Chirapapaisan Niphon, Laotaweerungsawat Sawarin, Chuenkongkaew Wanicha, Samsen Patthanee, Ruangvaravate Ngamkae, Thuangtong Atiporn, Chanvarapha Nacha
Department of Ophthalmology, Faculty of Medicine, Siriraj Hospital, Mahidol University, 2 Prannok, Bangkoknoi, Bangkok, 10700, Thailand,
Doc Ophthalmol. 2015 Feb;130(1):25-30. doi: 10.1007/s10633-014-9466-6. Epub 2014 Oct 21.
Prolonged latency of visual evoked potentials (VEP) has been used to identify clinically silent lesions in multiple sclerosis (MS) suspects. The objective of this study was to determine the reliability of VEP to predict the development of MS in MS suspects.
Retrospective hospital records of MS suspects were evaluated. VEP was analyzed together with subsequent diagnostic confirmation of MS by McDonald diagnostic criteria for MS-2005.
MS developed in 12 of 35 patients (34 %) and 23 (66 %) failed to exhibit diagnostic characteristics. P100 latencies and interocular latency differences were longer in clinically definite multiple sclerosis (CDMS) than non-CDMS patients (p = 0.002, 0.001, respectively). All patients in the subsequent MS group had P100 latencies longer than102 ms, a mean of our MS-free subjects thus providing 100 % of sensitivity. No patient developed MS with a P100 latency <102 ms. Brain MRI lesions associated significantly with developing CDMS (p = 0.001). Predictability of developing CDMS was highest when criteria for P100 latency, interocular latency difference, and brain MRI lesions were combined.
MS suspects with a P100 latency longer than mean of MS-free subjects are more likely to develop MS than those with lower values. VEP latency combined with MRI could improve the accuracy of MS prediction.
视觉诱发电位(VEP)潜伏期延长已被用于识别疑似多发性硬化症(MS)患者的临床无症状性病变。本研究的目的是确定VEP预测疑似MS患者发生MS的可靠性。
对疑似MS患者的医院回顾性记录进行评估。将VEP分析结果与随后根据2005年MS的麦克唐纳诊断标准对MS进行的诊断确认结果相结合。
35例患者中有12例(34%)发生了MS,23例(66%)未表现出诊断特征。临床确诊的多发性硬化症(CDMS)患者的P100潜伏期和两眼间潜伏期差异比非CDMS患者更长(分别为p = 0.002和0.001)。随后发生MS组的所有患者P100潜伏期均超过102毫秒,而我们无MS受试者的平均值为102毫秒,因此敏感性为100%。没有P100潜伏期<102毫秒的患者发生MS。脑MRI病变与发生CDMS显著相关(p = 0.001)。当结合P100潜伏期、两眼间潜伏期差异和脑MRI病变的标准时,预测发生CDMS的能力最高。
P100潜伏期长于无MS受试者平均值的疑似MS患者比潜伏期较短的患者更有可能发生MS。VEP潜伏期与MRI相结合可提高MS预测的准确性。