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Combined evoked potentials as markers and predictors of disability in early multiple sclerosis
Regina Schlaeger1, Marcus D'Souza, Christian Schindler
1Department of Neurology, University Hospital Basel, Switzerland.
Objective:
To prospectively assess combined evoked potentials (EP) as markers and predictors of the disease course of early MS over 3 years.
Methods:
Fifty patients in the early phase of relapsing remitting MS prospectively received visual, somatosensory and motor EP and EDSS assessments at baseline (T1) and at 6 months intervals during 3 years. Spearman rank correlation was used to determine the relationship between z-transformed EP-latencies (z-EPL) and EDSS. Multivariable linear regression was performed to predict EDSS at year 3 (T7) in function of z-EPL(T1). Validity of the models was assessed using group cross-validation.
Results:
At each of the seven points in time, EDSS correlated with the sum of z-EPL (0.64 ≤ rho ≤ 0.79, p<0.001). The change of the sum of z-EPL(T7-T1) correlated with the change of EDSS(T7-T1) (rho=0.51, p=0.001). EDSS(T7) as predicted by the sum of z-scores of EP latencies or by the number of pathological EP results at baseline correlated with the observed clinical values after 3 years (rho>0.70, p<0.001, for both measures).
Conclusions:
Multimodal EPs correlate well with clinical disability in cross-sectional and longitudinal comparison in early MS and allow prediction of disease evolution over 3 years.
Significance:
EPs seem well suited as markers of the disease course in early MS in clinical trials and bear potential for supporting decision-finding in individual patients.
