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PS-40-6 Longitudinal evaluation of multimodal evoked potentials in asymptomatic HIV seropositive subjects
Poster session 40. Pain-related somatosensory evoked potentials and multimodal evoked potentials
I PS-40-6 1 Longitudinal evaluation of multimodal evoked potentials in asymptomatic HIV seropoalUve subjects Paola Gambaro, Michela Mauri, Maurizio Osio, Pierluigi Bertora, Paola Meraviglia 1, Alfonso Mangoni. 1st
Neurologic Clinic, University of Milan, Italy; 12nd Department of Infectious Diseases, Hospital "L. Sacco ", Milan, Italy The aim of this study was to evaluate early nervous system changes in neurologically asymptomatic HIV positive patients by multimodal evoked potentials (VEPs, BAEPs, P300, median and tibial nerve SSEPs). We selected 30 subjects (19 men, 11 women, mean age 31.5 yrs) with HIV infection at CDC stages II, III, IVC2 and IVE without neurological symptoms. We present the results of baseline and follow-up visits: the data of 25 subjects at 6-month, 12 at 12-month and 8 at 18-month controls are at present available. Mean neurophysiologic data were compared by Student's t-test. VEPs, BAEPs and P300 results were normal. Median nerve SSEPs showed a prolonged N9-N13 difference (p < 0.05) at 6- and 12month follow-up visits and a reduction in amplitude of N20 wave (p < 0.005) at 12- and 18-month follow-up visits. Tibial nerve SSEPs showed a prolonged latency of P40 wave (p < 0.02) and an increase of central conduction time (p < 0.01) at 6- and 12-month follow-up. No changes occurred for P300 values throughout the study. None of the patients evaluated disclosed overt neurological symptoms or signs nor superior function abnormalities during the study, with the exception of one case of DDC-induced neuropathy. These partial data suggest that subclinical alterations of central and peripheral nervous system, the appearance of which is well documented in the course of HIV infection, can be evaluated by SSEP study also in early stages of the disease. The usefulness of BAEE VEP and P300 study for the early diagnosis of neurological alterations remains however to be ascertained.
I PS-40-7 t Multi evoked potential study in systemic lupus erithmatosus (SLE) B. Fierro, E Brighina, L. Amico 1, A. Aloisio, D. Buffa, G. Caravaglios, V. La Bua, M. Oliveri, O. Daniele. Istituto di
Neuropsichiatria, Universith di Palermo; 1Divisione di Nefrologia, Ospedale Civico, Palermo SLE is a complex multisystem disease, often associated with central and peripheral nervous system involvement. Although the pathogenesis of this condition remains obscure, several mechanisms including small vessels vasculopathy and direct antibody mediated neuronal dysfunction have been proposed to explain it. However, so far, there have been no consistent diagnostic clinical criteria for neuropsychiatric lupus (NPSLE). Evoked potentials (EPs) are recognised as useful technique in clinical neurophysiology and have also been advocated as sensitive measure in NPSLE. In order to detect clinical as well as subclinical abnormal function of peripheral and central nervous system we performed NCV and multi-evoked potential study in a group of 35 SLE patients and in 30 sex and age matched normal subjects. In particular, we studied motor and sensory median and tibial NCV, median SEP bilaterally, VEPs-RP, ERGs, BAEPs, auditory ERP (P300). All SLE subjects underwent to neurological and neuropsychological evaluations, immunological determinations (including aPL, antiGM1 antibodies) and neuroimaging study (MRI). Electrophysiological parameters of both neurologically symptomatic and asymptomatic patients were analysed and the relationships to clinical, immunological and radiological variables were then assessed.
S187
No significant differences of the mean values of EPs were found between patients and controls. Fourteen patients (40%) presented clinically definite nervous system dysfunction. Electrophysiologicai evidence of peripheral or central nervous system involvement (NCV or EPs values > 2 SD) were observed in 15 patients (42%): seven with definite neurological signs and eight without signs definitely attributable to nervous system alterations. Neurophysiological abnormalities were significantly associated (O.R. = 7.3 p < 0.05) with high prevalence of antiphospholipide antibodies, while did not correlate with clinical and radiological variables.
