Effect of Fampridine-PR (prolonged released 4-aminopyridine) on the manual functions of patients with Multiple Sclerosis

Background Persons with MS (PwMS) commonly present ambulatory and manual dysfunctions. While ambulation is recognized as important to PwMS, manual dysfunction is only lately gaining attention. Fampridine-PR was approved for MS ambulatory impairments. Anecdotal evidences indicate possible therapeutic effects on manual function. Objective To comprehensively assess the effect of Fampridine-PR on manual functions of PwMS. Methods Twenty six PwMS with ambulatory and manual dysfunction assessed before, 1 and 3 months after treatment with Fampridine-PR, applying Timed 25-Foot Walk (T25FW) for ambulation while manual functions were evaluated by several tools addressing the International Classification of Functioning (ICF) concepts. This includes hand grip and pinch strength, 9 Hole Peg Test (9HPT), Arthritis Hand Function Test (AHFT), activities of daily life (ADL) tests, ABILHAND questionnaire and Computerized Penmanship Evaluation Tool (ComPET). Results Fampridine-PR increased dominant hand grip and pinch strength 1 month following treatment initiation by 12% and 10% (p < 0.05), respectively. 9HPT improved by 11.3% after 3 months of treatment (p < 0.05%) and ABILHAND improved by 16% and 31% (p < 0.05%) after 1 and 3 months of treatment. Mean stroke duration in air of the name writing task improved by 21% (p < 0.05) following 3 months of treatment. T25FW results were similar to previous reports. Conclusion The results of this pilot study suggest that Fampridine-PR improves manual function of PwMS. Methods herein indicate that an integrative approach may be useful for evaluation of manual function in MS and in additional neurological diseases.