NEUROPHYSIOLOGICAL AND COGNITIVE MARKERS OF DISEASE EVOLUTION IN MULTIPLE-SCLEROSIS

Both evoked potentials and cognitive tests may provide useful informat ion which cannot be derived from the clinical observation. For this re ason, there have been some attempts to use EPs in monitoring the natur al history of the disease and in assessing the efficacy of therapeutic trials. However, no conclusion con be derived from the few available data. Although MRI is more sensitive than EPs in revealing new lesions in brain, cerebellum and brainstem, EPs are more sensitive in reveali ng optic nerve and spinel cord lesions. Moreover, the poor relationshi p between brain MRI abnormalities and disability has raised the possib ility that cognitive evaluation may be an additional sensitive marker of brain involvement over lime. Since the gold standard for the assess ment of disease activity is uncertain, it is therefore advisable that frequent MRI, EPs and cognitive assessment may integrate clinical outc omes measured by conventional scales, both in the study of the natural disease course and in monitoring clinical trials.