Evoked potentials and disability in multiple sclerosis: A different perspective to a neglected method

Kıylıoğlu, Nefati; Parlaz, Ahu Unsal; Akyıldız, Utku Oğan; Tataroglu, Cengiz

doi:10.1016/j.clineuro.2015.03.012

Cited by 12 publications

(6 citation statements)

References 31 publications

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“…In two studies, both SEPs and MEPs were shown to have the highest sensitivity and specificity in predicting MS-related disability 4. This correlation was even higher than that obtained with MRI and EDSS 25.…”

Section: Somatosensory Evoked Potentialsmentioning

confidence: 88%

“…However, electrophysiological techniques allow non-invasive exploration and provide quantitative information on the functional status of selected functional systems with a temporal resolution in the range of milliseconds; in addition, they can be repeated as often as necessary with relatively low cost. EP studies allow the detection of subclinical lesions,3 and the prediction of long-term disability4 and/or conversion to symptomatic disease phases 5. Further attempts to increase the diagnostic and prognostic accuracy by using multimodal EP (mmEP) scoring systems6 and high-density electroencephalogram (HD EEG:>64 electrodes) analysis with topographical mapping and dipole modelling have been proposed 7…”

Section: Introductionmentioning

confidence: 99%

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Clinical evoked potentials in neurology: a review of techniques and indications

Lascano

Lalive

Hardmeier

et al. 2017

J Neurol Neurosurg Psychiatry

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Evoked potentials (EPs) are a powerful and cost-effective tool for evaluating the integrity and function of the central nervous system. Although imaging techniques, such as MRI, have recently become increasingly important in the diagnosis of neurological diseases, over the past 30 years, many neurologists have continued to employ EPs in specific clinical applications. This review presents an overview of the recent evolution of 'classical' clinical applications of EPs in terms of early diagnosis and disease monitoring and is an extension of a previous review published in this journal in 2005 by Walsh and collaborators. We also provide an update on emerging EPs based on gustatory, olfactory and pain stimulation that may be used as clinically relevant markers of neurodegenerative disorders such as Parkinson's disease, Alzheimer's disease and cortical or peripheral impaired pain perception. EPs based on multichannel electroencephalography recordings, known as high-density EPs, help to better differentiate between healthy subjects and patients and, moreover, they provide valuable spatial information regarding the site of the lesion. EPs are reliable disease-progression biomarkers of several neurological diseases, such as multiple sclerosis and other demyelinating disorders. Overall, EPs are excellent neurophysiological tools that will expand standard clinical practice in modern neurology.

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Section: Somatosensory Evoked Potentialsmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Clinical evoked potentials in neurology: a review of techniques and indications

Lascano

Lalive

Hardmeier

et al. 2017

J Neurol Neurosurg Psychiatry

View full text Add to dashboard Cite

show abstract

“…Accordingly, in published reports on mixed-patients cohorts, the best correlations with disability were granted by lower limb somatosensory EPs (SEPs) and MEPs to the lower limb. 103,109,121 MEP latency displays the most specific correlation and the highest predictive value for disability progression 122 and sensitivity to change over time. 109 The mismatch between worsening of spinal EPs and unchanged disability may be the expression of nervous system plasticity, at the expense of reduced functional reserve predictive of subsequent EDSS increase.…”

Section: Electrophysiological Outcomesmentioning

confidence: 99%

Fluid biomarker and electrophysiological outcome measures for progressive MS trials

et al. 2017

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Progressive multiple sclerosis (MS) is characterized by insidious clinical worsening that is difficult to accurately quantify and predict. Biofluid markers and electrophysiological measures are potential candidate outcome measures in clinical trials, allowing the quantification of nervous damage occurring in the disease. Neurofilaments are highly specific neuronal proteins. They may have come closest to such applications by their higher concentrations repeatedly demonstrated in cerebrospinal fluid (CSF) in all stages of MS, during relapses, their responsiveness to disease-modifying treatments in relapsing and progressive MS and their associations with measures of inflammatory and degenerative magnetic resonance imaging (MRI) outcomes. Digital single-molecule array (Simoa) technology improves accuracy of bioassays in the quantification of neurofilament light chain (NfL) in serum and plasma. NfL seems to mark a common final path of neuroaxonal injury independent of specific causal pathways. CSF and blood levels of NfL are highly correlated across various diseases including MS, suggesting that blood measurements may be useful in assessing response to treatment and predicting future disease activity. Other biomarkers like matrix metalloproteinases, chemokines, or neurotrophic factors have not been studied to a similar extent. Such measures, especially in blood, need further validation to enter the trial arena or clinical practice. The broadening armamentarium of highly sensitive assay technologies in the future may shed even more light on patient heterogeneity and mechanisms leading to disability in MS. Evoked potentials (EPs) are used in clinical practice to measure central conduction of central sensorimotor pathways. They correlate with and predict the severity of clinical involvement of their corresponding function. Their validation for use in multicenter studies is still lacking, with the exception of visual EPs. If further validated, EPs and fluid biomarkers would represent useful outcome measures for clinical trials, being related to specific mechanisms of the ongoing pathologic changes.

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“…For some neurophysiological methods, like the blink reflex, it has even been shown a good correlation between the pathological response and brainstem disease burden. (18) Despite of this, only one study investigated the correlation between T25FW and different evoked potentials (motor and somatosensory evoked potentials) (19). That study has shown that both motor and somatosensory evoked potentials and their combination correlate well with T25FW, indicating that evoked potentials might be useful in the clinical follow up of MS patients.…”

Section: Discussionmentioning

confidence: 99%