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Motor evoked potentials in clinically isolated syndrome suggestive of multiple sclerosis

¹ Centre de Résonance Magnétique Biologique et Médicale UMR CNRS 6612, Faculté de Médecine, Université de la Méditerranée, Marseille, France; Pôle de Neurosciences Cliniques, Service de Neurologie, Faculté de Médecine de Marseille, Université de la Méditerranée, Hôpital de la Timone, Marseille, France
² Pôle de Neurosciences Cliniques, Service de Neurologie et des pathologies neuromusculaires, Faculté de Médecine de Marseille, Université de la Méditerranée, Hôpital de la Timone, Marseille, France
³ Pôle de Neurosciences Cliniques, Service de Neurologie, Faculté de Médecine de Marseille, Université de la Méditerranée, Hôpital de la Timone, Marseille, France

^* To whom correspondence should be addressed.

	Abstract

The aim of the present study was to determine the sensitivity and the profile of motor evoked potentials (MEP) in patients with clinically isolated syndrome (CIS) suggestive of multiple sclerosis (MS). We measured the central motor conduction time (CMCT), amplitude ratio (AR), and surface ratio (SR) in tibialis anterior and first dorsal interosseous muscles in 22 patients with CIS. In 12 patients, the triple stimulation technique (TST) was also performed. AR was abnormal in 50% of patients, CMCT in 18% of patients, and TST in 25% of patients. AR had the highest sub-clinical sensitivity and the best positive predictive value. In the absence of clinical pyramidal signs, an early AR decrease seems to result from demyelination inducing excessive temporal dispersion of the MEP, while in territories with clinical pyramidal signs, it seems to result from conduction failure, which suggests that clinical pyramidal signs may be attributable to conduction failure. This study demonstrates that MEP, especially the AR, is sensitive to motor pathway dysfunction right from the early stages of MS.

Key Words: multiple sclerosis, outcome measurement, relapsing/remitting

First published on January 19, 2009, doi:10.1177/1352458508099612

Multiple Sclerosis 2009;15:355.

A more recent version of this article appeared on March 1, 2009


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