# Transbulbar B-Mode Sonography for Clinical Phenotyping Multiple Sclerosis
## 3 Results
Specifically, the MI\({}^{\rm{H}}\) group contained diseased subjects with high P100A and low P100L (respectively 6.36 \(\upmu\)v and 136.09 ms), high PGMv and TBv (630,238.75 mm\({}^{3}\) and 1,558,847.53 mm\({}^{3}\)), low T1 LL and T2 LL (respectively, 688.68 mm\({}^{3}\) and 2087.35 mm\({}^{3}\)) and low age and DD (38.29 y and 8.36 y, respectively). This group included all the RR patients among the MS study population with a mean EDSS of 2.0. The MI\({}^{\rm{L}}\) cluster included patients with low P100A and high P100L (respectively 4.06 \(\upmu\)v and 146.25 ms), low PGMv and TBv (respectively 552,318.25 mm\({}^{3}\) and 1,447,772.14 mm\({}^{3}\)), high T1 LL and T2 LL (respectively 5316.72 mm\({}^{3}\) and 11,128.67 mm\({}^{3}\)) and high age and DD (45.47 y and 14.11 y, respectively). Figure 1: Correlation between P100 and EDSS (expanded disability status scale). (**A**) Significant inverse correlation between P100 Amplitude (\(\upmu\)v) and EDSS pyramidal sub-score (\(r=-0.37\); \(p=0.03\)); (**B**) Significant direct correlation between P100 Latency (ms) and EDSS pyramidal sub-score (\(r=0.46\); \(p=0.007\)). EDSS Expanded Disability Status Scale. \begin{table}
\begin{tabular}{c c c c} \hline \hline
**Parameter** & **RR Patients** & **SP Patients** & \(p\) \\ \hline \(N\) & 41 & 19 & \\ Age (y) & \(39.5\pm 7.9\) (36.4–42.2) \(\ddagger\) & 46.7 \(\pm\) 8.1 (41.2–51.7) & 0.008 \\ Female-to-male ratio & 1.05 & 1.37 & \\ Disease duration (y) & 10.0 \(\pm\) 6.6 (7.8–12.5) & 15.8 \(\pm\) 8.6 (3.9–11.8) & 0.050 \\ Expanded Disability Status Scale & 2.2 \(\pm\) 0.8 (1.9–2.5) & 5.3 \(\pm\) 0.7 (4.8–5.7) & 0.000 \\ pyramidal sub-score & 1.48 \(\pm\) 0.64 (1.23–1.73) & 3.36 \(\pm\) 0.67 (3.00–3.75) & 0.000 \\ sensitive sub-score & 1.04 \(\pm\) 1.05 (0.63–1.43) & 2.45 \(\pm\) 0.82 (2.00–3.00) & 0.000 \\ cerebellar sub-score & 0.18 \(\pm\) 0.56 (0.00–0.41) & 2.63 \(\pm\) 0.50 (2.33–2.91) & 0.000 \\ brain-stem sub-score & 0.37 \(\pm\) 0.74 (0.12–0.68) & 1.27 \(\pm\) 1.27 (0.58–2.00) & 0.046 \\ Sphincter sub-score & 0.15 \(\pm\) 0.53 (0.00–0.37) & 1.64 \(\pm\) 1.21 (0.90–2.30) & 0.002 \\ Optic nerve sheath diameter (cm) & & & \\ At 3 mm & 0.51 \(\pm\) 0.072 (0.48–0.53) & 0.46 \(\pm\) 0.077 (0.42–0.51) & n.s. \\ At 5 mm & 0.59 \(\pm\) 0.081 (0.56–0.62) & 0.55 \(\pm\) 0.065 (0.51–0.58) & \textless{}0.001 \\ Myelination index & 0.86 \(\pm\) 0.083 (0.85–0.88) & 0.83 \(\pm\) 0.11 (0.76–0.87) & n.s. \\ \hline \hline \end{tabular}  
* Note that the optic nerve sheath diameter at 5 mm was found to be lower in SP patients than in RR patients. The Wilcoxon–Mann–Whitney test was applied to the difference between means. \(\ddagger\) Values are given as the mean or mean \(\pm\) standard deviation, with the 95% confidence interval in parentheses. RR Relapsing Remitting: SP Secondary progressive.  
\end{table} 
Table 3: Demographic and clinical characteristics of the study population \(\ddagger\). This low MI group included the transitional phenotype patients among the MS study population having a mean EDSS of 3.7 and intermediate clinical and instrumental characteristics between the RR and SP groups. These intermediate clinical and instrumental characteristics are summarized in Table 5 as \"Transitional\", with values between those of RR patients in the same table and those of SP patients represented in Table 4.  
The \(\chi^{2}\) test confirmed a significant difference between the frequencies of the MI\({}^{\rm H}\) (RR) and MI\({}^{\rm L}\) (transitional) patient groups. The centres of the clusters and their distances between groups are summarized in Table 5.  
Finally, the ROC analysis highlighted the accuracy (good sensitivity and specificity) in classifying the MI\({}^{\rm H}\) and MI\({}^{\rm L}\) patients among the general population. The conviction strength of the test was statistically significant for EDSS (\(p\) = 0.001), T1 LL (\(p\) = 0.017), T2 LL (\(p\) = 0.006), PGMv (\(p\) = 0.015),