Regina Schlaeger1, Martin Hardmeier1, Marcus D'Souza1, Leticia Grize2, Christian Schindler2, Ludwig Kappos3, Peter Fuhr4. 1. Department of Neurology, University Hospital Basel, Switzerland. 2. Swiss Tropical and Public Health Institute, Switzerland; University of Basel, Switzerland. 3. Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland. 4. Department of Neurology, University Hospital Basel, Switzerland; University of Basel, Switzerland. Electronic address: peter.fuhr@usb.ch.
Abstract
OBJECTIVE: To compare the ability of different evoked potential scores (EPS) to monitor and predict the disease course in multiple sclerosis (MS). METHODS: Seventy-two patients with MS or clinically isolated syndrome were investigated by visual, motor, and somatosensory EP and expanded disability status scale (EDSS) at baseline (T0) and months 6, 12, 24, 36 (T4). EP results were rated according to ordinal (o), semi-quantitative (sq), and quantitative (q) EPS. Spearman rank correlation and multivariable linear regression were used to investigate the associations between EPS and clinical disability. RESULTS: All EPS correlated with EDSS cross-sectionally (0.72⩽rho⩽0.87, all p<0.001) and longitudinally (0.39⩽rho⩽0.47, all p⩽0.004). EPS(T0) and EDSS(T0) together explained 85-86% of EDSS(T4) variance. A posteriori power calculation showed that the sample sizes needed to detect significant changes over 6 months in q-EPS, sq-EPS and o-EPS with 90% certainty would be 50, 129 and 222, respectively. q-EPS change(T1-T0) correlated with EDSS change(T4-T0) (rho=0.56, p<0.001), while sq-EPS and o-EPS changes(T1-T0) did not. CONCLUSION: All three EPS allow disease course monitoring in MS. However, the quantitative EPS detects clinically relevant short-term changes with a smaller sample size than semi-quantitative or ordinal EPS. SIGNIFICANCE: These results underscore the potential of EPS to characterize MS disease evolution.
OBJECTIVE: To compare the ability of different evoked potential scores (EPS) to monitor and predict the disease course in multiple sclerosis (MS). METHODS: Seventy-two patients with MS or clinically isolated syndrome were investigated by visual, motor, and somatosensory EP and expanded disability status scale (EDSS) at baseline (T0) and months 6, 12, 24, 36 (T4). EP results were rated according to ordinal (o), semi-quantitative (sq), and quantitative (q) EPS. Spearman rank correlation and multivariable linear regression were used to investigate the associations between EPS and clinical disability. RESULTS: All EPS correlated with EDSS cross-sectionally (0.72⩽rho⩽0.87, all p<0.001) and longitudinally (0.39⩽rho⩽0.47, all p⩽0.004). EPS(T0) and EDSS(T0) together explained 85-86% of EDSS(T4) variance. A posteriori power calculation showed that the sample sizes needed to detect significant changes over 6 months in q-EPS, sq-EPS and o-EPS with 90% certainty would be 50, 129 and 222, respectively. q-EPS change(T1-T0) correlated with EDSS change(T4-T0) (rho=0.56, p<0.001), while sq-EPS and o-EPS changes(T1-T0) did not. CONCLUSION: All three EPS allow disease course monitoring in MS. However, the quantitative EPS detects clinically relevant short-term changes with a smaller sample size than semi-quantitative or ordinal EPS. SIGNIFICANCE: These results underscore the potential of EPS to characterize MS disease evolution.
Authors: Martin Hardmeier; François Jacques; Philipp Albrecht; Habib Bousleiman; Christian Schindler; Letizia Leocani; Peter Fuhr Journal: Mult Scler J Exp Transl Clin Date: 2019-05-01