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Elektrofizyolojik Çalışmalar Multipl Skleroz Prognozunu Öngörebilir mi?

Yıl 2022, Cilt: 75 Sayı: 2, 231 - 238, 30.06.2022

Özlem Ergin

Öz

Amaç: Multipl skleroz (MS), prognozu öngörülemeyen otoimmün nörodejeneratif bir hastalıktır. MS lezyonları, elektrofizyolojik çalışmaların uyarılmış
potansiyellerini (UP) etkileyebilir. Bu çalışmada elektrofizyolojik parametreleri kullanarak MS hastalarının prognozunu öngörmeyi amaçladık.

Gereç ve Yöntem: İki yıl boyunca, vizüel UP (VUP) ve somatosensoryal UP (SUP) tetkikleri yapılmış olan MS hastaları çalışmaya dahil edildi.
Hastaların demografik özellikleri, MS tipi, atak sayıları, muayene esnasındaki genişletilmiş engellilik durum skalaları (EDSS), elektrofizyolojik UP, kan
testleri, ilk beyin omurilik sıvısı (BOS) ve manyetik rezonans görüntüleme (MRG) bulguları değerlendirildi.

Bulgular: Toplam iki yüz elli dokuz MS hastası değerlendirildi. Her iki elektrofizyolojik inceleme için de, tespit edilen patolojik sonuçlar ile hastaların
EDSS skorları arasında istatistiksel olarak anlamlı bir ilişki vardı (p<0,001). MS ataklarının sayısı, sadece SEP patolojileri ile ilişkili bulundu (p=0,045).
BOS IgG indeksinin VEP üzerinde anlamlı bir etkisi yokken (p=0,065), posterior tibial SEP üzerinde istatistiksel olarak anlamlı bir etkisi vardı. IgG
indeksi yüksek olan MS hastalarında, posterior tibial SEP incelemeleri istatistiksel olarak anlamlı derecede iki yanlı patolojikti (p=0,039). Uluslararası
Huzursuz Bacak Sendromu Çalışma Grubu tanı kriterlerini karşılayan MS hastalarında hem VEP hem de tibial SEP incelemelerinde istatistiksel olarak
anlamlı olan iki taraflı bozukluk vardı (sırasıyla p=0,003 ve 0,000). Başlangıçta elektrofizyolojik incelemelerde patolojisi olan hastaların güncel
MRG’lerinde spinal ve infratentoryalde istatistiksel olarak anlamlı derecede daha sık demiyelinizan lezyonlar vardı.

Sonuç: UP MS hastalarında klinik progresyonu öngörebilir. MS hastalığında nörofizyolojik anormallikler prognostik faktör olarak kullanılabilir

Anahtar Kelimeler

Multipl Skleroz Prognoz Elektrofizyoloji Uyarılmış Potansiyeller

Etik Beyan

Ethics Committee Approval: The local ethics committee approved the study protocol (Ankara City Hospital, E1-21-2252). Informed Consent: Informed consent was not obtained. Peer-reviewed: Externally peer-reviewed.

