Abstract
The ability to predict disability development in multiple sclerosis (MS) is limited.
While abnormalities of evoked potentials (EP) have been associated with disability,
the prognosticating utility of EP in MS remains to be fully elucidated. The present
study assessed the utility of multimodal EP as a prognostic biomarker of disability
in a cohort of clinically heterogeneous MS patients. Median and tibial nerve somatosensory,
visual, and brainstem auditory EP were performed at initial assessment on 63 MS patients
(53 relapsing–remitting and 10 secondary progressive) who were followed for an average
of 2 years. A combined EP score (CEPS) was calculated consisting of the total number of
abnormal EP tests, and was correlated with the Expanded Disability Status Scale (EDSS)
at baseline and follow-up. There was a significant correlation between multimodal
EP and baseline and follow-up EDSS. Specifically, tibial nerve P37 latencies correlated
with EDSS (RBASELINE = 0.49, p < 0.01; RFOLLOW-UP = 0.47, p < 0.01), as did the median nerve N13 (RBASELINE = 0.40, p < 0.01; RFOLLOW-UP = 0.35, p < 0.05) and N20 latencies (RBASELINE = 0.43, p < 0.01; RFOLLOW-UP = 0.47, p < 0.01), and P100 full-field (RBASELINE = 0.50, p < 0.001; RFOLLOW-UP = 0.45, p < 0.001) and central field latencies (RBASELINE = 0.60, p < 0.001; RFOLLOW-UP = 0.50, p < 0.001). In addition, there was a significant correlation between the CEPS with baseline
(R = 0.65, p < 0.001) and follow-up (R = 0.57, p < 0.01) EDSS. In contrast, white matter disease burden, as measured by T2 lesion load,
exhibited a weaker correlation with EDSS (RBASELINE = 0.28, p < 0.05). In conclusion, these findings suggest that abnormalities of EP, as quantified
by the novel CEPS, may be a useful biomarker for prognosticating clinical disability
in MS, and may aid in the quantification of MS disease severity and in guiding therapeutic
decisions.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Clinical NeuroscienceAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Multiple sclerosis.Lancet. 2008; 372: 1502-1517
- Accumulation of hypointense lesions (“black holes”) on T1 spin-echo MRI correlates with disease progression in multiple sclerosis.Neurology. 1996; 47: 1469-1476
- The clinico-radiological paradox in multiple sclerosis revisited.Curr Opin Neurol. 2002; 15: 239-245
- A longitudinal study of abnormalities on MRI and disability from multiple sclerosis.N Engl J Med. 2002; 346: 158-164
- Disability and T2 MRI lesions: a 20-year follow-up of patients with relapse onset of multiple sclerosis.Brain. 2008; 131: 808-817
- Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study.J Neurol Neurosurg Psychiatry. 2006; 77: 1030-1035
- Transected neurites, apoptotic neurons, and reduced inflammation in cortical multiple sclerosis lesions.Ann Neurol. 2001; 50: 389-400
- Gray matter involvement in multiple sclerosis.Neurology. 2007; 68: 634-642
- Gray matter atrophy in multiple sclerosis: a longitudinal study.Ann Neurol. 2008; 64: 255-265
- Intracortical excitability in patients with relapsing-remitting and secondary progressive multiple sclerosis.J Neurol. 2009; 256: 933-938
- Cortical dysfunction underlies disability in multiple sclerosis.Mult Scler. 2012; 18: 425-432
- Grey matter volume in a large cohort of MS patients: relation to MRI parameters and disability.Mult Scler. 2011; 17: 1098-1106
- Evoked potentials in clinical medicine.3rd ed. Lippincott Williams & Wilkins, 1997
- The re-emergence of evoked potentials in multiple sclerosis; from diagnosis to prognostication.Clin Neurophysiol. 2012; 123: 221-222
- Evoked potential abnormality scores are a useful measure of disease burden in relapsing-remitting multiple sclerosis.Ann Neurol. 1998; 44: 404-407
- Visual and motor evoked potentials in the course of multiple sclerosis.Brain. 2001; 124: 2162-2168
- Early abnormalities of evoked potentials and future disability in patients with multiple sclerosis.Mult Scler. 2006; 12: 58-65
- Multimodal evoked potentials measure and predict disability progression in early relapsing-remitting multiple sclerosis.Mult Scler. 2008; 14: 553-556
- Prognostic value of multimodal evoked potentials in multiple sclerosis: the EP score.J Neurol. 2011; 258: 1933-1939
- Prediction of long-term disability in multiple sclerosis.Mult Scler. 2012; 18: 31-38
- Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria.Ann Neurol. 2011; 69: 292-302
- Rating neurologic impairment in multiple sclerosis: an expanded disability status scale (EDSS).Neurology. 1983; 33: 1444-1452
- Evoked potentials in suspected multiple sclerosis: diagnostic value and prediction of clinical course.J Neurol Sci. 1988; 83: 191-210
- Evoked potential changes in clinically definite multiple sclerosis: a two year follow up study.J Neurol Neurosurg Psychiatry. 1982; 45: 494-500
- Serial evoked potential studies and MRI imaging in chronic progressive multiple sclerosis.J Neurol Sci. 1999; 171: 79-83
- Decreased amplitudes in multiple sclerosis patients with normal visual acuity: a VEP study.J Clin Neurosci. 2003; 10: 67-70
- Axonal loss and myelin in early ON loss in postacute optic neuritis.Ann Neurol. 2008; 64: 325-331
- Gray-matter injury in multiple sclerosis.N Engl J Med. 2009; 361: 1505-1506
- Multimodal sensory and motor evoked potentials in a two-year follow-up study of MS patients with relapsing course.Acta Neurol Scand. 1992; 86: 15-18
- Motor evoked potential: a reliable and objective measure to document the functional consequences of multiple sclerosis? Relation to disability and MRI.Clin Neurophysiol. 2007; 118: 1332-1340
- Multiple sclerosis.N Engl J Med. 2000; 343: 938-952
- Combined evoked potentials as markers and predictors of disability in early multiple sclerosis.Clin Neurophysiol. 2012; 123: 406-410
- Do multimodal evoked potentials add information on to MRI in clinically isolated syndromes?.Mult Scler. 2010; 16: 55-61
Article info
Publication history
Accepted:
January 15,
2013
Received:
April 18,
2012
Identification
Copyright
© 2013 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
