Abstract Details

Title Evoked Potentials May Predict Response to Immunomodulating Treatment in Multiple Sclerosis

Topic Clinical Neurophysiology

Presentation(s) S39 - (-)

Poster/Presentation
Number 003

Objective

Background Early diagnosis and treatment of multiple sclerosis-MS is now granted after the advent of magnetic resonance imaging-MRI, raising the need of biomarkers for monitoring and predicting treatment response and disability. Evoked potentials-EPs are a good candidate since they explore functional involvement of eloquent pathways.

Design/Methods Disability-EDSS and multimodal EPs were assessed in patients with RRMS (96) before immunomodulating treatment and after 2.5 + 0.8 years follow-up (75), when patients were classified as non-responders (<50% relapse rate reduction, or >2 MRI enhancing lesions, or >4 new lesions), full-responders (no MRI /clinical activity), or partial responders. The severity of all EPs abnormalities was scored using a 0-3 conventional scale from normal to absent and summed to obtain a global EPs score.

Results EPs score and EDSS at baseline was significantly correlated with EDSS at baseline (r=0.511, p<0.001) and even more at follow-up (r=0.686 p<0.001), and was significantly higher in non responders subgroup vs the other subgroups. At follow-up, the EPs score significantly increased in the whole group, more significantly in the non-responders vs other subgroups, while EDSS significantly increased in non-responders. Moreover, 34% of full responders had a global EPs score increase >2. Patients with baseline global EPs score >6 had increased risk (OR=5.82) of worsened follow-up EDSS (positive predictive value-PPV 78 %, negative PV 67.5%, chi square p=0.001).

Conclusions If performed early, EPs may help predicting and monitoring treatment response better than clinical or MRI assessment alone, suggesting their validation as surrogate biomarker in MS.

Authors/Disclosures
Letizia M. Leocani, MD (University Vita-Salute San Raffaele, INSPE) PRESENTER	Dr. Leocani has received personal compensation in the range of $0-$499 for serving as a Consultant for Roche . Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Bristol Myers Squibb. Dr. Leocani has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Med-ex learning.
	No disclosure on file
	No disclosure on file
Tracy T. Batchelor, MD, MPH (Brigham and Women's Hospital)	Dr. Batchelor has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Up To Date, Inc. An immediate family member of Dr. Batchelor has received publishing royalties from a publication relating to health care. Dr. Batchelor has received publishing royalties from a publication relating to health care.
	No disclosure on file
	No disclosure on file
Raffaella Chieffo, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
Lucia Moiola, MD, PhD (Fondazione Centro San Raffaele)	Dr. Moiola has nothing to disclose.
Giancarlo Comi, MD (University Vita-Salute)	Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Janssen. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Bristol Myers Squibb. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Aspen Healthcare. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Sanofi. Dr. Comi has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Rewind.

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