Destekleyen Kurum

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Proje Numarası

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Teşekkür

-

Kaynakça

  • 1. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. Lancet Neurol. 2015;14:263-273.
  • 2. Sawcer S, Franklin RJ, Ban M. Multiple sclerosis genetics. Lancet Neurol. 2014;13:700-709.
  • 3. Katz Sand I. Classification, diagnosis, and differential diagnosis of multiple sclerosis. Curr Opin Neurol. 2015;28:193-205.
  • 4. Comi G, Locatelli T, Leocani L, Medaglini S, Rossi P, Martinelli V. Can evoked potentials be useful in monitoring multiple sclerosis evolution? Electroencephalogr Clin Neurophysiol Suppl. 1999;50:349-357.
  • 5. Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278-286.
  • 6. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162-173.
  • 7. Giffroy X, Maes N, Albert A, Maquet P, Crielaard JM, Dive D. Do evoked potentials contribute to the functional follow-up and clinical prognosis of multiple sclerosis? Acta Neurol Belg. 2017;117:53-59.
  • 8. Hardmeier M, Fuhr P. Multimodal Evoked Potentials as Candidate Prognostic and Response Biomarkers in Clinical Trials of Multiple Sclerosis. J Clin Neurophysiol. 2021;38:171-180.
  • 9. Allen RP, Picchietti DL, Garcia-Borreguero D, et al. Restless legs syndrome/ Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med. 2014;15:860-873.
  • 10. Giffroy X, Maes N, Albert A, Maquet P, Crielaard JM, Dive D. Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis. BMC Neurol. 2016;16:83.
  • 11. Nuwer MR, Packwood JW, Myers LW, Ellison GW. Evoked potentials predict the clinical changes in a multiple sclerosis drug study. Neurology. 1987;37:1754-1761.
  • 12. Leocani L, Guerrieri S, Comi G. Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis. J Neuroophthalmol. 2018;38:350-357.
  • 13. Carter J, Stevens J. Somatosensory evoked potentials. In: Daube J, Rubin D, editors. Clinical Neurophysiology. New York: Oxford University Press; 2009. p. 257-280.
  • 14. Invernizzi P, Bertolasi L, Bianchi MR, Turatti M, Gajofatto A, Benedetti MD. Prognostic value of multimodal evoked potentials in multiple sclerosis: the EP score. J Neurol. 2011;258:1933-1939.
  • 15. Ramanathan S, Lenton K, Burke T, et al. The utility of multimodal evoked potentials in multiple sclerosis prognostication. J Clin Neurosci. 2013;20:1576-1581.
  • 16. Comi G, Leocani L, Medaglini S, et al. Measuring evoked responses in multiple sclerosis. Mult Scler. 1999;5:263-267.
  • 17. Dobson R, Giovannoni G. Multiple sclerosis - a review. Eur J Neurol. 2019;26:27-40.
  • 18. Tremlett H, Paty D, Devonshire V. Disability progression in multiple sclerosis is slower than previously reported. Neurology. 2006;66:172-177.
  • 19. Trojano M, Liguori M, Bosco Zimatore G, et al. Age-related disability in multiple sclerosis. Ann Neurol. 2002;51:475-480.
  • 20. Bergamaschi R, Romani A, Tonietti S, Citterio A, Berzuini C, Cosi V. Usefulness of Bayesian graphical models for early prediction of disease progression in multiple sclerosis. Neurol Sci. 2000;21(4 Suppl 2):S819-S823.
  • 21. Leocani L, Rovaris M, Boneschi FM, et al. Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study. J Neurol Neurosurg Psychiatry. 2006;77:1030-1035.
  • 22. Matthews WB, Small DG. Serial recording of visual and somatosensory evoked potentials in multiple sclerosis. J Neurol Sci. 1979;40:11-21.
  • 23. Sater RA, Rostami AM, Galetta S, Farber RE, Bird SJ. Serial evoked potential studies and MRI imaging in chronic progressive multiple sclerosis. J Neurol Sci. 1999;171:79-83.
  • 24. de Weerd AW, Jonkman EJ. Changes in visual and short-latency somatosensory evoked potentials in patients with multiple sclerosis. Adv Neurol. 1982;32:527-534.
  • 25. Fuhr P, Borggrefe-Chappuis A, Schindler C, Kappos L. Visual and motor evoked potentials in the course of multiple sclerosis. Brain. 2001;124:2162-2168.
  • 26. Ghezzi A, Zaffaroni M, Caputo D, Montanini R, Cazzullo CL. Evaluation of evoked potentials and lymphocyte subsets as possible markers of multiple sclerosis: one year follow up of 30 patients. J Neurol Neurosurg Psychiatry. 1986;49:913-919.
  • 27. Andersson T, Sidén A. Multimodality evoked potentials and neurological phenomenology in patients with multiple sclerosis and potentially related conditions. Electromyogr Clin Neurophysiol. 1991;31:109-117.
  • 28. Hardmeier M, Fuhr P. Multimodal Evoked Potentials as Candidate Prognostic and Response Biomarkers in Clinical Trials of Multiple Sclerosis. J Clin Neurophysiol. 2021;38:171-180.
  • 29. Iodice R, Carotenuto A, Dubbioso R, Cerillo I, Santoro L, Manganelli F. Multimodal evoked potentials follow up in multiple sclerosis patients under fingolimod therapy. J Neurol Sci. 2016;365:143-146.
  • 30. Cree BAC, Arnold DL, Chataway J, et al. Secondary Progressive Multiple Sclerosis: New Insights. Neurology. 2021;97:378-388.
  • 31. Azevedo CJ, Cen SY, Khadka S, et al. Thalamic atrophy in multiple sclerosis: A magnetic resonance imaging marker of neurodegeneration throughout disease. Ann Neurol. 2018;83:223-234.
  • 32. Zhornitsky S, McKay KA, Metz LM, Teunissen CE, Rangachari M. Cholesterol and markers of cholesterol turnover in multiple sclerosis: relationship with disease outcomes. Mult Scler Relat Disord. 2016;5:53-65.
  • 33. Calabrese M, Federle L, Bernardi V, et al. The association of intrathecal immunoglobulin synthesis and cortical lesions predicts disease activity in clinically isolated syndrome and early relapsing-remitting multiple sclerosis. Mult Scler. 2012;18:174-180.
  • 34. Gasperi C, Salmen A, Antony G, et al. Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis. JAMA Neurol. 2019;76:841-849.
  • 35. Ellidag HY, Eren E, Erdogan N, Ture S, Yilmaz N. Comparison of neurophysiological and MRI findings of patients with multiple sclerosis using oligoclonal band technique. Ann Neurosci. 2013;20:149-154.
  • 36. Tiftikcioglu BI, Ilgezdi I, Zorlu Y, Sener U, Tokucoglu F. Long-term disability and progression in spinal onset multiple sclerosis. Acta Neurol Belg. 2018;118:217-225.
  • 37. Bergamaschi R. Prognostic factors in multiple sclerosis. Int Rev Neurobiol. 2007;79:423-47.
  • 38. Sieminski M, Losy J, Partinen M. Restless legs syndrome in multiple sclerosis. Sleep Med Rev. 2015;22:15-22.
  • 39. Nardone R, Sebastianelli L, Versace V, et al. Involvement of central sensory pathways in subjects with restless legs syndrome: A neurophysiological study. Brain Res. 2021;1772:147673.
  • 40. Kısabay A, Sarı US, Korkmaz T, Dinçhorasan G, Yılmaz H, Selçuki D. Evaluation of neurodegeneration through visual evoked potentials in restless legs syndrome. Acta Neurol Belg. 2016;116:605-613.

Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?

Yıl 2022, Cilt: 75 Sayı: 2, 231 - 238, 30.06.2022

Özlem Ergin

Öz

Objectives: Multiple sclerosis (MS) is an autoimmune neurodegenerative disease with an unpredictable course. MS lesions can affect the evoked
potentials (EP) of electrophysiological studies. In this study, we aimed to predict the prognosis of MS patients with electrophysiological parameters.

Materials and Methods: MS patients with visual EP (VEP) and somatosensorial EP (SEP) were included in the study during two-year period.
Demographic characteristics, MS type, attack numbers, current expanded disability status scales (EDSS), electrophysiological EP, blood tests, first
cerebrospinal fluid (CSF) and magnetic resonance imaging (MRI) findings of the patients were evaluated.

Results: Two hundred and fifty-nine MS patients were evaluated. There was a statistically significant difference between EDSS scores and the
pathologies detected in both electrophysiological examinations (p<0.001). The number of MS attacks were only associated with SEP pathologies
(p=0.045). IgG index of CSF had no significant effect on VEP (p=0.065) but had a statistically significant effect on posterior tibial SEP. Posterior
tibial SEP was statistically significant in two-sided abnormalities in MS patients with an elevated IgG index (p=0.039). MS patients who met the
International Restless Legs Syndrome Study Group consensus criteria had two-sided abnormalities that were statistically significant on both VEP
and tibial SEP examinations (p=0.003 and 0.000, respectively). Patients who had pathology in electrophysiological examinations at the beginning
had statistically significantly more frequent demyelinating lesions in spinal and infratentorial according to current MRI.

Conclusion: EP can predict clinical deterioration in MS patients. Neurophysiological abnormalities can be considered in MS disease as a prognostic factor

