Submitted by: Nakul Katyal, MD
Edited by: Eman Tawfik, MD
Prada V, Laurà M, Zuccarino R, Reilly MM, Shy ME. Virtual charcot-marie-tooth examination score: A validated virtual evaluation for people with charcot-marie-tooth disease.
Neurol Clin Pract. 2022;12(5):e98-e104. doi:10.1212/CPJ.0000000000200070
Summary: The Charcot-Marie-Tooth (CMT) Examination Score Version 2 (CMTESv2) is used in clinical practice to measure impairment in patients with CMT. However, the CMTES requires an in-person visit, which may not be possible for all CMT patients. This study evaluated a virtual form of CMTES (vCMTES) as a remote clinical outcome assessment tool to measure impairment in CMT patients. The pinprick and vibration domains of CMTESv2 are replaced with light touch and position sensation in the vCMTES. The patient can perform these domains remotely either independently or with the help of an assistant while being observed by the clinic evaluator.
Sixty-four patients with genetically confirmed CMT were evaluated using the vCMTES and CMTESv2 scale, in-person and remotely. During the first in-person visit, both CMTESv2 and the vCMTES scales were performed. Fifty-three patients were re-evaluated virtually 3 weeks after the initial examination. Moreover, 10 patients were evaluated virtually twice by two different evaluators, 5 days apart to evaluate intra-examiner variability and for test-retest assessment. CMTESv2 correlated strongly with the vCMTES conducted both in-person and virtually (
p < 0.0001) and similar results were obtained comparing symptoms score items, sensory items, and motor items. The authors concluded that vCMTES was reproducible and reliable as a clinical outcome assessment for CMT.
Comments: The strong correlation that was observed in this study between the vCMTES and conventional CMTSv2, conducted in-person and virtually denotes that vCMTES could serve as a reliable outcome assessment measure. However, further studies are needed to assess its reproducibility with disease progression and different CMT subtypes.