81. Motor evoked potential as a predictor of clinical response in multiple sclerosis patients treated with 4 aminopyridine

• Published in: Clinical neurophysiology Vol. 126; no. 1; p. e19
• Main Authors: Scarpino, M, Lanzo, G, Repice, A, Magnani, E, Carrai, R, Amantini, A, Massacesi, L, Grippo, A
• Format: Journal Article
• Language: English
• Published: Elsevier Ireland Ltd 01.01.2015
• Subjects: Neurology
• ISSN: 1388-2457; 1872-8952
• DOI: 10.1016/j.clinph.2014.10.100

4-Aminopyridine (4-AP) has been recently introduced as a symptomatic treatment of walking impairment in MS patients. The clinical benefits have been reported in about 1/3 of patients. The study was intended to verify in patients treated with 4-AP: – the ability of motor-evoked potentials (MEPs) in identifying patients responding to treatment; – if there are MEP parameters changes related to clinical improvement. Patients were enrolled in a prospective study. Patients underwent neurological examination, in order to determine: EDSS, T25WF (a walking test, measuring speed). MEPs have been recorded at lower limb, central motor conduction time (CMTT) and CMAP/MEPs ratio have been evaluated before starting and after 30 days of 4-AP treatment. We enrolled 14 patients. Patients with high EDSS score (>4) and bilateral CMTT alteration were most likely responding to therapy. MEP parameters changes observed in some patients were not related to clinical effect measured with T25WF. The response to 4-AP occurs only in 35% of MS patients. Given the drug’s side effects and its high cost, it would be useful to have predictor of response to treatment. Joining together EDSS score and CMTT value we could identify a great number of patients responding to therapy (nearly 85%).