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原发性进行性多发性硬化症的预后生物标志物:验证和仔细研究多模态诱发电位。

Prognostic biomarkers in primary progressive multiple sclerosis: Validating and scrutinizing multimodal evoked potentials.

机构信息

Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland.

Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland.

出版信息

Clin Neurophysiol. 2022 May;137:152-158. doi: 10.1016/j.clinph.2022.02.019. Epub 2022 Mar 7.

DOI:10.1016/j.clinph.2022.02.019
PMID:35316624
Abstract

OBJECTIVE

To validate the prognostic value of multimodal evoked potentials (mmEP) in primary progressive multiple sclerosis (PPMS) and to determine the most predictive EP-modalities.

METHODS

Thirty-nine patients with PPMS (expanded disability status scale (EDSS): 2.0-6.5; mean clinical follow-up: 2.8 years) had visual (VEP), upper and lower limb somatosensory (SEP) and motor EP (MEP) at baseline. Quantitative EP-scores for single (qVEP, qSEP, qMEP) and combined modalities were correlated to EDSS and compared to previously published data of 21 PPMS patients. Predictors of EDSS-change were analyzed in pooled data by linear regression.

RESULTS

Samples were comparable. Except qVEP, all EP-scores were correlated to EDSS at baseline (Rho: 0.45-0.69; p < 0.01) and follow-up (Rho: 0.59-0.80; p < 0.001). Combined EP-modalities significantly predicted EDSS-change (R: 0.24), while EDSS and age did not. Tibial qSEP (R: 0.22) and qMEP (R: 0.26) were the best single modality predictors, outperformed by their combination (R: 0.32).

CONCLUSIONS

Quantitative EP-scores predict up to 32% of EDSS-change over three years. Modalities representing motor and long tract function carry the main prognostic information.

SIGNIFICANCE

Replication of previous results corroborates the use of mmEP as a prognostic biomarker candidate in PPMS.

摘要

目的

验证多模态诱发电位(mmEP)在原发性进展型多发性硬化(PPMS)中的预后价值,并确定最具预测性的 EP 模式。

方法

39 例 PPMS 患者(扩展残疾状况量表(EDSS):2.0-6.5;平均临床随访:2.8 年)在基线时进行视觉(VEP)、上下肢体感(SEP)和运动诱发电位(MEP)。对单模态(qVEP、qSEP、qMEP)和联合模态的定量 EP 评分与 EDSS 相关,并与 21 例 PPMS 患者的先前发表数据进行比较。通过线性回归分析汇总数据中 EDSS 变化的预测因子。

结果

样本具有可比性。除 qVEP 外,所有 EP 评分在基线(Rho:0.45-0.69;p<0.01)和随访时(Rho:0.59-0.80;p<0.001)均与 EDSS 相关。联合 EP 模式显著预测 EDSS 变化(R:0.24),而 EDSS 和年龄则不显著。胫骨 qSEP(R:0.22)和 qMEP(R:0.26)是最佳的单模态预测因子,优于其组合(R:0.32)。

结论

定量 EP 评分可预测三年内高达 32%的 EDSS 变化。代表运动和长束功能的模式携带主要的预后信息。

意义

对先前结果的复制证实了 mmEP 可作为 PPMS 中预后生物标志物的候选物。

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Prognostic biomarkers in primary progressive multiple sclerosis: Validating and scrutinizing multimodal evoked potentials.原发性进行性多发性硬化症的预后生物标志物:验证和仔细研究多模态诱发电位。
Clin Neurophysiol. 2022 May;137:152-158. doi: 10.1016/j.clinph.2022.02.019. Epub 2022 Mar 7.
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