Validation of Multimodal Evoked Potentials (mmEP) for Predicting Disease Progression in Multiple Sclerosis

Study Overview
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Brief Summary
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Utility of Multimodal Evoked potentials (mmEP) for monitoring disease course and prediction of progression at different stages of Multiple Sclerosis (MS) is investigated

Official Title
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Validation of Multimodal Evoked Potentials (mmEP) for Predicting Disease Progression in Multiple Sclerosis: Sub-study Within the Swiss Multiple Sclerosis Cohort (SMSC)

Conditions
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Multiple Sclerosis

Intervention / Treatment
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* Diagnostic Test: multimodal evoked potentials (mmEP)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: diagnosed with a clinically isolated syndrome (CIS) or MS with a relapsing-remitting (RRMS) or a primary progressive disease course (PPMS): CIS: EDSS <= 5.5 within six months of first clinical event early RRMS: EDSS: <= 3.5 disease course of 5 up to 10 years late RRMS: EDSS: 2.0-5.5 inclusive disease course of 5 to 15 years PPMS: EDSS: 2.0-6.5 inclusive disease course up to 15 years participation in the Swiss Multiple Sclerosis Cohort Study (SMSC) mental ability to cooperate written informed consent Exclusion Criteria: alcohol or substance abuse progressive disease other than Multiple Sclerosis psychiatric disorder requiring a treatment by a psychiatrist patients with movable metal implants, e.g. pace-maker, stents, deep brain stimulators etc.;(patients with jaw- or bone-fixed metal implants can be included)

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| clinically isolated syndrome (CIS)<br>Multiple sclerosis (MS) with a clinically isolated syndrome (CIS) within six months of first clinical event. Multimodal evoked potentials (mmEP) assessments will take place at baseline, month 12 (from baseline), month 24 (from baseline) and month 36 (from baseline) | Diagnostic Test: multimodal evoked potentials (mmEP)<br>* combination of visual evoked potentials (VEP) and motor evoked potentials (MEP) or the combination of VEP, MEP and somato-sensory evoked potentials (SSEP)<br>|
| early relapsing-remitting late disease course (RRMS)<br>MS with relapsing-remitting early disease course (RRMS) </= 10 years, Expanded Disability Status Scale (EDSS) </=3.5 EDSS: 1.0: No disability, minimal signs in 1 functional System (FS) 1.5: No disability, minimal signs in more than one FS 2.0: Minimal disability in one FS 2.5: Mild disability in one FS or minimal disability in two FS 3.0: Moderate disability in one FS, or mild disability in three or four FS. No impairment to Walking 3.5: Moderate disability in one FS and more than minimal disability in several others. No impairment to Walking. Multimodal evoked potentials (mmEP) assessments will take place at baseline, month 12 (from baseline), month 24 (from baseline) and month 36 (from baseline) | Diagnostic Test: multimodal evoked potentials (mmEP)<br>* combination of visual evoked potentials (VEP) and motor evoked potentials (MEP) or the combination of VEP, MEP and somato-sensory evoked potentials (SSEP)<br>|
| late relapsing-remitting late disease course (RRMS)<br>MS with relapsing-remitting late disease course (late RRMS) of 5 to 15 years, EDSS: 2.0-5.5 inclusive EDSS: 4.0: Significant disability but self-sufficient and up and about some 12 hours a day. Able to walk without aid or rest for 500m 4.5: Significant disability but up and about much of the day, able to work a full day, may otherwise have some limitation of full activity or require minimal assistance. Able to walk without aid or rest for 300m 5.0: Disability severe enough to impair full daily activities and ability to work a full day without special provisions. Able to walk without aid or rest for 200m 5.5: Disability severe enough to preclude full daily activities. Able to walk without aid or rest for 100m. Multimodal evoked potentials (mmEP) assessments will take place at baseline, month 12 (from baseline), month 24 (from baseline) and month 36 (from baseline) | Diagnostic Test: multimodal evoked potentials (mmEP)<br>* combination of visual evoked potentials (VEP) and motor evoked potentials (MEP) or the combination of VEP, MEP and somato-sensory evoked potentials (SSEP)<br>|
| primary progressive disease course (PPMS)<br>MS with a primary progressive disease course (PPMS) up to 15 years, EDSS: 2.0-6.5 inclusive EDSS: 6.0: Requires a walking aid - cane, crutch, etc. - to walk about 100m with or without resting 6.5: Requires two walking aids - pair of canes, crutches, etc. - to walk about 20m without resting. Multimodal evoked potentials (mmEP) assessments will take place at baseline, month 12 (from baseline), month 24 (from baseline) and month 36 (from baseline) | Diagnostic Test: multimodal evoked potentials (mmEP)<br>* combination of visual evoked potentials (VEP) and motor evoked potentials (MEP) or the combination of VEP, MEP and somato-sensory evoked potentials (SSEP)<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| correlation of EP-sum-score (Σ-EP) and the Expanded Disability Status Scale (EDSS) | logistic regression model will be used to predict worsening in EDSS defined by a 1-point-change (0.5 if EDSS is 5.5 or higher) at year 3 | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Multimodal Evoked potentials, Visual evoked potentials, Somato-sensory evoked potentials, Motor evoked potentials, Expanded Disability Status Scale (EDSS)