Contributions
Abstract: EP1284
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: Multiple Sclerosis (MS) diagnosis is based on clinical and para-clinical tools to demonstrate dissemination in space (DIS) and time. Although Visual Evoked Potentials (VEPs) are commonly used in MS diagnosing, 2010 diagnostic criteria (DC, Polman Ch et al.2011)) did not include the optic nerve (ON) within typical sites considered to meet DIS. In 2016 MAGNIMS (Filippi et al, 2016) group proposed, inclusion of optic nerve (ON) lesions and alteration of VEP parameters to demonstrate DIS.
A further proposal from the MAGNIMS group is to use a more restrictive criterion to locate the periventricular involvement (at least 3 lesions).
The aim of our study is to evaluate whether the inclusion of VEPs among the typical sites of demyelinating disease allows to anticipate the diagnosis of MS.
Material and methods: We retrospectively evaluated patients hospitalized between 2010 and 2015. All patients included were subsequently diagnosed with MS. For all patients included were detected major clinical and demographic variables, MRI of the brain and spinal cord, VEPs were performed at the time of hospitalization for MS diagnosis.
We evaluated 4 DIS definitions:
- 4 areas DIS (according to 2010 DC: involvement of at least 2 of the following 4 CNS areas: iuxtacortical, periventricular, infratentorial and spinal cord demonstrated on MRI);
- 4 areas DIS plus VEPs (involvement of at least 2 areas of the following 5 CNS areas: iuxtacortical, periventricular, infratentorial and spinal cord demonstrated on MRI or ON demonstrated by VEPs);
- 3 Areas DIS (involvement of at least 2 of the following 3 MRI areas: suvratentorial, infratentorial and spinal cord);
- 3 Areas DIS plus VEPs (involvement of at least 2 of the following 4 CNS areas: suvratentorial, infratentorial and spinal cord demonstrated on MRI or ON demonstrated by VEPs).
Results: We included 200 MS patients. At the time of hospitalization, space dissemination was demonstrated in 154 /200 patients (77%) using 4 areas DIS and in 174 / 200 patients (87%) using 4 areas DIS plus VEPS, in 121 / 200 patients (60.5%) using 3 areas DIS and in 153/200 (76.5%) using 3 areas DIS plus VEPs.
Discussion and conclusion: Integrating VEPs into DIS allows to anticipate diagnosis in 10% of patients by supplementing DC 2010 and 16.5% using a more restrictive MRI criterion. Our data support the importance of assessing ON involvement through VEPs to achieve DIS according with the MAGNIMS group proposes.
Disclosure:
Dr. Fenu, Frau, Coghe, Lorefice received consulting fees from Biogen Idec, Merck Serono, Teva, Genzyme, Roche, Novartis.
Prof. Cocco and prof. Marrosu received honoraria for lecturing, travel expenses for attending meetings and financial support for research from Bayer Schering, Biogen Idec, Sanofi-Aventis, Novartis and Merck Serono,
Dr Maggiore: nothing to disclose
Dr. Arru: nothing to disclose
Abstract: EP1284
Type: ePoster
Abstract Category: Clinical aspects of MS - 1 Diagnosis and differential diagnosis
Background: Multiple Sclerosis (MS) diagnosis is based on clinical and para-clinical tools to demonstrate dissemination in space (DIS) and time. Although Visual Evoked Potentials (VEPs) are commonly used in MS diagnosing, 2010 diagnostic criteria (DC, Polman Ch et al.2011)) did not include the optic nerve (ON) within typical sites considered to meet DIS. In 2016 MAGNIMS (Filippi et al, 2016) group proposed, inclusion of optic nerve (ON) lesions and alteration of VEP parameters to demonstrate DIS.
A further proposal from the MAGNIMS group is to use a more restrictive criterion to locate the periventricular involvement (at least 3 lesions).
The aim of our study is to evaluate whether the inclusion of VEPs among the typical sites of demyelinating disease allows to anticipate the diagnosis of MS.
Material and methods: We retrospectively evaluated patients hospitalized between 2010 and 2015. All patients included were subsequently diagnosed with MS. For all patients included were detected major clinical and demographic variables, MRI of the brain and spinal cord, VEPs were performed at the time of hospitalization for MS diagnosis.
We evaluated 4 DIS definitions:
- 4 areas DIS (according to 2010 DC: involvement of at least 2 of the following 4 CNS areas: iuxtacortical, periventricular, infratentorial and spinal cord demonstrated on MRI);
- 4 areas DIS plus VEPs (involvement of at least 2 areas of the following 5 CNS areas: iuxtacortical, periventricular, infratentorial and spinal cord demonstrated on MRI or ON demonstrated by VEPs);
- 3 Areas DIS (involvement of at least 2 of the following 3 MRI areas: suvratentorial, infratentorial and spinal cord);
- 3 Areas DIS plus VEPs (involvement of at least 2 of the following 4 CNS areas: suvratentorial, infratentorial and spinal cord demonstrated on MRI or ON demonstrated by VEPs).
Results: We included 200 MS patients. At the time of hospitalization, space dissemination was demonstrated in 154 /200 patients (77%) using 4 areas DIS and in 174 / 200 patients (87%) using 4 areas DIS plus VEPS, in 121 / 200 patients (60.5%) using 3 areas DIS and in 153/200 (76.5%) using 3 areas DIS plus VEPs.
Discussion and conclusion: Integrating VEPs into DIS allows to anticipate diagnosis in 10% of patients by supplementing DC 2010 and 16.5% using a more restrictive MRI criterion. Our data support the importance of assessing ON involvement through VEPs to achieve DIS according with the MAGNIMS group proposes.
Disclosure:
Dr. Fenu, Frau, Coghe, Lorefice received consulting fees from Biogen Idec, Merck Serono, Teva, Genzyme, Roche, Novartis.
Prof. Cocco and prof. Marrosu received honoraria for lecturing, travel expenses for attending meetings and financial support for research from Bayer Schering, Biogen Idec, Sanofi-Aventis, Novartis and Merck Serono,
Dr Maggiore: nothing to disclose
Dr. Arru: nothing to disclose