Prognostic value of multimodal evoked potentials in multiple sclerosis: the EP score
Autor: | Maria Donata Benedetti, Paolo Invernizzi, Alberto Gajofatto, Maria Rachele Bianchi, Laura Bertolasi, Marco Turatti |
---|---|
Rok vydání: | 2011 |
Předmět: |
Adult
Male medicine.medical_specialty Multiple Sclerosis Neurology Adolescent Sensitivity and Specificity Central nervous system disease Young Adult EP score Internal medicine medicine Humans Evoked potential Evoked Potentials Neuroradiology Expanded Disability Status Scale medicine.diagnostic_test Receiver operating characteristic business.industry Multiple sclerosis Magnetic resonance imaging Middle Aged Prognosis medicine.disease Surgery Area Under Curve Disease Progression Female EDSS Neurology (clinical) multiple sclerosis evoked potentials prognosis business |
Zdroj: | Journal of Neurology. 258:1933-1939 |
ISSN: | 1432-1459 0340-5354 |
Popis: | Evoked potentials (EPs) have long been used as diagnostic tools in multiple sclerosis (MS), although their importance decreased as magnetic resonance imaging (MRI) became available. However, the prognostic value of EPs in MS has not been completely established. The aim of the study was to analyze the prognostic significance of EPs in a cohort of MS cases. From the Verona University Hospital MS Clinic database we retrospectively identified 80 MS patients who underwent a complete neurophysiological evaluation, including visual, brain stem, somatosensory and motor EPs and who were followed for at least 5 years after the study. EPs abnormalities were quantified through an index of global EPs alteration (EP score). The relationship between EP score and disability in terms of Expanded Disability Status Scale (EDSS) was analyzed by the Kaplan–Meier survival method and Spearman ρ correlation coefficient. ROC curves were used to determine the best EP score cut off to predict different EDSS endpoints. For each endpoint, sensitivity, specificity, positive and negative predictive value of EP score were calculated. We found a significant correlation (p < 0.001) between EP score and EDSS score at the time of neurophysiological study and at 1, 3 and 5 years of follow-up, particularly for motor and somatosensory EPs. Kaplan–Meier curves confirmed an increased risk of disability in those patients with EP score higher than the median value. EP score of 8 or 9 showed the highest sensitivity and specificity in predicting EDSS 4.0 and 6.0. EPs are reliable procedures to predict disability in MS patients. The correlation between EPs abnormalities and EDSS is higher than between conventional MRI and EDSS. |
Databáze: | OpenAIRE |
Externí odkaz: |