“It’s like a disconnect” - Investigating the role of sensorimotor integration in upper extremity dysfunction in MS

Summary: Approximately half of people with MS report impairments in hand function, leading to difficulties performing everyday tasks and activities, such as using eating and buttoning clothing. Avoiding use of the troublesome limb not only leads to a decreased quality of life, but also affects disability development on a neurological level because disuse of a limb is related to negative changes in the brain (‘use it or lose it’). Furthermore, inactivity and disuse of the hands can lead to secondary wasting of muscles. The upper limb has been neglected in MS rehabilitation, and the current assessments are not capturing the full story of impairments. Therefore, new therapies that increase hand use are essential to the overall health of people with MS. This work aims to understand where in the brain the deficits are arising, a critical first step before therapies can be developed and delivered.

Project Description: Loss of manual dexterity is an alarming symptom for people with MS. Although half of people with MS report impairments in hand function, rehabilitative approaches are lacking. To advance the field, this group investigated the lived experiences of people with MS with hand dysfunction. Individuals described impairments of sensation that resulted in movements feeling ‘disconnected’. These findings pointed towards impairment in a process underlaying all forms of movement known as ‘sensorimotor integration’ that involves the communication between the sensory and motor parts of the brain. This pilot project will use mixed methods research to build upon these research findings, and be the first to electrophysiologically assess sensorimotor integration, and its relationship to hand function in people with MS.

Potential Impact:  In the long-term, the assessment of sensorimotor integration has the potential to change the course of treatment and rehabilitative interventions for individuals with MS. This laboratory will be the first to assess the integrity of sensorimotor pathways of the MS brain, rather than looking at one pathway in isolation, and relate it to motor recovery in MS. Using advanced neurological assessment of sensorimotor integration is a novel, viable approach to help clinicians and researchers develop better clinical treatments to improve the lives of people living with MS. 

Project Status: In progress