Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Sherman Hall Annex Room 114, Buffalo, NY 14214, USA.
Department of Neurology, Lady Davis Carmel Medical Center, Haifa, Israel; Multiple Sclerosis and Neuroimmunology Clinic, Clalit Health Services, Nazareth, Israel; Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Mult Scler Relat Disord. 2022 Dec;68:104116. doi: 10.1016/j.msard.2022.104116. Epub 2022 Aug 14.
Visual evoked potentials (VEP) index visual pathway functioning, and are often used for clinical assessment and as outcome measures in people with multiple sclerosis (PwMS). VEPs may also reflect broader neural disturbances that extend beyond the visual system, but this possibility requires further investigation. In the present study, we examined the hypothesis that delayed latency of the P100 component of the VEP would be associated with broader structural changes in the brain in PwMS. We obtained VEP latency for a standard pattern-reversal checkerboard stimulus paradigm, in addition to Magnetic Resonance Imaging (MRI) measures of whole brain volume (WBV), gray matter volume (GMV), white matter volume (WMV), and T2-weighted fluid attenuated inversion recovery (FLAIR) white matter lesion volume (FLV). Correlation analyses indicated that prolonged VEP latency was significantly associated with lower WBV, GMV, and WMV, and greater FLV. VEP latency remained significantly associated with WBV, GMV, and WMV even after controlling for the variance associated with inter-ocular latency, age, time between VEP and MRI assessments, and other MRI variables. VEP latency delays were most pronounced in PwMS that exhibited low volume in both white and gray matter simultaneously. Furthermore, PwMS that had delayed VEP latency based on a clinically relevant cutoff (VEP latency ≥ 113 ms) in both eyes had lower WBV, GMV, and WMV and greater FLV in comparison to PwMS that had normal VEP latency in one or both eyes. The findings suggest that PwMS that have delayed latency in both eyes may be particularly at risk for exhibiting greater brain atrophy and lesion volume. These analyses also indicate that VEP latency may index combined gray matter and white matter disturbances, and therefore broader network connectivity and efficiency. VEP latency may therefore provide a surrogate marker of broader structural disturbances in the brain in MS.
视觉诱发电位（VEP）反映视觉通路的功能，常用于临床评估和多发性硬化症（MS）患者的疗效评估。VEP 也可能反映出超出视觉系统的更广泛的神经紊乱，但这一可能性需要进一步研究。在本研究中，我们检验了这样一个假设，即 VEP 的 P100 成分潜伏期的延迟与 MS 患者大脑中更广泛的结构变化有关。我们获得了标准棋盘格翻转模式刺激范式的 VEP 潜伏期，以及大脑整体容积（WBV）、灰质容积（GMV）、白质容积（WMV）、T2 加权液体衰减反转恢复（FLAIR）白质病变容积（FLV）的磁共振成像（MRI）测量值。相关分析表明，VEP 潜伏期延长与 WBV、GMV 和 WMV 降低以及 FLV 增加显著相关。即使在控制了眼间潜伏期、年龄、VEP 和 MRI 评估之间的时间以及其他 MRI 变量与方差的相关性后，VEP 潜伏期仍与 WBV、GMV 和 WMV 显著相关。VEP 潜伏期的延迟在同时表现出灰白质容积均降低的 MS 患者中最为明显。此外，与一只或两只眼睛 VEP 潜伏期正常的 MS 患者相比，双眼 VEP 潜伏期延迟（基于临床相关截定点，即 VEP 潜伏期≥113ms）的 MS 患者 WBV、GMV 和 WMV 更低，FLV 更大。这些发现表明，双眼 VEP 潜伏期延迟的 MS 患者可能特别容易出现大脑萎缩和病变体积增加。这些分析还表明，VEP 潜伏期可能反映出灰质和白质的综合紊乱，以及更广泛的网络连接和效率。因此，VEP 潜伏期可能是 MS 患者大脑中更广泛结构紊乱的替代标志物。
