Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis

• Published in: BMC neurology 2016-06, Vol.16 (1), p.83-83, Article 83
• Main Authors: Giffroy, Xavier, Maes, Nathalie, Albert, Adelin, Maquet, Pierre, Crielaard, Jean-Michel, Dive, Dominique
• Format: Article
• Language: English
• Subjects: Adult; Biological activity; Biomarkers - metabolism; Confidence intervals; Cross-Sectional Studies; Data analysis; Development and progression; Disability; Disabled Persons; Disease Progression; Electrodes; Evoked potentials; Evoked Potentials, Motor - physiology; Evoked Potentials, Somatosensory - physiology; Female; Funding; Human health sciences; Humans; Magnetic Resonance Imaging; Male; Middle Aged; Multimodal Imaging - methods; Multiple sclerosis; Multiple Sclerosis - physiopathology; Neurologie; Neurology; NMR; Nuclear magnetic resonance; Prognosis; Retrospective Studies; ROC Curve; Sciences de la santé humaine; Variance analysis
• ISSN: 1471-2377; 1471-2377
• DOI: 10.1186/s12883-016-0608-1

Functional biomarkers able to identify multiple sclerosis (MS) patients at high risk of fast disability progression are lacking. The aim of this study was to evaluate the ability of multimodal (upper and lower limbs motor, visual, lower limbs somatosensory) evoked potentials (EP) to monitor disease course and identify patients exposed to unfavourable evolution. One hundred MS patients were assessed with visual, somatosensory and motor EP and rated on the Expanded Disability Status Scale (EDSS) at baseline (T0) and about 6 years later (T1). The Spearman correlation (rS) was used to evaluate the relationship between conventional EP scores and clinical findings. Multiple (logistic) regression analysis estimated the predictive value of baseline electrophysiological data for three clinical outcomes: EDSS, annual EDSS progression, and the risk of EDSS worsening. In contrast to longitudinal correlations, cross-sectional correlations between the different EP scores and EDSS were all significant (0.33 ≤ rS < 0.67, p < 0.001). Baseline global EP score and EDSS were highly significant predictors (p < 0.0001) of EDSS progression 6 years later. The baseline global EP score was found to be an independent predictor of the EDSS annual progression rate (p < 0.001), and of the risk of disability progression over time (p < 0.005). Based on a ROC curve determination, we defined a Global EP Score cut off point (17/30) to identify patients at high risk of disability progression illustrated by a positive predictive value of 70%. This study provides a proof of the concept that electrophysiology could be added to MRI and used as another complementary prognostic tool in MS patients.