Effectiveness of Brainstem Auditory Evoked Potentials Scoring in Evaluating Brainstem Dysfunction and Disability Among Individuals With Multiple Sclerosis

2021 ◽  
pp. 1-11
Author(s):  
Vignesh Sangu Srinivasan ◽  
Rajalakshmi Krishna ◽  
Bhoopathy Rangappan Munirathinam

Purpose The brainstem dysfunction in multiple sclerosis (MS) often causes significant functional impairment leading to disability. This study aims to explore modified brainstem auditory evoked potential (BAEP) scores based on the pattern of BAEP abnormalities and relate with brainstem symptoms, brainstem functional system scores (BFSS), brainstem lesions, and disability. Method Forty-five participants with relapsing–remitting MS and 45 age- and gender-matched healthy controls underwent case history assessment, otoscopic examination, pure-tone audiometry, and BAEP testing. Also, neurological examination (Expanded Disability Status Scale, FSS scales) and magnetic resonance imaging were carried out on MS participants. Patterns of BAEP abnormalities were categorized and converted to BAEP scores. Results Out of 45 participants' brainstem symptoms, BFSS > 1, brainstem lesions (magnetic resonance imaging), and BAEP abnormalities were observed in 75.6%, 42.2%, 62.2%, and 55.56% of participants, respectively. Waves V and III abnormalities were more common among MS participants and showed a significant difference from the control group in the Mann–Whitney U test. Chi-square test did not show a significant association of BAEP abnormalities with brainstem symptoms and lesions but showed significant association with BFSS. The mean and standard deviation of BAEP scores in MS participants were 1.73 + 2.37. All healthy controls showed BAEP scores of 0. BAEP scores in MS participants showed significant correlation with BFSS scores and predict Expanded Disability Status Scale scores. Conclusion BAEP scores based on the pattern of BAEP abnormality can be a valid and useful measure in evaluating brainstem functions and predicting disability in MS.

2007 ◽  
Vol 13 (7) ◽  
pp. 880-883 ◽  
Author(s):  
Y. Zhang ◽  
RK Zabad ◽  
X. Wei ◽  
LM Metz ◽  
MD Hill ◽  
...  

T2 hypointensity (black T2, BT2) in the deep grey matter of multiple sclerosis (MS) patients correlate weakly with disability at 1.5 T. BT2 is likely to be caused by abnormal iron deposition. We compared the correlation between disability and deep grey matter BT2 measured on 3 T MRI and on 1.5 T MRI in 17 MS patients. We observed a significant correlation between expanded disability status scale and signal intensity on 3 T MRI in the globus pallidus and the caudate nucleus ( r = —0.5, P < 0.05). BT2 at 3 T may be a useful MRI measure associated with disability in MS and warrants further study. Multiple Sclerosis 2007; 13: 880—883. http://msj.sagepub.com


2015 ◽  
Vol 4 (2) ◽  
Author(s):  
E. Mark Haacke ◽  
Sean K. Sethi ◽  
Jing Jiang ◽  
Ying Wang ◽  
David T. Utriainen

The study of chronic cerebrospinal venous insufficiency (CCSVI) and its impact on the development and progression of multiple sclerosis (MS) remains controversial. Although the initial thrust in evaluating CCSVI was with ultrasound, other modalities including magnetic resonance imaging (MRI) have been used to study venous vascular abnormalities. This review focuses on the findings of a number of past MRI studies including a look at a combined study of four previous works with a cohort of 559 MS patients regarding structure and function of the extra-cranial vasculature. Strengths and limitations of each paper are discussed which give insight into conflicting reports of venous abnormalities in MS patients and healthy controls. Guidelines for data acquisition and analysis for future studies related to extra-cranial structure and flow, both arterial and venous, are discussed. This includes the grading of stenosis of the internal jugular veins (IJVs) as well as normalized flows through major veins of the neck. The lack of agreement between most studies is likely due to inconsistent data acquisition and incomplete data analysis. Our own work over four independent sites shows good agreement, indicating that there is a high incidence of stenosis and structural venous abnormalities in the MS population and that this change results in reduced outflow of the IJVs and increased collateralization of venous return to the heart compared to healthy controls.


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