Anahtar Kelimeler

Multiple Sclerosis Prognosis Electrophysiology Evoked Potentials

Proje Numarası

-

Kaynakça

  • 1. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. Lancet Neurol. 2015;14:263-273.
  • 2. Sawcer S, Franklin RJ, Ban M. Multiple sclerosis genetics. Lancet Neurol. 2014;13:700-709.
  • 3. Katz Sand I. Classification, diagnosis, and differential diagnosis of multiple sclerosis. Curr Opin Neurol. 2015;28:193-205.
  • 4. Comi G, Locatelli T, Leocani L, Medaglini S, Rossi P, Martinelli V. Can evoked potentials be useful in monitoring multiple sclerosis evolution? Electroencephalogr Clin Neurophysiol Suppl. 1999;50:349-357.
  • 5. Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: the 2013 revisions. Neurology. 2014;83:278-286.
  • 6. Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17:162-173.
  • 7. Giffroy X, Maes N, Albert A, Maquet P, Crielaard JM, Dive D. Do evoked potentials contribute to the functional follow-up and clinical prognosis of multiple sclerosis? Acta Neurol Belg. 2017;117:53-59.
  • 8. Hardmeier M, Fuhr P. Multimodal Evoked Potentials as Candidate Prognostic and Response Biomarkers in Clinical Trials of Multiple Sclerosis. J Clin Neurophysiol. 2021;38:171-180.
  • 9. Allen RP, Picchietti DL, Garcia-Borreguero D, et al. Restless legs syndrome/ Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance. Sleep Med. 2014;15:860-873.
  • 10. Giffroy X, Maes N, Albert A, Maquet P, Crielaard JM, Dive D. Multimodal evoked potentials for functional quantification and prognosis in multiple sclerosis. BMC Neurol. 2016;16:83.
  • 11. Nuwer MR, Packwood JW, Myers LW, Ellison GW. Evoked potentials predict the clinical changes in a multiple sclerosis drug study. Neurology. 1987;37:1754-1761.
  • 12. Leocani L, Guerrieri S, Comi G. Visual Evoked Potentials as a Biomarker in Multiple Sclerosis and Associated Optic Neuritis. J Neuroophthalmol. 2018;38:350-357.
  • 13. Carter J, Stevens J. Somatosensory evoked potentials. In: Daube J, Rubin D, editors. Clinical Neurophysiology. New York: Oxford University Press; 2009. p. 257-280.
  • 14. Invernizzi P, Bertolasi L, Bianchi MR, Turatti M, Gajofatto A, Benedetti MD. Prognostic value of multimodal evoked potentials in multiple sclerosis: the EP score. J Neurol. 2011;258:1933-1939.
  • 15. Ramanathan S, Lenton K, Burke T, et al. The utility of multimodal evoked potentials in multiple sclerosis prognostication. J Clin Neurosci. 2013;20:1576-1581.
  • 16. Comi G, Leocani L, Medaglini S, et al. Measuring evoked responses in multiple sclerosis. Mult Scler. 1999;5:263-267.
  • 17. Dobson R, Giovannoni G. Multiple sclerosis - a review. Eur J Neurol. 2019;26:27-40.
  • 18. Tremlett H, Paty D, Devonshire V. Disability progression in multiple sclerosis is slower than previously reported. Neurology. 2006;66:172-177.
  • 19. Trojano M, Liguori M, Bosco Zimatore G, et al. Age-related disability in multiple sclerosis. Ann Neurol. 2002;51:475-480.
  • 20. Bergamaschi R, Romani A, Tonietti S, Citterio A, Berzuini C, Cosi V. Usefulness of Bayesian graphical models for early prediction of disease progression in multiple sclerosis. Neurol Sci. 2000;21(4 Suppl 2):S819-S823.
  • 21. Leocani L, Rovaris M, Boneschi FM, et al. Multimodal evoked potentials to assess the evolution of multiple sclerosis: a longitudinal study. J Neurol Neurosurg Psychiatry. 2006;77:1030-1035.
  • 22. Matthews WB, Small DG. Serial recording of visual and somatosensory evoked potentials in multiple sclerosis. J Neurol Sci. 1979;40:11-21.
  • 23. Sater RA, Rostami AM, Galetta S, Farber RE, Bird SJ. Serial evoked potential studies and MRI imaging in chronic progressive multiple sclerosis. J Neurol Sci. 1999;171:79-83.
  • 24. de Weerd AW, Jonkman EJ. Changes in visual and short-latency somatosensory evoked potentials in patients with multiple sclerosis. Adv Neurol. 1982;32:527-534.
  • 25. Fuhr P, Borggrefe-Chappuis A, Schindler C, Kappos L. Visual and motor evoked potentials in the course of multiple sclerosis. Brain. 2001;124:2162-2168.
  • 26. Ghezzi A, Zaffaroni M, Caputo D, Montanini R, Cazzullo CL. Evaluation of evoked potentials and lymphocyte subsets as possible markers of multiple sclerosis: one year follow up of 30 patients. J Neurol Neurosurg Psychiatry. 1986;49:913-919.
  • 27. Andersson T, Sidén A. Multimodality evoked potentials and neurological phenomenology in patients with multiple sclerosis and potentially related conditions. Electromyogr Clin Neurophysiol. 1991;31:109-117.
  • 28. Hardmeier M, Fuhr P. Multimodal Evoked Potentials as Candidate Prognostic and Response Biomarkers in Clinical Trials of Multiple Sclerosis. J Clin Neurophysiol. 2021;38:171-180.
  • 29. Iodice R, Carotenuto A, Dubbioso R, Cerillo I, Santoro L, Manganelli F. Multimodal evoked potentials follow up in multiple sclerosis patients under fingolimod therapy. J Neurol Sci. 2016;365:143-146.
  • 30. Cree BAC, Arnold DL, Chataway J, et al. Secondary Progressive Multiple Sclerosis: New Insights. Neurology. 2021;97:378-388.
  • 31. Azevedo CJ, Cen SY, Khadka S, et al. Thalamic atrophy in multiple sclerosis: A magnetic resonance imaging marker of neurodegeneration throughout disease. Ann Neurol. 2018;83:223-234.
  • 32. Zhornitsky S, McKay KA, Metz LM, Teunissen CE, Rangachari M. Cholesterol and markers of cholesterol turnover in multiple sclerosis: relationship with disease outcomes. Mult Scler Relat Disord. 2016;5:53-65.
  • 33. Calabrese M, Federle L, Bernardi V, et al. The association of intrathecal immunoglobulin synthesis and cortical lesions predicts disease activity in clinically isolated syndrome and early relapsing-remitting multiple sclerosis. Mult Scler. 2012;18:174-180.
  • 34. Gasperi C, Salmen A, Antony G, et al. Association of Intrathecal Immunoglobulin G Synthesis With Disability Worsening in Multiple Sclerosis. JAMA Neurol. 2019;76:841-849.
  • 35. Ellidag HY, Eren E, Erdogan N, Ture S, Yilmaz N. Comparison of neurophysiological and MRI findings of patients with multiple sclerosis using oligoclonal band technique. Ann Neurosci. 2013;20:149-154.
  • 36. Tiftikcioglu BI, Ilgezdi I, Zorlu Y, Sener U, Tokucoglu F. Long-term disability and progression in spinal onset multiple sclerosis. Acta Neurol Belg. 2018;118:217-225.
  • 37. Bergamaschi R. Prognostic factors in multiple sclerosis. Int Rev Neurobiol. 2007;79:423-47.
  • 38. Sieminski M, Losy J, Partinen M. Restless legs syndrome in multiple sclerosis. Sleep Med Rev. 2015;22:15-22.
  • 39. Nardone R, Sebastianelli L, Versace V, et al. Involvement of central sensory pathways in subjects with restless legs syndrome: A neurophysiological study. Brain Res. 2021;1772:147673.
  • 40. Kısabay A, Sarı US, Korkmaz T, Dinçhorasan G, Yılmaz H, Selçuki D. Evaluation of neurodegeneration through visual evoked potentials in restless legs syndrome. Acta Neurol Belg. 2016;116:605-613.
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Nöroloji ve Nöromüsküler Hastalıklar
Bölüm Makaleler
Yazarlar