t PS-40-81 Neurophisiological (MEP) estimation of Central Nervous System (CNS) at Diabetes Mellitus (DM) patients K. Pierzcha~a. II Department of Neurology, Silesian Medical Academy, Katowice The aim of this paper is estimation of changes in CNS at DM patients, using the method of multimodal evoked potentials (MEP), and to define dependence of MEP to clinical symptoms of DM. Sixty-three diabetics (mean age 51.9 + 12.5 years, mean lasting of DM 13.8 4- 8.3 years) were made visual evoked potentials (VEP), brainstem evoked potentials (BAEP) and trigeminal evoked potentials (TEP). At the examined group of patients, there were found 26 persons with diabetic cranial neuropathy, rest of them had no neurological changes. Following waves latencies were estimated: P100-VEP P1-TEP, I, IIl, V and interlatencies BAEE As an abnormal result was found one witch was different about 3SD from the results at control group. Abnormal results were mostly received at TEP (88.4%), BAEP (68.3%), VEP (61.1%). Abnormal results at BAEP were found more often at patients over 50 years with type II DM. The changes at VEP and TEP were mostly observed at type I DM with insufficient diabetic control. Abnormal results at TEP appeared significance more frequent at DM patients treated by insulin (p 0.0001). The frequency of abnormal MEP results at patients with diabetic cranial neurophaty was higher that at the rest of patients and reached the significant level (p 0.001) for TEE This high percentage of abnormal MEP results indicated the occurrence of diabetic encephalopathy. MEP are sensitive and useful diagnostic method for estimation subclinical symptoms of CNS damage.
I PS-40-91 Topographic analysis of long latency VEPs and AEPs In patients suffering from multiple sclerosis in comparison with brain RM: study on 100 subjects F. Monti 1, M. Gioseffi ], A. Bosco ], R. Pol 1, G. Cazzato 1, S. Magnaldi 2, M. Ukmar 2. 1Department of Neurology, University of Trieste, Trieste, Italy; 2Department of Radiology, University of Trieste, Trieste, Italy The aim of the study was to compare the functional evaluation provided by the topographic analysis of Cortical Long Latency E.E, both from visual and auditory stimuli, in patients suffering from relapsing-remitting and chronic progressive multiple sclerosis and the morphological informations about the number and the location of demyelinating lesions evident at brain RM. We studied 100 patients with diagnosis of multiple sclerosis. The mean age at the onset of the disease was 29.5. years. Mean illness' duration was 6.5 years. Diagnosis was defined according to Poser's criteria. The long-latency EP were recorded with scalp electrodes (10/20) and the topographyc distribution was performed using a Nicolet
I PS-40-6 1 Longitudinal evaluation of multimodal evoked potentials in asymptomatic HIV seropoalUve subjects Paola Gambaro, Michela Mauri, Maurizio Osio, Pierluigi Bertora, Paola Meraviglia 1, Alfonso Mangoni. 1st
Neurologic Clinic, University of Milan, Italy; 12nd Department of Infectious Diseases, Hospital "L. Sacco ", Milan, Italy The aim of this study was to evaluate early nervous system changes in neurologically asymptomatic HIV positive patients by multimodal evoked potentials (VEPs, BAEPs, P300, median and tibial nerve SSEPs). We selected 30 subjects (19 men, 11 women, mean age 31.5 yrs) with HIV infection at CDC stages II, III, IVC2 and IVE without neurological symptoms. We present the results of baseline and follow-up visits: the data of 25 subjects at 6-month, 12 at 12-month and 8 at 18-month controls are at present available. Mean neurophysiologic data were compared by Student's t-test. VEPs, BAEPs and P300 results were normal. Median nerve SSEPs showed a prolonged N9-N13 difference (p < 0.05) at 6- and 12month follow-up visits and a reduction in amplitude of N20 wave (p < 0.005) at 12- and 18-month follow-up visits. Tibial nerve SSEPs showed a prolonged latency of P40 wave (p < 0.02) and an increase of central conduction time (p < 0.01) at 6- and 12-month follow-up. No changes occurred for P300 values throughout the study. None of the patients evaluated disclosed overt neurological symptoms or signs nor superior function abnormalities during the study, with the exception of one case of DDC-induced neuropathy. These partial data suggest that subclinical alterations of central and peripheral nervous system, the appearance of which is well documented in the course of HIV infection, can be evaluated by SSEP study also in early stages of the disease. The usefulness of BAEE VEP and P300 study for the early diagnosis of neurological alterations remains however to be ascertained.
