Ordinally adjusted SEP and MEP response relationsship wth EDSS and walking measures in patients with multiple sclerosis

Multiple sclerosis is an inflammatory, progressive and demyelinizating multifocal CNS disease. Secondary to altered anatomical structures during the disease process the physiologic system deteriorates which clinically manifests as disability. Evoked potentials have crucial role to reflect these deterioration of physiologic system.In this study SEP and MEP examinations were performed on RRMS patients, healthy subjects and patients diagnosed with cervical spondylitic myelopathy and results were adjusted and assessed. Data was analyzed in terms of EDSS and walking measures associations.28 patients with MS, 13 patients with cervical spondylitic myopathy and 26 healthy subjects, whose age and gender distributions were similar, from Department of Neurology of Adnan Menderes University Hospital were enrolled/included in this study.Our findings suggest that MEP responses, especially in lower extremities, have greater sensitivity and specifity for establishing disability. Lower extremity (LE) MEP, total MEP, SEP + MEP, upper extremity (UE) MEP, median SEP, tibial SEP, total SEP were all found to have high spesicifity and sensitivity. Of the MEP parameters; lower extremity MEP M latency, LE silent period/trancallosal inhibiton duration (LE SP/TCI) ratio, LE cortical/peripheral M ratio, LE central motor delay (CMD), LE threshold value, LE SP/TCI baseline and end-point abnormalities, LE callosal transition time abnormalitires, UE SP baseline and end-point abnormalities, LE TCI duration, UE CMD abnormalities were also had close sensitivitity and specificity values to total points.Ordinally adjusted SEP and MEP examinations showed significant associations between subjective measures which assess MS-related walking (Multiple Sclerosis Walking Scale-12) and objective measures (The Timed 25-Foot Walk and EDSS in MSFC). When we analyzed EDSS functional systems separately we found that while motor functional system score did not associated with EP points, had significant and higher association with EP points ambulation score. In myelopathy group, EDSS motor function score had significant and higher association and this effect depends on LE EP points. It was also proposed that association between EP points and EDSS-MFS in myopathy cases which didn't stand for MS cases was possibly due to differencies between diseases' physiopathologies and severity.This study revealed significant and high association between objective-subjective walking measures and EDSS measure and ordinally adjusted points of SEP and VEP which are among the evoked potential examining methods. Although there are studies investigated SEP and MEP alone, there are little study investigated both methods. Including a different disease group, myelopathy, beside healthy subjects as a control group make us possible to assessed working principles of this method in different physiopathology