Özlem Ergin 0000-0002-9982-3650

Proje Numarası -
Yayımlanma Tarihi 30 Haziran 2022
Yayımlandığı Sayı Yıl 2022 Cilt: 75 Sayı: 2

Kaynak Göster

APA Ergin, Ö. (2022). Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 75(2), 231-238. https://doi.org/10.4274/atfm.galenos.2022.26779
AMA Ergin Ö. Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. Haziran 2022;75(2):231-238. doi:10.4274/atfm.galenos.2022.26779
Chicago Ergin, Özlem. “Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75, sy. 2 (Haziran 2022): 231-38. https://doi.org/10.4274/atfm.galenos.2022.26779.
EndNote Ergin Ö (01 Haziran 2022) Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75 2 231–238.
IEEE Ö. Ergin, “Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 2, ss. 231–238, 2022, doi: 10.4274/atfm.galenos.2022.26779.
ISNAD Ergin, Özlem. “Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 75/2 (Haziran 2022), 231-238. https://doi.org/10.4274/atfm.galenos.2022.26779.
JAMA Ergin Ö. Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75:231–238.
MLA Ergin, Özlem. “Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, c. 75, sy. 2, 2022, ss. 231-8, doi:10.4274/atfm.galenos.2022.26779.
Vancouver Ergin Ö. Can Electrophysiological Studies Predict Multiple Sclerosis Prognosis?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2022;75(2):231-8.
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