine can also affect upper extremity dysfunction. This study evaluated the potential effect of fampridine therapy on upper extremity functions in patients with multiple sclerosis (pwMS) by comparing these on the basis of cerebellar and pyramidal dysfunctions.
METHODS: Patients aged between 18 and 60 years with a diagnosis of multiple sclerosis and eligible for fampridine therapy due to walking difficulties were followed-up. Of these, patients with problems such as lack of coordination in hand functions or deficiencies in fine motor skills, dressing, writing, and/or buttoning were invited to take part in the study. Upper extremity functions were evaluated using the 9-Hole Peg Test (9-HPT), and general disability was evaluated with the Expanded Disability Status Scale.
RESULTS: One hundred fifty-nine patients were followed-up for 12 months, and 151of them were included in the analysis. Seventy-seven (50 women) healthy controls (HCs) were also included. There was no statistically significant difference between the demographic characteristics of the two groups. A 19.8% improvement was observed in 9-HPT scores after one month of treatment (p=0.004). This improvement was observed to persist at the 24th month. Patients with a cerebellar FS score of 0 to 2 (n=76) improved significantly more (p<0.001) than those (23.5%) with a cerebellar FS score of 3 or higher (9.2%).
DISCUSSION AND CONCLUSION: The results of this study show that fampridine improves upper extremity functions in pwMS. This improvement was more pronounced in the group with cerebellar dysfunction.