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Multimodal neurophysiological evaluation of primary progressive multiple sclerosis - An increasingly valid biomarker,
L J W Canham1, N Kane2, A Oware2
1Bristol & Avon MS Centre, Department of Neurosciences, Southmead Hospital, North Bristol NHS Trust, UK.
Multiple Sclerosis and Related Disorders
|November 23, 2015
Summary
Multi-modality evoked potential batteries show moderate correlation with physical status in Primary Progressive Multiple Sclerosis (PPMS) patients. The graded scoring system demonstrated the strongest relationship, but cognitive function was not associated.
Area of Science:
- Neuroscience
- Biomarker Discovery
- Clinical Neurology
Background:
- Multi-modality evoked potential (MEP) batteries are explored for objective multi-tract dysfunction assessment.
- Previous studies utilized diverse methodologies for MEP evaluation.
Purpose of the Study:
- To independently assess MEP batteries as biomarkers for physical and cognitive status in Primary Progressive Multiple Sclerosis (PPMS).
- To identify the most effective MEP scoring method among those described.
Main Methods:
- 28 PPMS patients underwent clinical assessments (EDSS, MSFC) and cognitive testing (MACFIMS).
- Visual, Brainstem Auditory, Somatosensory, and Motor Evoked Potentials were recorded.
- Results were analyzed using Global Evoked Potential Score, Multiple Evoked Potential Score (mEPS), and Summation of Z transformed Evoked Potential Latencies.
Main Results:
- MEP batteries demonstrated moderate correlation with clinical status: EDSS (r = .65 vs. mEPS, p < .005) and MSFC (r = .39 vs. mEPS, p < .05).
- The graded qualitative mEPS scoring system showed the strongest association with clinical measures.
- The choice of scoring system had a minimal influence on the results.
Conclusions:
- MEP batteries are useful surrogate biomarkers for physical status in PPMS.
- The mEPS scoring system is a potentially valuable method for evaluating PPMS progression.
- A significant limitation is the lack of association between MEPs and cognitive impairment in this cohort.