I PS-40-7 t Multi evoked potential study in systemic lupus erithmatosus (SLE) B. Fierro, E Brighina, L. Amico 1, A. Aloisio, D. Buffa, G. Caravaglios, V. La Bua, M. Oliveri, O. Daniele. Istituto di
Neuropsichiatria, Universith di Palermo; 1Divisione di Nefrologia, Ospedale Civico, Palermo SLE is a complex multisystem disease, often associated with central and peripheral nervous system involvement. Although the pathogenesis of this condition remains obscure, several mechanisms including small vessels vasculopathy and direct antibody mediated neuronal dysfunction have been proposed to explain it. However, so far, there have been no consistent diagnostic clinical criteria for neuropsychiatric lupus (NPSLE). Evoked potentials (EPs) are recognised as useful technique in clinical neurophysiology and have also been advocated as sensitive measure in NPSLE. In order to detect clinical as well as subclinical abnormal function of peripheral and central nervous system we performed NCV and multi-evoked potential study in a group of 35 SLE patients and in 30 sex and age matched normal subjects. In particular, we studied motor and sensory median and tibial NCV, median SEP bilaterally, VEPs-RP, ERGs, BAEPs, auditory ERP (P300). All SLE subjects underwent to neurological and neuropsychological evaluations, immunological determinations (including aPL, antiGM1 antibodies) and neuroimaging study (MRI). Electrophysiological parameters of both neurologically symptomatic and asymptomatic patients were analysed and the relationships to clinical, immunological and radiological variables were then assessed.
S187
No significant differences of the mean values of EPs were found between patients and controls. Fourteen patients (40%) presented clinically definite nervous system dysfunction. Electrophysiologicai evidence of peripheral or central nervous system involvement (NCV or EPs values > 2 SD) were observed in 15 patients (42%): seven with definite neurological signs and eight without signs definitely attributable to nervous system alterations. Neurophysiological abnormalities were significantly associated (O.R. = 7.3 p < 0.05) with high prevalence of antiphospholipide antibodies, while did not correlate with clinical and radiological variables.
t PS-40-81 Neurophisiological (MEP) estimation of Central Nervous System (CNS) at Diabetes Mellitus (DM) patients K. Pierzcha~a. II Department of Neurology, Silesian Medical Academy, Katowice The aim of this paper is estimation of changes in CNS at DM patients, using the method of multimodal evoked potentials (MEP), and to define dependence of MEP to clinical symptoms of DM. Sixty-three diabetics (mean age 51.9 + 12.5 years, mean lasting of DM 13.8 4- 8.3 years) were made visual evoked potentials (VEP), brainstem evoked potentials (BAEP) and trigeminal evoked potentials (TEP). At the examined group of patients, there were found 26 persons with diabetic cranial neuropathy, rest of them had no neurological changes. Following waves latencies were estimated: P100-VEP P1-TEP, I, IIl, V and interlatencies BAEE As an abnormal result was found one witch was different about 3SD from the results at control group. Abnormal results were mostly received at TEP (88.4%), BAEP (68.3%), VEP (61.1%). Abnormal results at BAEP were found more often at patients over 50 years with type II DM. The changes at VEP and TEP were mostly observed at type I DM with insufficient diabetic control. Abnormal results at TEP appeared significance more frequent at DM patients treated by insulin (p 0.0001). The frequency of abnormal MEP results at patients with diabetic cranial neurophaty was higher that at the rest of patients and reached the significant level (p 0.001) for TEE This high percentage of abnormal MEP results indicated the occurrence of diabetic encephalopathy. MEP are sensitive and useful diagnostic method for estimation subclinical symptoms of CNS damage.
I PS-40-91 Topographic analysis of long latency VEPs and AEPs In patients suffering from multiple sclerosis in comparison with brain RM: study on 100 subjects F. Monti 1, M. Gioseffi ], A. Bosco ], R. Pol 1, G. Cazzato 1, S. Magnaldi 2, M. Ukmar 2. 1Department of Neurology, University of Trieste, Trieste, Italy; 2Department of Radiology, University of Trieste, Trieste, Italy The aim of the study was to compare the functional evaluation provided by the topographic analysis of Cortical Long Latency E.E, both from visual and auditory stimuli, in patients suffering from relapsing-remitting and chronic progressive multiple sclerosis and the morphological informations about the number and the location of demyelinating lesions evident at brain RM. We studied 100 patients with diagnosis of multiple sclerosis. The mean age at the onset of the disease was 29.5. years. Mean illness' duration was 6.5 years. Diagnosis was defined according to Poser's criteria. The long-latency EP were recorded with scalp electrodes (10/20) and the topographyc distribution was performed using a Nicolet