Outcome measures for trials of remyelinating agents in multiple sclerosis: retrospective longitudinal analysis of visual evoked potential latency

2009 ◽  
Vol 15 (1) ◽  
pp. 68-74 ◽  
Author(s):  
A Niklas ◽  
H Sebraoui ◽  
E Heß ◽  
A Wagner ◽  
F Then Bergh
Keyword(s):  
Multiple Sclerosis ◽  
Outcome Measures ◽  
Visual Evoked Potential ◽  
P100 Latency ◽  
Surrogate Outcome ◽  
Acute Optic Neuritis ◽  
Normal Latency ◽  
Surrogate Outcome Measure ◽  
Visual Evoked

Objective Visual evoked potentials (VEP) may be suitable surrogate outcome measures in multiple sclerosis (MS) remyelination trials. The extent of spontaneous changes of subclinically delayed VEP is unknown, whereas VEP improve after acute optic neuritis (ON). Methods In all, 124 patients with three VEP recordings at least 3 months apart: 71 patients with MS who had never suffered clinical ON; 53 patients with ON (isolated ON or ON as an attack of MS at first recording). Latencies of P100 were analyzed by multivariate analysis of variance. Results Eyes of patients with MS had a mean P100 latency of 110.2 ms, worsening mildly over time ( n = 104 eyes, P = 0.022). MS patients' eyes with subclinical demyelination (delayed P100 latency at first recording >116 ms) showed no significant evidence of remyelination ( n = 24 eyes, P = 0.27). By contrast, in ON patients' affected eyes, mean P100 latency decreased ( P = 0.001), whereas unaffected eyes remained stable ( P = 0.26). Clinically non-affected eyes from both diagnostic groups with subclinically prolonged latencies remained stable ( n = 32: mean P100 at 124.8 ± 10.7, 123.5 ± 13.6, and 122.8 ± 13.1 ms; P = 0.57), whereas non-affected eyes with normal latency at baseline deteriorated slightly ( P = 0.001). A subgroup with more homogeneously defined follow-up periods confirmed this observation. Non-affected eyes selected for stability (difference <5 ms) between first and second recording deteriorated (normal baseline, n = 66 eyes, P = 0.013) or remained stable (prolonged baseline, n = 18 eyes, 95% confidence interval of change –5.42 to +6.89 ms, P = 0.805). Conclusion Prolonged P100 latencies in eyes never affected by clinical ON remain stable and thus can be used as surrogate outcome measure for remyelination trials.

scholarly journals Clinical Features and Visual outcome in Acute and Recurrent Case of Optic Neuritis.

2018 ◽  
Vol 1 (01) ◽  
pp. 56-63
Author(s):  
Jyoti Bastola Paudel ◽  
Ananda Kumar Sharma ◽  
Sanjeeta Sitaula ◽  
Madhu Thapa
Keyword(s):  
Multiple Sclerosis ◽  
Natural History ◽  
Optic Neuritis ◽  
Clinical Features ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Oral Steroid ◽  
Visual Recovery ◽  
Visual Evoked

Introduction: Optic neuritis is an inflammation of the optic nerve that usually affects young females. In Western countries, natural history and treatment of optic neuritis(ON) has been studied extensively. However aetiology, natural history, clinical features of ON and their relation to multiple sclerosis in Asian population needs to be defined yet. Methods: 30 patients who were diagnosed as optic neuritis were included between June 2013 to December 2014 at BP Koirala Lions Centre for Ophthalmic Studies (BPKLCOS). A detailed history was obtained followed by examination of anterior and posterior segment. Assessment of visual acuity, color vision, contrast sensitivity, visual evoked potential (VEP),visual field and MRI of orbit and brain was done in all cases. All patients were treated with intravenous Methylprednisolone 500mg twice daily for 3 days followed by oral steroid for 11 days which was tapered in the next 4 days.The patients were reassessed at 2 weeks, 1 month and 3months. Results: Commonest presenting symptom was diminution of vision(65%). MRI showed multiple paraventricular oval plaques definite of multiple sclerosis in one patient and one was diagnosed as probable MS who had a single periventricular plaque. Visual evoked potential (VEP) showed increase in the mean P100 latency at 60’ and reduction in amplitude in eyes affected with optic neuritis compared to normal eyes. At 3 months follow up, 70% had good visual recovery (>6/18). The cause of non-improvement in vision was disc pallor. Optic disc pallor was detected in 37.5% of the eyes during follow up. Conclusions: Good visual recovery was observed in most eyes with acute optic neuritis. Multiple sclerosis was seen in 1 patient who had recurrent optic neuritis.

scholarly journals Correlations between developmental test of visual perception-adolescent and adult and visual evoked potential in people with multiple sclerosis

2021 ◽  
Author(s):  
Yasaman Rezaei ◽  
Malahat Akbarfahimi ◽  
Mojtaba Azimian ◽  
Fahimeh Mohaghegh ◽  
Mehdi Moghaddasi
Keyword(s):  
Multiple Sclerosis ◽  
Visual Perception ◽  
Negative Correlation ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Significant Negative Correlation ◽  
Small Sample ◽  
P100 Latency ◽  
Developmental Test ◽  
Visual Evoked

