Interactive robotic technologies provide a precise approach to study brain function. The objective of the present study was to examine the feasibility of the Kinarm robotic platform in assessing MS patients.  

A major challenge for demonstrating the efficacy of multiple sclerosis (MS) therapies is a lack of objective measurements to quantify sensory, motor, and cognitive functions. The current gold standard, the Expanded Disability Status Scale (EDSS), is mainly centered on ambulation and lower limb function and does not capture important changes in the upper limbs or cognition.  

Patients with relapsing or progressive MS completed 8 behavioural tasks testing motor, cognitive, and sensory domains (Kinarm Standard Tests^TM/KSTs). Performance was corrected for age-, sex-, and handedness based on a large cohort of healthy controls. We quantified performance on tasks using Task Scores, which quantify overall task performance. MS patients also completed a series of standard clinical assessments of motor function, cognition, and fatigue.

We recruited 34 MS patients and 92 healthy controls. Most people in the MS cohort were able to complete the robotic assessments; the primary reason that some individuals couldn’t was fatigue. Twenty-one out of 34 patients were impaired on at least one cognitive task, 20/34 were impaired on at least one motor task, and 6/34 were impaired in at least one measure in the sensory domain. Tasks testing primarily motor skill correlated the most strongly with the EDSS when grouped together (R=0.65, p<0.05). We also identified reasonable relationships between robotic tasks and corresponding clinical tests such as cognitive tests.

Our study highlights that it is feasible to use the Kinarm to quantify sensory, motor and cognitive impairments in people with MS. The Kinarm provides  objective, granular measures of multiple behavioural domains, and could be used in future clinical research and MS drug trials.