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Tic Suppression Ability Predicts Future Symptom Outcomes, Wearable-Detected Gait Changes Predict Parkinson Disease, Early MRI Scans Predict Relapse-Onset Multiple Sclerosis

Neurology News Network for the week ending August 3, 2019.

This week, Neurology News Network covered the results from the NewTics study, study results that suggest that wearable devices can play an important role in the identification of prodromal Parkinson disease and its progression, and a study that found that MRI abnormalities can predict long-term outcomes in relapse-onset multiple sclerosis (transcript below).

Jenna: Welcome to Neurology News Network. I’m Jenna Payesko. Let’s get into the news from this week.

Recent results from the NewTics study suggest that better ability to suppress tics within months of tic onset may be a predictor of future symptom outcomes in patients with tic disorders. Ultimately, 45 children with a mean of 3.47 months since their tic onset showed a better tic severity at their 12-month follow-up visit when they were able to suppress tics in the presence of a reward. Tic suppression was also found to be particularly successful when patients received a contingent reward.

“Specifically, in children with recent-onset tics, we found that those children with better tic suppression in the presence of a reward had lower tic burden at the 1-year anniversary of tic onset, the time when a persistent tic disorder can first be diagnosed. Thus, we have identified a potential predictor of clinical outcome in provisional tic disorder,” the authors wrote.

In combination with prodromal markers, quantitative gait characteristics measured by wearable devices can play an important role in the identification of prodromal Parkinson disease and its progression, new study results suggest. Additionally, the findings help confirm the timing of these changes, which appear to occur within 4—5 years prior to diagnosis.

The study was an attempt to establish gait impairments and trajectories within this phase of Parkinson disease, and identify which gait characteristics within 5 domains—pace, variability, rhythm, asymmetry, and postural control—are potentially early diagnostic markers of Parkinson. Investigators found that at usual-speed walking, the domains of gait variability, pace, asymmetry, and postural control were significantly predictive of conversion to Parkinson.

A recent study found that MRI abnormalities such as early focal inflammatory disease activity and spinal cord lesions seen around the time of presentation with clinically isolated syndrome and throughout the first few years after disease onset predict the development of long-term outcomes in relapse-onset multiple sclerosis.

Researchers aimed to identify early MRI predictors of long-term outcomes in relapse-onset multiple sclerosis including secondary progressive disease course, physical disability, and cognitive performance, and to do so, studied a cohort of subjects with clinically isolated syndrome suggestive of multiple sclerosis who underwent MRI scans around the time of presentation and follow-up MRI scans after 1 and 3 years.

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