Methylphenidate to Improve Balance and Walking in MS

Treatment tested

• Methylphenidate

  Dopamine transporter inhibitor|Norepinephrine transporter inhibitor

Placebo or sham

• Placebo

Other measures (7)

Inclusion Criteria: * Age 20-65 * Able to walk at least 100m without an aide or with unilateral assistance * Poor static balance, specifically prolonged APR latencies (≥ 1 standard deviation (SD) > mean for healthy people in this age range), OR * Reduced balance-related activity (ABC scores ≤ 85%) * Walking difficulties, specifically T25FW > 6 seconds, OR reduced self perceived walking (MSWS-12 scores ≥ 50/60) Exclusion Criteria: * Currently taking methylphenidate, modafinil, or armodafinil.(any within the last 2 weeks) * Cause(s) of imbalance other than MS * Systolic pressure consistently greater than 150 mm Hg or diastolic pressure consistently greater than 90 mm Hg * Contraindications to methylphenidate (Anxiety, tension, agitation, thyrotoxicosis, tachyarrhythmias, severe angina pectoris or glaucoma, hypersensitivity to methylphenidate, motor tics or a family history or diagnosis of Tourette's syndrome, seizures, severe or poorly controlled hypertension, treatment with monoamine oxidase inhibitors currently or within the last 14 days, current use of guanethidine, pressors, coumarin anticoagulants, anticonvulsants, phenylbutazone, or tricyclic antidepressants, history of drug abuse or alcoholism) * Pregnancy or breastfeeding

Methylphenidate is an amphetamine-like psychomotor stimulant drug currently approved for the treatment of attention-deficit hyperactivity disorder (ADHD), postural orthostasis tachycardia syndrome and narcolepsy. It is also often prescribed off label to people with MS to improve fatigue. It is proposed that methylphenidate may also improve imbalance and walking deficits in MS by improving concentration and central integration, one of the primary mechanisms thought to underlie imbalance and walking deficits in MS.