Hostname: page-component-77c89778f8-cnmwb Total loading time: 0 Render date: 2024-07-17T01:10:57.587Z Has data issue: false hasContentIssue false
  • English
  • Français

The Vibration Quantitation Scale (VQS): A Simple, Reproducible Bedside Measure of Sensory Function in Multiple Sclerosis

Published online by Cambridge University Press:  02 December 2014

J. Carter ,
T. Wasser ,
S. Statler  and
A.D. Rae-Grant
J. Carter
Affiliation:
Lehigh Valley Hospital, Allentown, Pa. 18103 USA
T. Wasser
Affiliation:
Lehigh Valley Hospital, Allentown, Pa. 18103 USA
S. Statler
Affiliation:
Lehigh Valley Hospital, Allentown, Pa. 18103 USA
A.D. Rae-Grant
Affiliation:
Lehigh Valley Hospital, Allentown, Pa. 18103 USA
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Objectives:

To assess the utility of a bedside measure of sensation (the Vibration Quantitation Scale (VQS)) in patients with multiple sclerosis (MS) and in normal controls. To correlate the VQS with the Kurtzke Expanded Disability Severity Score (EDSS) and sensory abnormalities in these patients.

Methods:

We developed the VQS and tested its performance in patients with MS of various ages, MS types, and EDSS scores. We compared this with controls (normal volunteers or patients with other neurological diseases) who did not have sensory symptoms. In a subgroup, two examiners measured VQS independently at the same patient visit. Astandard C-128 tuning fork was used for the VQS measurement.

Results:

The VQS had a good inter-observer reproducibility (r=0.920, p<0.001). The VQS fell with increasing age in normals consistent with declining sensory function. The VQS was significantly lower in the multiple sclerosis patients compared with age - matched controls (p<0.001). Abnormalities in VQS were present in patients with brief duration of MS (<5 years) and low EDSS scores, correlating with the presence of sensory abnormalities early in the disease course in some patients. There was a strong correlation between the VQS and EDSS (r=-0.509). The VQS correlated with abnormal sensation in the hands (r=0.310), but did not meet statistical significance for abnormal sensation in the feet or face. Asecond cohort of MS patients was studied using a modified VQS measure (single stimulation, omitting forehead measurement). This reconfirmed the correlation between the modified VQS and EDSS as well as with age. The modified VQS may be useful in clinical practice since it takes little time and is strongly correlated with the EDSS (r=0.578).

Conclusion:

The VQS provides a continuous sensory scale applicable in most patients with MS, which is measurable with standard bedside equipment, and which may avoid some of the pitfalls of sensory scoring in MS.

Type
Other
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 4 , November 2004 , pp. 490 - 493
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1. Sipe, JC, Knobler, RL, Braheny, SL, et al. A neurological rating scale (NRS) for use in multiple sclerosis. Neurology 1984; 34:1368–1372.CrossRefGoogle ScholarPubMed
2. Lublin, FD, Reingold, SC. Defining the clinical course of multiple sclerosis: results of an international survey. Neurology 1996; 46: 907–911.CrossRefGoogle ScholarPubMed
3. Cutter, GR, Baier, ML, Rudick, RA, et al. Development of a multiple sclerosis functional composite as a clinical trial outcome measure. Brain 1999; 122(5): 871–882.CrossRefGoogle ScholarPubMed
4. Kurtzke, JF. Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS). Neurology 1983; 33: 1444–1452.CrossRefGoogle ScholarPubMed
5. McDonald, WI, Compston, A, Edan, G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol 2001; 50(1):121–127.CrossRefGoogle ScholarPubMed
6. Waxman, SG. Acquired channelopathies in nerve injury and MS. Neurology 2001; 56:1621–1627.CrossRefGoogle ScholarPubMed
7. Rae-Grant, AD, Eckert, NJ, Bartz, S, Reed, JF. Sensory symptoms of multiple sclerosis: a hidden reservoir of morbidity. Multiple Sclerosis 1999; 5:179–183.CrossRefGoogle ScholarPubMed
8. Sanders, EACM, Arts, RJHM. Paraesthesiae in multiple sclerosis. J Neurol Sci 1986; 74: 297–305.Google Scholar
9. Paty, DW. Initial Symptoms. In: Burks, JS, Johnson, KR. Multiple Sclerosis: Diagnosis, Medical Management, and Rehabilitation. New York: Demos Medical Publishing 2000; 75–80.Google Scholar
10. Martina, IS, van Koningsveld, R, Schmitz, PI, van der Meche, FG, van Doorn, PA. Measuring vibration threshold with a graduated tuning fork in normal aging and in patients with polyneuropathy. European Inflammatory Neuropathy Cause and Treatment (INCAT) group. J Neurol Neurosurg Psychiatry 1998; 65(5): 743–747.CrossRefGoogle ScholarPubMed
11. Meh, D, Denislic, M. Correlation between temperature and vibration thresholds and somatosensory evoked potentials. Electromyogr Clin Neurophysiol 2000; 40:131–134.Google ScholarPubMed
12. Merchut, MP, Gruener, G. Quantitative sensory threshold testing in patients with multiple sclerosis. Electromyogr Clin Neurophysiol 1993; 33:119–124.Google ScholarPubMed
13. Goldberg, JM, Lindblom, U. Standardized method of determining vibratory perception thresholds for diagnosis and screening in neurological investigation. J Neurol Neurosurg Psychiatry 1979; 42:793–803.CrossRefGoogle ScholarPubMed
14. Heijenbrok, MW, Anema, JR, Faes, TJC, et al. Quantitative measurement of vibratory sense and temperature sense in patients with multiple sclerosis. Electromyogr Clin Neurophysiol 1992; 32: 385–388.Google ScholarPubMed