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Prediction of MS disability by multimodal evoked potentials: investigation during relapse or in the relapse-free
R Schlaeger1, M D'Souza1, C Schindler2
1Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland.
Objective:
Little is known about optimal timing of multimodal evoked potential (EP)-investigations regarding prediction of MS disability. The aim of this study was to investigate whether timing of EP-investigations during a relapse or in the relapse-free interval influences prediction of MS disability.
Methods:
Two groups of MS patients with similar age and gender distributions received visual, motor and somatosensory EPs either during a relapse (Group 1) or in the relapse-free interval (Group 2). Expanded Disability Status Score (EDSS) was obtained at baseline (T0) and year 3 (T2). Linear regression analysis was performed to examine the association between EDSS(T2) and a baseline EP compound measure (s-EP-Q(T0)) for each group.
Results:
Median EDSS(T0) was 3.0 for Group 1 and 1.5 for Group 2. Mean disease durations were 2.0 and 2.8 years, respectively. Median EDSS(T2) was 2.0 for both groups. The s-EP-Q(T0) significantly predicted EDSS(T2) (R(2)=0.47) for patients in Group 2, but not for patients in Group 1 (R(2)=0.07).
Conclusion:
In early MS the functional remnants of relapses are a better predictor for development of medium-term disability than is the extent of impulse propagation impairment measured during relapse.
Significance:
This suggests a role of multimodal EPs in prediction of MS disability if performed in the relapse-free interval.
Insights
Timing of evoked potential (EP) tests in multiple sclerosis (MS) impacts disability prediction. Performing EP investigations during the relapse-free interval, not during a relapse, better predicts medium-term MS disability.
Area of Science:
- Neuroscience
- Clinical Neurology
- Biomedical Engineering
Background:
- Predicting disability progression in multiple sclerosis (MS) is crucial for patient management.
- Multimodal evoked potentials (EPs) assess the integrity of sensory and motor pathways.
- Optimal timing for EP investigations to predict MS disability remains unclear.
Purpose of the Study:
- To determine if the timing of multimodal EP investigations (during relapse vs. relapse-free interval) influences their predictive value for MS disability.
- To compare the predictive power of EP measures taken at different time points in relation to MS relapses.
Main Methods:
- Two groups of MS patients underwent visual, motor, and somatosensory EPs either during a relapse (Group 1) or in remission (Group 2).
- Expanded Disability Status Scale (EDSS) was assessed at baseline (T0) and 3 years (T2).
- Linear regression analyzed the association between baseline EP measures (s-EP-Q(T0)) and EDSS(T2) for each group.
Main Results:
- Group 2 (relapse-free) showed a significant prediction of EDSS(T2) by s-EP-Q(T0) (R²=0.47).
- Group 1 (during relapse) did not show a significant prediction (R²=0.07).
- Median EDSS at 3 years was similar between groups, despite different baseline EDSS and EP predictive power.
Conclusions:
- In early MS, the functional impact of relapses is a better predictor of medium-term disability than EP measures taken during an acute relapse.
- Multimodal EPs are valuable for predicting MS disability when conducted during the relapse-free interval.
