Clinical Types of Movement Disorders in Patients with Multiple Sclerosis
Bibliographic record
Abstract
Background Little is known about the true prevalence and clinical characteristics of movement disorders in early multiple sclerosis (MS), associated clinical disability and their effect on QOL. We conducted a cross sectional study to fill this knowledge gap. Objectives to study the prevalence of movement disorders in early stages of multiple sclerosis, presence of other clinical disability and their effect on QOL. Patients and method This is a cross sectional observational study. The patients group included 250 patients with RRMS whom were recruited consecutively from the MS clinic of Ain Shams and Nasr institute hospitals. Each eligible patient was interviewed and examined for presence of movement disorders, Patients were divided into 2 groups, group A without movement disorders and group B showing movement disorders. General and neurological examination including Expanded Disability Status Scale (EDSS) score at time of interview for both groups. Magnetic resonance imaging (MRI) of brain and cervical spinal cord (with contrast whenever available) obtained at the time of interview with documentation of MS plaques involvement for both groups. RRMS patients with movement disorders (group B) are subjected to different assessment for depression by Beck Depression Inventory (BDI), cognitive assessment by Montreal Cognitive Assessment (MOCA) scale, disability and quality of life (QOL) by the Short Form 36 Health Survey Questionnaire. Results This study included 250 RRMS. onset of their movement disorders was 2.69 ± 2.34 years from MS diagnosis with mean EDSS 3.515 ± 1.04. Cerebellar signs are present in 97% of total number of movement disorders and 26% of total sample, regarding tremors, 36 patients in this study showed tremors representing 53.7% of movement disorders patients, 14.4% of total sample of RRMS patients. This study showed presence of 5 cases of restless leg syndrome 7.5% of total number of MD. 4 cases of dystonia are present in this study representing 6% of MD patients. Patients with MD showed presence of depressive symptoms and cognitive affection with negative impact on QOL. Tremors severity is not correlated with either cognition or depression scores where ataxia is correlated with depression score only. MRI assessment of patients with MD showed higher lesion load and involvement of infratentorial structures especially cerebellum and its connections and cerebellum. Conclusion Movement disorders are common to occur than previously known especially ataxia and tremors early in the course of the disease. Presence of MD is related to high lesion load and strategic location of these lesions. special assessment of movement disorders as independent cause of disability with concomitant depression and cognitive impairment especially early in the disease course should be taken in consideration due to their negative impact on QOL.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".