Rachel, MS Reporter: How can MSers monitor their own disease activity between annual appointments with their neurologist?
Prof. Jeremy Hobart, Consultant Neurologist:Okay, so just to lay out the ground here, that clinicians provide some sort of service for people in which they see people with MS on an irregular basis and at one level I’m anticipating that will become more irregular over time. And then we have MRI scanning which we try to bring in routinely across countries, but is also patchy. But we know that the disease plays out in a day-by-day basis and we need to understand, for an individual person, in how their disease affects them and how that varies over time and what that tells us about the level of disease activity that they have.
So, what we do for that is we encourage a set of different approaches to measurement, one of which is to monitor your symptoms. So there are available now quite easy to use symptom checklists, and then you can grade the level of the symptoms and you can do that on a day-by-day or a week-by-week basis, or you could do it as the symptoms arise, so you’ve got a record. Then there are performance indicators, and I guess at this point in time, three important performance indicators are of lower limb function, upper limb function and cognition. So for lower limb function the standard methods at this point in time are walking distances. So you can monitor your walking distance or your speed over a certain distance. Then for upper limb function we have simple tests, like the nine-hole peg test, and these are now easily available in cheap cardboard formats and you just time the time taken to put nine pegs into nine holes and take them out again. And then there are cognitive performance tests that you can use. Now, if you’re measuring those parameters on a regular basis, then you have a beautiful record of the impact of MS on certain things and its variance over time. If that is taken to the clinic, then that forms a perfect interface for people to report their data and for clinicians to interpret their data so that we maximise the care of people with MS.
Expert:Prof. Jeremy Hobart, Consultant Neurologist