Multimodal evoked potentials follow up in multiple sclerosis patients under fingolimod therapy

Iodice, Rosa; Carotenuto, Antonio; Dubbioso, Raffaele; Cerillo, Ilaria; Santoro, Lucio; Manganelli, Fiore

doi:10.1016/j.jns.2016.04.026

Cited by 28 publications

(24 citation statements)

References 30 publications

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“…Studies using EP latencies or EP scores to evaluate treatment effects in relapsing or progressive MS are summarized in Table 2 and studies in the visual system are summarized in Table 3 . Possible treatment effects could be identified with EP latencies and mmEP scores in small cohorts of RRMS patients using natalizumab, 53 fingolimod, 54 and after re-infusion of the patient’s own bone-marrow cells. 55 A large study testing azathioprine in progressive MS has shown increasing latencies in sensory EP in the placebo, as well as in the treated group in parallel to clinical deterioration in both groups.…”

Section: Ep As Response Biomarkermentioning

confidence: 99%

A new role for evoked potentials in MS? Repurposing evoked potentials as biomarkers for clinical trials in MS

2017

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Evoked potentials (EP) characterize signal conduction in selected tracts of the central nervous system in a quantifiable way. Since alteration of signal conduction is the main mechanism of symptoms and signs in multiple sclerosis (MS), multimodal EP may serve as a representative measure of the functional impairment in MS. Moreover, EP have been shown to be predictive for disease course, and thus might help to select patient groups at high risk of progression for clinical trials. EP can detect deterioration, as well as improvement of impulse propagation, independently from the mechanism causing the change. Therefore, they are candidates for biomarkers with application in clinical phase-II trials. Applicability of EP in multicenter trials has been limited by different standards of registration and assessment.

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Section: Ep As Response Biomarkermentioning

confidence: 99%

A new role for evoked potentials in MS? Repurposing evoked potentials as biomarkers for clinical trials in MS

2017

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“…The impact of DMT on evoked potentials, including VEP, has been evaluated in different studies and suggest their potential as an outcome marker in clinical trials. In a small study on clinically stable RRMS subjects treated with fingolimod, for example, an improvement in multimodal evoked potentials, including VEP, was observed after 1 year of treatment [88], whereas in an unblinded study of biotine VEP improvement was observed in a subgroup of patients [89]. VEP moreover, have been successfully used as an outcome markers of simvastatin treatment after acute optic neuritis [90].…”

Section: Visual System Measures: Optical Coherence Tomography and Vismentioning

confidence: 99%

Assessing Repair in Multiple Sclerosis: Outcomes for Phase II Clinical Trials

Sormani

Pardini

2017

Neurotherapeutics

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Multiple Sclerosis (MS) pathology is complex and includes inflammatory processes, neurodegeneration, and demyelination. While multiple drugs have been developed to tackle MS-related inflammation, to date there is scant evidence regarding which therapeutic approach, if any, could be used to reverse demyelination, foster tissue repair, and thus positively impact on chronic disability. Here, we reviewed the current structural and functional markers (magnetic resonance imaging, positron emission tomography, optical coherence tomography, and visual evoked potentials) which could be used in phase II clinical trials of new compounds aimed to foster tissue repair in MS. Magnetic transfer ratio recovery in newly formed lesions currently represents the most widely used biomarker of tissue repair in MS, even if other markers, such as optical coherence tomography and positron emission tomography hold great promise to complement magnetic transfer ratio in tissue repair clinical trials. Future studies are needed to better characterize the different possible biomarkers to study tissue repair in MS, especially regarding their pathological specificity, sensitivity to change, and their relationship with disease activity.

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“…Effects of treatment on optic neuritis have been tested with PVEP in many studies [28][29][30][31][32] .…”

Section: Multiple Sclerosis and Optic Neuritismentioning

confidence: 99%

“…VEPs, combined with other EPs, proved useful in evaluating the efficacy of drugs designed to impede the course of MS, such as interferon 1b 29 , natalizumab 30 , and fingolimod 31 . Compared to the pre-treatment delays, latency of PVEPs in these studies improved after the treatment with natalizumab, and VEP sum score was stable in 95% of patients and 5% worsened 1 year after the start of fingolimod treatment 31 . The improvement is most likely explained by the occurrence of remyelination in treated patients (Figure 2) 32 .…”

Section: Multiple Sclerosis and Optic Neuritismentioning

confidence: 99%