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A signal-to-noise-ratio-based analysis of multifocal visual-evoked potentials in multiple sclerosis risk assessment
L De Santiago1, M Ortiz Del Castillo1, R Blanco2
1Biomedical Engineering Research Group, Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain; Department of Electronics, University of Alcalá, Plaza de S. Diego, s/n, 28801 Alcalá de Henares, Spain.
Objective:
To study the value of using the signal-to-noise ratio (SNR) of multifocal visual-evoked potentials (mfVEPs) in assessment of subjects at risk of developing multiple sclerosis (MS).
Methods:
MfVEP signals were obtained from 15 patients with radiologically isolated syndrome (RIS), from 28 patients with clinically isolated syndrome (CIS), from 28 with clinically definite MS and from 24 control subjects. The CIS and MS groups were divided into two subgroups: those with eyes affected by optic neuritis (ON) and those without (non-ON). The mfVEPs' SNR was obtained for both the whole visual field and at various eccentric rings. The area under the curve (AUC) was calculated by comparing the control subjects' mfVEP SNR values with those of the RIS, CIS and MS groups.
Results:
In whole visual field analysis, risk of developing MS increased as SNR decreased (SNRCONTROL=0.70, SNRRIS=0.62, SNRCIS-nonON=0.54, SNRCIS-ON=0.40, SNRMS-nonON=0.52, SNRMS-ON=0.40). Ring 5 (9.8°-15° eccentricity) was most affected by the SNR decrease, as indicated by its higher AUC values (AUCFULL_EYE=0.81, AUCRING_5=0.89). A significant relationship (Spearman correlation, ρRING_5=0.61) between SNR values and disability severity on the Expanded Disability Status Scale (EDSS) was observed in clinically definite MS patients.
Conclusion:
A new method based on analysis of the SNR of mfVEP signal amplitude improves assessment of patients at risk of developing MS.
Significance:
Improved mfVEP assessment of MS-risk patients was achieved by using SNR values at 9.8°-15° eccentricity of the visual field.
Insights
Signal-to-noise ratio (SNR) of multifocal visual-evoked potentials (mfVEPs) effectively assesses multiple sclerosis (MS) risk. Lower SNR indicates higher MS risk, particularly in specific visual field eccentricities.
Area of Science:
- Neuroscience
- Ophthalmology
- Medical Imaging
Background:
- Multiple Sclerosis (MS) is a progressive neurological disease.
- Early detection of MS risk is crucial for timely intervention.
- Current diagnostic methods may not fully capture early visual pathway changes.
Purpose of the Study:
- To evaluate the utility of multifocal visual-evoked potential (mfVEP) signal-to-noise ratio (SNR) for assessing individuals at risk of developing MS.
- To determine if mfVEP SNR can differentiate between healthy controls and individuals with varying stages of MS risk.
Main Methods:
- mfVEP signals were recorded from subjects with radiologically isolated syndrome (RIS), clinically isolated syndrome (CIS), definite MS, and healthy controls.
- SNR was analyzed for the entire visual field and specific eccentric rings (0-15°).
- Area under the curve (AUC) was calculated to compare mfVEP SNR between groups.
Main Results:
- Decreased mfVEP SNR correlated with increased risk of developing MS.
- The most significant SNR reduction was observed in the 5th ring (9.8°-15° eccentricity), indicated by higher AUC values.
- A correlation was found between reduced SNR and disability severity (EDSS) in MS patients.
Conclusions:
- mfVEP SNR analysis offers a valuable, non-invasive method for assessing MS risk.
- Utilizing SNR values within the 9.8°-15° visual field eccentricity enhances the assessment of MS-risk patients.
