Abstract Details

Title Clinical Isolated Syndromes: Sensitivity To Detect Clinically Silent Lesions with the Triple Stimulation Technique in Comparison to Transcranial Magnetic Stimulation and Visual/Somatosensory Evoked Potentials

Topic MS and Related Diseases

Presentation(s) P06 - (-)

Poster/Presentation
Number 123

Objective

Background BACKGROUND: Patients with CIS like optic neuritis, myelitis or cerebral inflammatory disease are at high risk to develop multiple sclerosis (MS). Magnetic resonance imaging (MRI) of the brain or spinal cord and neurophysiologic tests could demonstrate further lesions which are clinically silent in affected patients. TST examines the corticospinal tract by magnetic stimulation of cortical motor areas followed by sequential distal and proximal peripheral nerve electric stimulation. The emerging potential results from the collison of sequenced stimuli. Compared with sequential stimulation of peripheral nerves alone, the amplitude ratio quantifies central motor conduction failure.

Design/Methods DESIGN/METHODS: Upper limb (to abductor digiti minimi muscle) and lower limb (to abductor hallucis muscle) TST and TMS were applied to 54 healthy controls to establish normal values and to 110 patients with CIS. Patients were examined including the Expanded disability status score (EDSS), brain and spinal cord MRI, VEP, SEP and TMS. MRI were analysed according to criteria of Barkhoff/ Tintore.

Results RESULTS: The EDSS of patients varied between 1 and 5.5. MRI demonstrated lesions in 90,9 % of patients, of whom 60 % were typical for MS. TST was abnormal in 59,1 % (46,1 % had clinical silent lesions), findings for SEP were 37,1 % (30,5 %), for VEP 29,6 % (15,1 %), for TMS 27,3 % (25,9 %). According to the revised McDonald-criteria, MS was diagnosed in 64,1 % of patients on follow-up for 12 - 60 months.

Conclusions CONCLUSIONS: TST is a sensitive method to detect central motor conduction failure in patients with a high risk to develop MS. In comparison to TMS, SEP and VEP, TST is markedly more sensitive to detect clinically silent lesions.

Authors/Disclosures
Ulrich Hofstadt-van Oy, MD (Knappschaftskrankenhaus Dortmund - Klinikum Westfalen) PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Alasdair Coles, MD, PhD (University of Cambridge)	Dr. Coles has nothing to disclose.
	No disclosure on file
	No disclosure on file

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