Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis

Abstract

: ABSTRACT:: Multiple sclerosis (MS) is an inflammatory, degenerative disease of the central nervous system (CNS) characterized by progressive neurological decline over time. The need for better "biomarkers" to more precisely capture and track the effects of demyelination, remyelination, and associated neuroaxonal injury is a well-recognized challenge in the field of MS. To this end, visual evoked potentials (VEPs) have a role in assessing the extent of demyelination along the optic nerve, as a functionally eloquent CNS region. Moreover, VEPs testing can be used to predict the extent of recovery after optic neuritis (ON) and capture disabling effects of clinical and subclinical demyelination events in the afferent visual pathway. In this review, the evolving role of VEPs in the diagnosis of patients with ON and MS and the utility of VEPs testing in determining therapeutic benefits of emerging MS treatments is discussed.

Optic Nerve Topography in Multiple Sclerosis Diagnosis

“…In our work, we have demonstrated that patients fulfilling the modDIS criteria at baseline were at a high risk of developing a second attack during follow-up, which was similar to the risk observed in patients fulfilling the 2017 DIS criteria. These findings are in line with the work by Filippi et al 9 that 18 and reinforces the fact that symptomatic lesions should be taken into account when considering the diagnosis of MS in patients with CIS. 19,20 As for the diagnostic performance analysis, we have proved that the addition of the optic nerve to the current DIS criteria slightly increases the accuracy and sensitivity without lowering the specificity, both in the whole cohort and in symptomatic and asymptomatic patients with CIS.…”

“…These results are partially discordant with the results published by Brownlee et al and may be partly explained by a slight overrepresentation of optic neuritis in their work 8 or by the fact that VEPs are more capable of detecting subclinical optic nerve involvement than clinical assessment alone. 18,[21][22][23] The 2016 MAGNIMS proposal suggested that optic nerve involvement may be ascertained clinically (by detecting optic nerve atrophy or pallor), with neurophysiologic tests (VEPs), or by imaging with either MRI to detect optic nerve lesions or OCT to detect peripapillary retinal nerve fiber layer thinning. 7 Assessment of optic nerve involvement based only on clinical findings may be challenging if not assessed by a trained neuro-ophthalmologist, 24 and thus, the use of paraclinical tests to confirm optic nerve damage may be advisable.…”

Prognostic Factors for Recovery of Vision in Canine Optic Neuritis of Unknown Etiology: 26 Dogs (2003–2018)

“…Future studies should combine behavioral assessment of visual acuity (151) and clinical testing with more objective methods such as visual evoked potentials (VEP). This is performed in people with ON to assess conduction recovery along the visual pathway and represents a valuable tool in interpreting relapses (152). The use of VEP in dogs has been reported, and results are reliable and reproducible (153–155).…”

Parâmetros Clínicos, Biológicos E Moleculares Na Resposta Ao Tratamento Com Interferon-Beta Em Pacientes Com Esclerose Múltipla

“…O PEV pode demonstrar anormalidades até mesmo em pacientes que não apresentam sintomas de distúrbio visual, o que demonstra a sensibilidade da técnica, ao contrário dos potenciais evocados somatossensitivos e auditivos, que são pouco sensíveis, tendo, portanto menor valor diagnóstico. Portanto, o PEV é importante em casos de suspeita de EM, onde há busca de lesões subclínicas no SNC (LEOCANI et al, 2018).…”