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.
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.
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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