Using advanced analysis of multifocal visual-evoked potentials to evaluate the risk of clinical progression in patients with radiologically isolated syndrome

This study aimed to assess the role of multifocal visual-evoked potentials (mfVEPs) as a guiding factor for clinical conversion of radiologically isolated syndrome (RIS). We longitudinally followed a cohort of 15 patients diagnosed with RIS. All subjects underwent thorough ophthalmological, neurological and imaging examinations. The mfVEP signals were analysed to obtain features in the time domain (SNRmin: amplitude, Lat(max): monocular latency) and in the continuous wavelet transform (CWT) domain (b(max): instant in which the CWT function maximum appears, N-max: number of CWT function maximums). The best features were used as inputs to a RUSBoost boosting-based sampling algorithm to improve the mfVEP diagnostic performance. Five of the 15 patients developed an objective clinical symptom consistent with an inflammatory demyelinating central nervous system syndrome during follow-up (mean time: 13.40 months). The (SNRmin) variable decreased significantly in the group that converted (2.74 +/- 0.92 vs. 4.07 +/- 0.95, p=0.01). Similarly, the (b(max)) feature increased significantly in RIS patients who converted (169.44 +/- 24.81 vs. 139.03 +/- 11.95 (ms), p=0.02). The area under the curve analysis produced SNRmin and b(max) values of 0.92 and 0.88, respectively. These results provide a set of new mfVEP features that can be potentially useful for predicting prognosis in RIS patients.

Automated summary

This study assessed the role of mfVEPs in predicting clinical conversion in RIS patients, finding significant changes in SNRmin and b(max) features in those who converted. The new features identified may be useful for predicting prognosis in RIS patients.