title: Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis.
abstract: BACKGROUND
  Functional biomarkers able to identify multiple sclerosis (MS) patients at high risk of fast disability progression are lacking. The aim of this study was to evaluate the ability of multimodal (upper and lower limbs motor, visual, lower limbs somatosensory) evoked potentials (EP) to monitor disease course and identify patients exposed to unfavourable evolution.
  
  
  METHODS
  One hundred MS patients were assessed with visual, somatosensory and motor EP and rated on the Expanded Disability Status Scale (EDSS) at baseline (T0) and about 6 years later (T1). The Spearman correlation (rS) was used to evaluate the relationship between conventional EP scores and clinical findings. Multiple (logistic) regression analysis estimated the predictive value of baseline electrophysiological data for three clinical outcomes: EDSS, annual EDSS progression, and the risk of EDSS worsening.
  
  
  RESULTS
  In contrast to longitudinal correlations, cross-sectional correlations between the different EP scores and EDSS were all significant (0.33 ≤ rS < 0.67, p < 0.001). Baseline global EP score and EDSS were highly significant predictors (p < 0.0001) of EDSS progression 6 years later. The baseline global EP score was found to be an independent predictor of the EDSS annual progression rate (p < 0.001), and of the risk of disability progression over time (p < 0.005). Based on a ROC curve determination, we defined a Global EP Score cut off point (17/30) to identify patients at high risk of disability progression illustrated by a positive predictive value of 70%.
  
  
  CONCLUSIONS
  This study provides a proof of the concept that electrophysiology could be added to MRI and used as another complementary prognostic tool in MS patients.
authors.affiliation: Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium. xgiffroy@chu.ulg.ac.be.|Department of Physical Medicine and Rehabilitation, University Hospital of Liege, B35, 4000, Liege, Belgium. xgiffroy@chu.ulg.ac.be.
authors.forename: Xavier
authors.initials: X
authors.lastname: Giffroy
authors.affiliation: Department of Biostatistics and Medico-Economic Information, University Hospital (CHU, ULg) of Liege, B35, 4000, Liège, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Maes
authors.affiliation: Department of Biostatistics and Medico-Economic Information, University Hospital (CHU, ULg) of Liege, B35, 4000, Liège, Belgium.
authors.forename: Adelin
authors.initials: A
authors.lastname: Albert
authors.affiliation: Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium.
authors.forename: Pierre
authors.initials: P
authors.lastname: Maquet
authors.affiliation: Department of Physical Medicine and Rehabilitation, University Hospital of Liege, B35, 4000, Liege, Belgium.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Crielaard
authors.affiliation: Department of Neurology, University Hospital of Liege, Rue Grandfosse 31-33, 4130, Esneux, Belgium.
authors.forename: Dominique
authors.initials: D
authors.lastname: Dive
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D018450:Disease Progression; D019054:Evoked Potentials, Motor / Q000502:physiology*; D005073:Evoked Potentials, Somatosensory / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D009103:Multiple Sclerosis / Q000503:physiopathology*; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers
keywords: Disability; Evoked potentials; Multiple sclerosis; Prognosis