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NOT YET RECRUITING
NCT07128160

Cortical Inhibition in Patients With Multiple Sclerosis

Sponsor: Assiut University

View on ClinicalTrials.gov

Summary

1. To investigate the relationship between corticospinal inhibition and clinical, psychological, and cognitive features in MS patients. 2. To examine the association between corticospinal inhibition and radiological findings, including MRI lesions and white matter damage

Official title: The Relationship Between Neuropsychiatric, Radiological Findings and Cortical Inhibition in Patients With Multiple Sclerosis: A Hospital-based Study

Key Details

Gender

All

Age Range

18 Years - Any

Study Type

OBSERVATIONAL

Enrollment

50

Start Date

2025-11-01

Completion Date

2026-12

Last Updated

2025-08-17

Healthy Volunteers

No

Interventions

OTHER

Clinical and Demographic Assessment

1. Expanded Disability Status Scale (EDSS) (Kurtzke, 1983): This scale will be used for neurological disability assessment 2. Multiple Sclerosis Functional Composite (MSFC): This composite will be used for the assessment of functional performance in patients with MS. It includes: a) Timed 25-foot walk (T25FW), b) Nine-hole peg test (9HPT) for both hands, and c) Paced auditory serial addition test (PASAT). 3. Toronto Alexithymia Scale (TAS-20): This scale reports Alexithymia. It is a 20-item self-report questionnaire measuring three domains: Difficulty identifying feelings (DIF), Difficulty describing feelings (DDF), and externally oriented thinking (EOT). A score ≥ 61 indicates alexithymia (Bagby, Parker \& Taylor, 1994). 4. Montreal Cognitive Assessment (MoCA), (Nasreddine ZS et al, 2005): a 30-point tool that investigates visuospatial abilities, language, attention, memory, abstraction, and orientation, with scores \<26 suggestive of mild cognitive impairment

OTHER

Corticospinal Inhibition Assessment

Corticospinal inhibition will be evaluated using Transcranial Magnetic Stimulation (TMS) (Ayache et al., 2022; Chalah et al., 2018). All TMS assessments will be conducted according to international safety guidelines. The following parameters will be measured: 1. Motor Evoked Potentials (MEPs) will be recorded from the abductor pollicis brevis muscle. 2. Cortical silent period (CSP) will be assessed to measure corticospinal excitability and inhibition. 3. The interhemispheric inhibition (IHI) is a parameter reflecting the transcallosal GABA-mediated inhibitory activity. It will be obtained at complete muscle rest using figure-of-eight coils (MC-B70; MagVenture), connected with a MagPro\_R20 (Medtronic Inc., USA) generator connected to a butterfly coil.

OTHER

Radiological Assessment

All patients will undergo brain and spinal cord Magnetic Resonance Imaging (MRI) using a 1.5T scanner. Brain MRI sequences include: T1-weighted, T2-weighted, FLAIR, and post-contrast sequences. Spinal MRI (cervical and thoracic) includes T2-weighted and STIR sequences. Radiological assessment focused on: * Number and location of T2/FLAIR lesions * Presence of contrast-enhancing lesions * Degree of brain atrophy (qualitatively) * Spinal cord lesion load A neuroradiologist will review MRI findings, blinded to the clinical and neuropsychological data