Optic Nerve Topography in Multiple Sclerosis Diagnosis: The Utility of Visual Evoked Potentials.
Optic Nerve Topography in Multiple Sclerosis Diagnosis: The Utility of Visual Evoked Potentials.
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DOI：
10.1212/wnl.0000000000011339
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发表时间：
2021-01-26
期刊：
影响因子：
9.9
通讯作者：
Tintoré M
中科院分区：
文献类型：
--
作者：
Vidal-Jordana A;Rovira A;Arrambide G;Otero-Romero S;Río J;Comabella M;Nos C;Castilló J;Galan I;Cabello S;Moncho D;Rahnama K;Thonon V;Rodríguez-Acevedo B;Zabalza A;Midaglia L;Auger C;Sastre-Garriga J;Montalban X;Tintoré M
评估视神经区(通过使用视觉诱发电位[VEP])对当前诊断标准的附加价值。从巴塞罗那临床隔离综合征(CIS)队列中，选择了基线时具有完整信息以评估空间播散(DIS)、视神经区域和时间播散的患者(n=388)。改进的DIS(ModDIS)标准是将视神经加入到当前的DIS区域中构建的。DIS和modDIS标准采用单因素Cox比例风险回归分析，以第二次发作的时间为结果。选择这些患者中至少有10年随访或在10年内发生第二次发作的患者子组(n=151)来评估诊断性能。分析还根据CIS地形图(视神经炎与非视神经炎)进行。视神经作为第五个区域的加入，在不降低特异度(2017年DIS 52.4%，modDIS 52.4%)的情况下，略微提高了诊断的准确性(2017 DIS 75.5%，modDIS 78.1%)和敏感性(2017 DIS 79.2%，modDIS 82.3%)，从而提高了诊断性能。当根据CIS地形图进行分析时，modDIS标准在视神经炎和非视神经炎CIS中的表现相似。在目前的DIS标准中，将视神经作为第五个区域添加到视觉诱发电位(VEP)评估中略微提高了诊断性能，因为它增加了敏感性而又不会失去特异性。
To assess the added value of the optic nerve region (by using visual evoked potentials [VEPs]) to the current diagnostic criteria. From the Barcelona clinically isolated syndrome (CIS) cohort, patients with complete information to assess dissemination in space (DIS), the optic nerve region, and dissemination in time at baseline (n = 388) were selected. Modified DIS (modDIS) criteria were constructed by adding the optic nerve to the current DIS regions. The DIS and modDIS criteria were evaluated with univariable Cox proportional hazard regression analyses with the time to the second attack as the outcome. A subset of these patients who had at least 10 years of follow-up or a second attack occurring within 10 years (n = 151) were selected to assess the diagnostic performance. The analyses were also performed according to CIS topography (optic neuritis vs non–optic neuritis). The addition of the optic nerve as a fifth region improved the diagnostic performance by slightly increasing the accuracy (2017 DIS 75.5%, modDIS 78.1%) and the sensitivity (2017 DIS 79.2%, modDIS 82.3%) without lowering the specificity (2017 DIS 52.4%, modDIS 52.4%). When the analysis was conducted according to CIS topography, the modDIS criteria performed similarly in both optic neuritis and non–optic neuritis CIS. The addition of the optic nerve, assessed by VEP, as a fifth region in the current DIS criteria slightly improves the diagnostic performance because it increases sensitivity without losing specificity.
影响因子：
3.1
作者：
Gundogan FC;Tas A;Altun S;Oz O;Erdem U;Sobaci G
通讯作者：
Sobaci G