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Early disturbances in multimodal evoked potentials as a prognostic factor for long-term disability in
Frédéric London1, Souraya El Sankari1, Vincent van Pesch1
1Department of Neurology, Cliniques Universitaires St-Luc, 10 Avenue Hippocrate, 1200 Brussels, Belgium.
Objective:
The aim of this study was to investigate whether early alterations in evoked potentials (EPs) have a prognostic value in relapsing-remitting multiple sclerosis (RRMS).
Methods:
We retrospectively selected 108 early MS patients with a neurological follow-up ranging from 5 to 15years, in whom multimodal EPs (visual, brainstem auditory, somatosensory and motor) were performed at diagnosis. A conventional ordinal score was used to quantify the observed abnormalities.
Results:
The extent of change in the composite EP score was well correlated to the Expanded Disability Status Scale (EDSS) at ten years (Y10) and up to 15years (Y11-15) after disease onset. Analysis of the predictive value of the EP score showed an increased risk of disability progression at Y10 and Y11-15 of 60% (p<0.0001) and 73% (p<0.0001) respectively in patients with an EP score >4. Conversely, the risk of disability progression at Y10 and Y11-15 associated with a lower EP score (⩽4) was reduced to 16% and 20% respectively.
Conclusions:
Our data support the good predictive value for long-term disability progression of multimodal EPs performed early after disease onset in RRMS patients.
Significance:
This study, performed in a homogeneous RRMS cohort with long term follow-up, demonstrates the value of an early comprehensive neurophysiological assessment as a marker for future disability.
