Fampridine-PR (prolonged released 4-aminopyridine) improves upper limb dysfunction in multiple sclerosis patients: Clinical and kinematic analysis

Introduction/Background Multiple sclerosis often results in upper limb dysfunction which significantly affects patients’ quality of life. However, little support is currently proposed for this deficit. Fampridine-PR is validated to improve walking speed but only few studies indicate that this drug may also be effective on upper limb function, with no detailed functional movement analysis. The aim of this study is to assess efficacy of fampridine-PR on improving grasping abilities in persons with Multiple Sclerosis (PwMS) by using a global analysis including both clinical and kinematic criteria. Material and method We included 14 consecutive PwMS with EDSS > 5 and we performed Jebsen Hand Function Test (JHFT) before treatment and under treatment. Patients showing a consistent improvement at D14 ( n  = 11 patients showing at least 12% reduction between D0 and D14) continued the treatment and the JHFT score were measured after 30 and 90 days under treatment. We also quantified upper force using dynamometers after 14, 30 and 90 days of treatment. In addition 3D kinematic analyses (grasping a glass) were realized with each arm on each assessment. Results JHFT score dropped from day 0 to day 14 by more than 20% and remained stable up to day 90. Individual analysis highlighted that improvement of JHFT score varied from 12.4% to 59.3% from initial score. The evolution of testing score followed the same trend. The hand dynanometer score remained heterogeneous. The kinematic analysis showed a better opening of the grip and a smoothing of the arm movement with less velocity peaks. Conclusion The results suggest that Fampridine-PR can significantly improve grasping function during at least the 90 days of our follow-up.