M. Krbot Skoric

The vestibular evoked myogenic potentials (VEMP) score: a promising tool for evaluation of brainstem involvement in multiple sclerosis

Concerning the great importance of brainstem involvement in multiple sclerosis (MS), the aim of this study was to explore the role of the newly developed vestibular evoked myogenic potentials (VEMP) score as a possible marker of brainstem involvement in MS patients.

P964: VEMP in longitudinal follow-up of vestibular neuritis

elbow-4cm proximal to the elbow segment (AE6-AE4) in 9 arms (9.8%), 2cm distal to the elbow-4cm distal to the elbow segment (BE2-BE4)in 8 arms (8.6%) and 4cm distal to the elbow-6cm distal to the elbow segment (BE4-BE6) in 6 arms (6.5%) respectively. Conclusion: The SSCSs are more sensitive significantly in detecting CubTS than the conventional long segmental motor conduction studies. It could localize the entrapment leisions precisely in the patients with CubTS. It is a useful tool for the detection of ulnar mononeuropathy at the elbow, especially in diagnosing the patients with CubTS who have no clinical features or a normal long segmental nerve conduction findings.

P577: Tongue somatosensory evoked potentials: evaluation of the brainstem involvement in patients with early multiple sclerosis

Background: In the assessment of visual pathway involvement in Multiple Sclerosis-MS, optical coherence tomography-OCT is used to measure retinal nerve fiber layer-RNFL thickness as a marker of axonal loss and visual evoked potentials-VEPs as an indicator of demyelination. However, no clear indications are available on their combined use in MS monitoring. We evaluated cross-sectional and longitudinal correlations and sensitivity of OCT and VEPs and their correlates with clinical and magnetic resonance imaging-MRI evidence of disease activity in a real-world clinical setting. Methods: 80 MS patients (13 clinically isolated syndrome-CIS, 55 relapsingremitting-RR, 9 secondary progressive-SP, 3 primary progressive-PP), age 36.7+9.7 years, disease duration 6.0+6.6 years, underwent neurological and neurophysiological evaluation with OCT and VEPs, with routine clinical and MRI monitoring for a mean period of 1 year. Additional OCT-VEPs follow-up was obtained in 50 patients. Results: While VEPs were more sensitive than OCT in eyes with recent (<3 months) optic neuritis-ON at baseline (80.0% Vs 6.7%, p=0.001), the two sensitivities were similar in chronic ON eyes (78.4%). Comparing eyes with and without previous ON, VEP latency and RNFL thickness were respectively significantly higher (131.2 ms Vs 118.8 ms, p=0.008) and lower (78.15 μm Vs 90.00 μm, p<0.001) in the first subgroup. No significant differences were found between the two subgroups when analyzing VEP latency and RNFL thickness evolution during the follow-up period. However, eyes with baseline recent ON had significant reduction in VEP latency (−15.3 ms) and RNFL thickness (−7,7 μm) at follow-up. No significant correlation was found between OCT-VEPs parameters and disease activity. Similar results were found when considering only RR and CIS patients. Conclusions: These results would exclude recommending OCT and VEPs as surrogate biomarkers in MS phase II clinical trials evaluating disease modifying drugs, even when focusing on relapsing form of MS. The main role for OCT and VEPs in short-to-medium term follow-up programs would consist in monitoring neural damage after acute ON. However, these findings cannot exclude the usefulness of these techniques for longer follow-ups and/or large phase III studies.