Visual and motor evoked potentials in the course of multiple sclerosis
Visual and motor evoked potentials in the course of multiple sclerosis
复制标题
DOI：
10.1093/brain/124.11.2162
复制
发表时间：
2001-11-01
期刊：
影响因子：
14.5
通讯作者：
Kappos, L
中科院分区：
文献类型：
--
作者：
Fuhr, P;Borggrefe-Chappuis, A;Kappos, L
虽然诱发电位是诊断多发性硬化症的敏感工具，但对其预后价值及其在确定疾病过程中的作用知之甚少。为了验证视觉和运动诱发电位（VEP和MEP）作为测量多发性硬化症病程的指标，我们前瞻性地检查了30例复发缓解型或继发性进展型多发性硬化症患者。分别于入组时、6个月、12个月、24个月时进行扩展残疾状态量表（EDSS）、视觉诱发电位（VEP）和运动诱发电位（MEP）检查。采用斯皮尔曼等级相关进行统计学分析。在15名随机化患者中应用多元回归允许推导用于基于MEP和VER的变化预测EDSS评分变化的公式。通过将预测值与其他15名患者中EDSS的真实的变化进行比较来进行验证。病理性VEP和MEP结果的数量在所有四个测量点与EDSS相关（rho大于或等于0.6，P小于或等于0.01）。当将VEP和MEP的Z评分之和与EDSS的相关性更显著（rho ≥ 0.6，P < 0.001）。电生理指标的变化与EDSS评分也呈显著相关（P < 0.05）。基线时VEP和MEP与2年后EDSS相关（= 0.43，P = 0.03）。根据VEP和MEP数据不可能可靠地预测单个患者的多发性硬化症病程。然而，我们的结论是，对于继发性进行性或复发缓解型多发性硬化症的患者组，VEP和MEP的联合测试产生的数值数据，允许客观估计的过程和预后的疾病。
While evoked potentials are sensitive tools for diagnosing multiple sclerosis, little is known about their prognostic value and their role in determining the course of the disease. To validate the visual and motor evoked potentials (VEP and MEP) as measures for the course of multiple sclerosis, we examined prospectively 30 patients with relapsing-remitting or secondary progressive multiple sclerosis. The Expanded Disability Status Scale (EDSS), VEP and MEP were measured at entry and after 6, 12 and 24 months. The Spearman rank correlation was used for statistical analysis. Applying multiple regression in 15 randomized patients allowed derivation of a formula for predicting changes in EDSS score based on changes in MEP and VER Validation was done by comparing the predicted with the real changes in EDSS in the other 15 patients. The number of pathological VEP and MEP results correlated at all four measurement points with the EDSS (rho greater than or equal to 0.6, P less than or equal to 0.01). When the latencies of VEP and MEP were combined using the sum of their Z scores, correlation with the EDSS was even more significant (rho greater than or equal to 0.6, P < 0.001). Changes over time of electrophysiological data and EDSS were also correlated ( = 0.43, P < 0.05). Moreover, VEP and MEP at baseline correlated with the EDSS after 2 years ( = 0.43, P = 0.03). Reliable prediction of the course of multiple sclerosis for individual patients is not possible from VEP and MEP data. However, we conclude that, for groups of patients with secondary progressive or relapsing-remitting multiple sclerosis the combined testing of VEP and MEP yields numerical data that allow objective estimation of the course and prognosis of the disease.