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. 2024 Sep 6;24(1):326.
doi: 10.1186/s12883-024-03828-4.

Mirror movements in multiple sclerosis -a clinical, electrophysiological, and imaging study

Korbinian Holzapfel  1 , Antonios Bayas  2 , Markus Naumann  2 , Tanupriya Ghosh  2 , Verena Steuerwald  2 , Martin Allweyer  2 , Jan S Kirschke  3 , Lars Behrens  4
Affiliations

Mirror movements in multiple sclerosis -a clinical, electrophysiological, and imaging study

Korbinian Holzapfel et al. BMC Neurol. .

Abstract

Background: Mirror movements (MM) are commonly caused by a defect of interhemispheric pathways also affected in multiple sclerosis (MS), particularly the corpus callosum. We investigated the prevalence of MM in MS in relation to functional and morphological callosal fiber integrity by transcranial magnetic stimulation (TMS), magnetic resonance imaging (MRI), as well as fatigue.

Methods: In 21 patients with relapsing-remitting MS and 19 healthy controls, MM were assessed and graded (Woods and Teuber scale: MM 1-4) using a bedside test. Fatigue was evaluated using the Fatigue Scale for Motor and Cognitive Functions (FSMC) questionnaire. TMS measured ipsilateral silent period latency and duration. MRI assessed callosal atrophy by measuring the normalized corpus callosum area (nCCA), corpus callosum index (CCI), and lesion volume.

Results: MS patients had significantly more often and pronounced MM compared to healthy controls (p = 0.0002) and nCCA was significantly lower (p = 0.045) in MRI studies. Patients with higher MM scores (MM > 1 vs. MM 0/1) showed significantly more fatigue (higher FSMC sum score, p = 0.04, motor score, p = 0.01). In TMS and MRI studies, no significant differences were found between patients with MM 0/1 and those with MM > 1 (ipsilateral silent period measurements, CCA, CCI and lesion volume).

Conclusions: MM are common in MS and can easily be detected through bedside testing. As MM are associated with fatigue, they might indicate fatigue in MS. It is possible that other cerebral structures, in addition to the corpus callosum, may contribute to the origin of MM in MS.

Keywords: Fatigue; Magnetic resonance imaging; Mirror movements; Multiple sclerosis; Silent period.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Mirror Movements (Wood and Teuber scale). MM, mirror movements; %, percentage of patients (black)/controls (grey)
Fig. 2
Fig. 2
Boxplots of the FSMC sum score, motor score, and cognitive score. 0/1, patients with MM 0/1; 2/3, patients with MM > 1; FSMC, Fatigue Scale for Motor and Cognitive Functions; Median (line at the middle), 25th to 75th percentile (box) and range (error bars) are shown. Left—sum score; middle—cognitive score; right—motor score
See this image and copyright information in PMC

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