Background: Optic neuritis (ON) is a common visual sign in multiple sclerosis (MS). Although ON is recovered in most cases, other visual functions such as visual perception are affected and are not fully recovered. The aim of this study is to investigate the relationship between visual evoked potential (VEP) P100 and N70 latencies and visual perception using the Developmental Test of Visual Perception-Adolescent and Adult (DTVP-A) in people with MS. Methods: In this cross-sectional study, 24 people with ON due to MS, aged 18-50 years old took part. In order to assess the visual perception and optic nerve conductivity, the DTVP-A and the VEP were accomplished, respectively. Pearson’s product-moment correlation coefficient was used to analyze the data. Results: There was a significant negative correlation between right VEP P100 latency and total score of DTVP-A (r = -0.450, P < 0.05) as well as a significant negative correlation between right VEP P100 latency with visual-motor integration (VMI) subtest of DTVP-A (r = -0.485, P < 0.05). Conclusion: The visual perception has an important role in safety and independent daily activities. Therefore, determining the related factors is essential. Although the findings of the current study revealed a moderate statistical correlation between visual perception and right VEP P100 latency, the small sample size might limit the generalization of our findings; therefore, further study is required to confirm our results.

scholarly journals Evolution of Visual Evoked Potentials in Optic Neuritis

1988 ◽  
Vol 15 (4) ◽  
pp. 394-396 ◽  
Author(s):  
Irvin H. Heinrichs ◽  
Donald R. McLean
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Visual Evoked Potentials ◽  
Visual Evoked Potential ◽  
Evoked Potential ◽  
Clinical Evidence ◽  
Initial Examination ◽  
Vep Latency ◽  
Visual Evoked

ABSTRACT:The visual evoked potential (VEP) latency was either abnormally prolonged or absent in the involved eye of 47 patients with optic neuritis. Twenty-two of these patients with known multiple sclerosis (MS), had similar abnormalities to 25 patients with no clinical evidence of MS. Follow-up clinical assessment and VEP were done 10 to 42 (mean 22) months later in 34 patients. In 15 of 34 patients with no VEP from the involved eye during initial examination, 6 returned to normal, 8 had prolonged latencies and 1 still had no response at follow up. Of 19 patients who initially had prolonged latencies in the involved eye, 6 returned to normal, 11 had prolonged latencies and 2 had no response at follow up. The VEP is helpful in confirming the diagnosis of ON. The examination must be performed when the patient is symptomatic or soon thereafter as 35% of our patients with an abnormal initial VEP had a normal VEP at follow up. This normalization was not related to the severity of the initial VEP abnormality.

scholarly journals The added value of cognition-targeted exercise versus symptom-targeted exercise for multiple sclerosis fatigue: A randomized controlled pilot trial

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0258752
Author(s):  
Azza Alketbi ◽  
Salah Basit ◽  
Nouran Hamza ◽  
Lori M. Walton ◽  
Ibrahim M. Moustafa
Keyword(s):  
Multiple Sclerosis ◽  
Clinical Outcome ◽  
Outcome Measures ◽  
Recruitment Rate ◽  
Control Group ◽  
Entire Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Intervention Protocol

Background Fatigue is considered one of the most common symptoms of multiple sclerosis (MS) and lacks a current standardized treatment. Therefore, the aim of this study was to examine the feasibility and effectiveness of a cognition-targeted exercise versus symptom-targeted exercise for MS fatigue. Methods In this Pilot, parallel-group, randomized controlled trial, sixty participants with multiple sclerosis, were randomly assigned to either a Cognition-Targeted Exercise (CTE) (N = 30, mean age 41) or a Symptom-Targeted Exercise (STE) (N = 30, mean age 42). The participants in the experimental group received eight, 50-minute sessions of weekly Cognitive Behavior Therapy (CBT) in addition to a CTE Program; whereas, participants in the control group received eight, 50-minute sessions of weekly CBT in addition to the standardized physiotherapy program (STE Program). Feasibility was assessed through recruitment rate, participant retention, adherence and safety, in addition to clinical outcome measures, including: (1) Modified Fatigue Impact Scale (MFIS), (2) Work and Social Adjustment Scale (WSAS), (3) Hospital Anxiety and Depression Scale (HADS), and Perceived Stress Scale (PSS). All outcome measures were assessed at baseline (pretreatment), following completion of the eight visit intervention protocol, and at 3-months follow-up. Results The recruitment rate was 60% and 93% of participants completed the entire study. The recruited participants complied with 98% of the required visits. No adverse events were recorded. A Generalized Estimation Equation Model revealed a significant difference over time as an interaction term during the post and follow up visit for all clinical outcome measures (p < .001). Conclusion The addition of CTE to CBT exhibited positive and more lasting influence on MS fatigue outcomes compared to Symptom-Targeted Exercise (STE). Feasibility and efficacy data from this pilot study provide support for a full-scale RCT of CTE as an integral component of Multiple Sclerosis fatigue management.

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