Serial evoked potentials in multiple sclerosis bouts. Relation to steroid treatment

Mantia, L. La; Riti, F.; Milanese, C.; Salmaggi, Andrea; Eoli, Marica; Ciano, Claudia; Avanzini, G.

doi:10.1007/bf02339929

Cited by 17 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a study performed during the period before the wide usage of immunomodulatory drugs, it was proposed that azathioprine causes changes in VEP and SEP one year before any clinical changes in chronic progressive MS. In another study where the effects of methylprednisolone were investigated, a relationship between the changes in disability and EP scores was suggested (24,26).…”

Section: Discussionmentioning

confidence: 99%

Clinical, Radiological and Electrophysiological Comparison of Immunomodulatory Therapies in Multiple Sclerosis

Genç¹,

Demirkaya

Bek

et al. 2017

Arch Neuropsychiatr

View full text Add to dashboard Cite

Multiple sclerosis (MS) is an autoimmune inflammatory demyelinating disease of the central nervous system (CNS) usually presenting with episodes of relapses and remissions, and sometimes progression of the disease can be triggered by environmental factors and the genetic background (1). Magnetic resonance imaging (MRI) provides significant data in MS regarding diagnosis, demonstration of the clinical-lesion relationship, disease activity and treatment follow-up (2). Examination of evoked potentials (EPs) is a simple and non-invasive method that is important in confirming clinical signs and symptoms as well as revealing silent lesions and multisystem involvement. Visual evoked potentials (VEPs), brainstem auditory evoked potentials (BAEPs), and somatosensory evoked potentials (SEPs) are used to electrophysiologically define lesions in CNS afferent pathways, and they reveal the multifocal characteristics of the disease.Because episodes might recover on their own and progression varies among patients or even in the same patient over time, it is difficult to decide whether treatment in MS is effective in the short run. Treatment interventions vary depending on the disease type and clinical period. In all randomized, placebo-controlled studies, interferon beta (IFN-B) and glatiramer acetate (GA) have been shown to reduce the frequency of episodes and MRI activity in relapsing-remitting multiple sclerosis (RRMS). These treatments should be given to patients diagnosed with RRMS with an Expanded Disability Status Scale (EDSS) score <5.5 who have had two or more episodes lasting longer than 24 hours with new symptoms or deterioration of previous symptoms and no fever. Debates as to which agent should be selected for which patient, the time to start treatment, the duration of treatment, and the roles of side effects in efficacy are ongoing. We aimed to compare these agents in terms of clinical, radiological, and electrophysiological measurements and to determine whether these agents showed any differences in efficacy or side effects. METHODS Study PopulationWe chose a cohort of 85 patients older than 18 years of age who applied to the MS outpatient clinic of the Gülhane Military Medical Academy between April 2006 and April 2009 and who were being followed up with a "Clinically Definite MS" diagnosis according to the Poser and Introduction: Although it has been shown that immunomodulatory therapies (IMTs) in multiple sclerosis (MS) can modify the course of the disease by reducing the relapse rate and delaying the progression of disability, no study comparing IMTs head-to-head in terms of clinical, radiological, and electrophysiological changes is available. We aimed to investigate the effects of interferon-beta (IFN-B) 1b, IFN-B-1a subcutaneous (sc), IFN-B-1a intramuscular (im), and glatiramer acetate (GA) therapies on clinical, electrophysiological, and radiological findings. Methods:We studied a cohort of 85 MS patients who were followed up for at least 2 years and had complete charting, including pre-treatment and post-...

show abstract

Section: Discussionmentioning

confidence: 99%

Clinical, Radiological and Electrophysiological Comparison of Immunomodulatory Therapies in Multiple Sclerosis

Genç¹,

Demirkaya

Bek

et al. 2017

Arch Neuropsychiatr

View full text Add to dashboard Cite

show abstract

“…Similar degrees of improvement in CMCT have also been documented with clinical improvement in response to physiotherapy (Kandler, 1990) and in patients who improve without treatment for a relapse (Sahota et al, 2005), making a specific effect of corticosteroids on neural excitability less likely. VEP latencies have been reported both to improve (Brusa et al, 2001) and to remain static (Compston et al, 1987;de Weerd and Jonkman, 1982) in patients who have improved clinically; SSEP latencies have not been shown to change longitudinally (de Weerd, 1987;Iragui et al, 1986;La Mantia et al, 1994;Smith et al, 1986) in patients who have improved clinically, with or without steroid therapy. Kidd et al (1998) studied a group of 20 patients with progressive MS longitudinally and demonstrated that clinical progression over the course of 1 year was seldom associated with progressive prolongation in CMCT, unless there were also new spinal cord lesions which developed over the same timeframe.…”

Section: Tms In Longitudinal Disease Assessmentmentioning

confidence: 93%

The use of transcranial magnetic stimulation in diagnosis, prognostication and treatment evaluation in multiple sclerosis

Simpson

Macdonell

2015

Multiple Sclerosis and Related Disorders

View full text Add to dashboard Cite

“…More recently, a sig-ni®cant correlation between changes of disability and of a composite EP score has been found in a clinical trial designed to evaluate the ef®cacy of methylprednisolone in acute MS bouts. 55 …”

Section: Neurophysiological Assessment Of Disease Severitymentioning

confidence: 99%

Neurophysiological and cognitive markers of disease evolution in multiple sclerosis

et al. 1998

View full text Add to dashboard Cite

Both evoked potentials and cognitive tests may provide useful information which cannot be derived from the clinical observation. For this reason, there have been some attempts to use EPs in monitoring the natural history of the disease and in assessing the efficacy of therapeutic trials. However, no conclusion can be derived from the few available data. Although MRI is more sensitive than EPs in revealing new lesions in brain, cerebellum and brainstem, EPs are more sensitive in revealing optic nerve and spinal cord lesions. Moreover, the poor relationship between brain MRI abnormalities and disability has raised the possibility that cognitive evaluation may be an additional sensitive marker of brain involvement over time. Since the gold standard for the assessment of disease activity is uncertain, it is therefore advisable that frequent MRI, EPs and cognitive assessment may integrate clinical outcomes measured by conventional scales, both in the study of the natural disease course and in monitoring clinical trials.

show abstract

Serial evoked potentials in multiple sclerosis bouts. Relation to steroid treatment

Cited by 17 publications

References 28 publications

Clinical, Radiological and Electrophysiological Comparison of Immunomodulatory Therapies in Multiple Sclerosis

Clinical, Radiological and Electrophysiological Comparison of Immunomodulatory Therapies in Multiple Sclerosis

The use of transcranial magnetic stimulation in diagnosis, prognostication and treatment evaluation in multiple sclerosis

Neurophysiological and cognitive markers of disease evolution in multiple sclerosis

Contact Info

Product

Resources

About