Abstract
This study aimed to assess the role of multifocal visual-evoked potentials (mfVEPs) as a guiding factor for clinical conversion of radiologically isolated syndrome (RIS). We longitudinally followed a cohort of 15 patients diagnosed with RIS. All subjects underwent thorough ophthalmological, neurological and imaging examinations. The mfVEP signals were analysed to obtain features in the time domain (SNRmin: amplitude, Latmax: monocular latency) and in the continuous wavelet transform (CWT) domain (bmax: instant in which the CWT function maximum appears, Nmax: number of CWT function maximums). The best features were used as inputs to a RUSBoost boosting-based sampling algorithm to improve the mfVEP diagnostic performance. Five of the 15 patients developed an objective clinical symptom consistent with an inflammatory demyelinating central nervous system syndrome during follow-up (mean time: 13.40 months). The (SNRmin) variable decreased significantly in the group that converted (2.74 ± 0.92 vs. 4.07 ± 0.95, p = 0.01). Similarly, the (bmax) feature increased significantly in RIS patients who converted (169.44 ± 24.81 vs. 139.03 ± 11.95 (ms), p = 0.02). The area under the curve analysis produced SNRmin and bmax values of 0.92 and 0.88, respectively. These results provide a set of new mfVEP features that can be potentially useful for predicting prognosis in RIS patients.
Highlights
This study aimed to assess the role of multifocal visual-evoked potentials as a guiding factor for clinical conversion of radiologically isolated syndrome (RIS)
All subjects with RIS presented normal neurological examination results and conventional magnetic resonance imaging (MRI) scans, and the Barkhof criteria were confirmed in all patients
This study provides a first insight into the afferent system of the visual pathway in RIS patients by analysing multifocal visual-evoked potentials (mfVEPs) responses and by describing and characterizing new parameters in the mfVEPs’ waveforms in order to monitor RIS progression
Summary
This study aimed to assess the role of multifocal visual-evoked potentials (mfVEPs) as a guiding factor for clinical conversion of radiologically isolated syndrome (RIS). The area under the curve analysis produced SNRmin and bmax values of 0.92 and 0.88, respectively These results provide a set of new mfVEP features that can be potentially useful for predicting prognosis in RIS patients. The increasing use of magnetic resonance imaging (MRI) to evaluate clinical pictures such as migraine, dizziness or vertigo has led to the emergence of a new clinical entity—radiologically isolated syndrome (RIS)—within demyelinating processes’ clinical s pectrum[4] This syndrome is characterized by the detection in MRI of lesions in the white matter of the central nervous system (CNS) that, due to their size, location and morphology, are highly suggestive of demyelinating plaques exhibiting dissemination in space (DIS) in subjects presenting with normal neurological examination results and no history of signs or symptoms of multiple sclerosis (MS)[4]. Recent studies suggest that patients with RIS, clinically isolated syndrome (CIS) and relapsing–remitting multiple sclerosis (RRMS) all share non-motor clinical characteristics[9,10] and suffer quantitative brain tissue d amage[11], indicating that RIS evinces MS in its early, preclinical form
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