Evoked Potential Testing in MS

Multiple sclerosis (MS) is a complex demyelinating disease of the central nervous system for which there is no single diagnostic test. Common tools used to diagnose MS include the neurological exam, complete medical history, magnetic resonance imaging (MRI), and evoked potential (EP) studies.

What are evoked potentials?

As the brain “talks” to various parts of the body, messages are sent as electrical signals that travel along nerves. Demyelination and neurodegeneration caused by MS can disrupt these electrical signals. Evoked potential studies, also called evoked potentials (EPs), measure signals that travel through specific sensory nerve pathways in response to external stimuli. Those electrical signals are measured through sensors placed on the skin in combination with sophisticated computer programs.

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Evoked Potential Tests: How Are They Used In MS?

Multiple Sclerosis Without Evidence of Demyelination?

People who are in the process of being tested for multiple sclerosis often have many questions. Some of the most common questions surround the subjects of MRIs and lesions. Magnetic Resonance Imaging (MRI) is a powerful tool used to help diagnosis MS as well as measure disease progression. Lesions are the scars caused by demyelination which can be detected by MRI scan.

There have been many occasions where people in the process of being diagnosed with MS ask whether it is possible to have MS and not have brain lesions. The short answer is an unequivocal YES.

When I first experienced blinding optic neuritis in 2000, the neurologist ordered MRI scans of my brain. The results showed inflammation of the optic nerve, but no detectable lesions in the brain. Thus I was not diagnosed with MS at that time.

Five years later, when I was undergoing MRI testing of both my brain and cervical spine, lesions were seen in my neck. But my brain was still clear from lesions or atrophy. We only had to wait a few months until additional lesions showed up in my cervical spine and an official diagnosis was made.

Eventually the smaller lesions in my spine grew together to form one large lesion that spanned from the C4 to C6 vertebras. At the time I switched from my original disease-modifying therapy (Copaxone) to a totally different treatment approach (off-label Rituxan), I was hoping to avoid developing even larger lesions in my spine as I was definitely experiencing increased symptoms and relapses.

After I had been on Rituxan for a year, my MRI report indicated stability in lesion load, meaning that I had not developed any new or larger lesions. Follow-up scans two years later were stable, without evidence of new or worsening lesions, once again.

Another two years have past and I’ve just recently undergone MRI exam to determine two things: 1) How is my MS is doing? and 2) Is my current treatment continuing to be effective? What follows are the radiologist’s reports following the recent MRIs.

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Living with MS: No Evidence of Demyelination

Modeling MS in Mice to Study Remyelination

To investigate potential causes and treatments for demyelinating diseases such as MS, researchers use various methods to cause a condition or symptoms similar to MS in laboratory animals.  Mice do not naturally develop MS, but mice are especially suited to studying MS-like disease because of their similarity to humans in anatomy, physiology, and genetics.  Researchers are able to create various genetic modifications in mice to mimic human disease.  Mice are small, inexpensive, and can reproduce quickly.

There are three major types of animal models used to study demyelinating disease: 1) genetic models, where genes important for CNS myelination, myelin maintenance or glial function have been altered; 2) immune-mediated models of induced pathogenesis towards myelin; and 3) toxin-mediated models using toxic substances that preferentially affect myelin (Pohl, 2011).
- See more at: http://www.healthcentral.com/multiple-sclerosis/c/19065/169331/sclerosis-disease#sthash.WodvrOeA.dpuf

To investigate potential causes and treatments for demyelinating diseases such as MS, researchers use various methods to cause a condition or symptoms similar to MS in laboratory animals.  Mice do not naturally develop MS, but mice are especially suited to studying MS-like disease because of their similarity to humans in anatomy, physiology, and genetics.  Researchers are able to create various genetic modifications in mice to mimic human disease.  Mice are small, inexpensive, and can reproduce quickly. 

There are three major types of animal models used to study demyelinating disease: 1) genetic models, where genes important for CNS myelination, myelin maintenance or glial function have been altered; 2) immune-mediated models of induced pathogenesis towards myelin; and 3) toxin-mediated models using toxic substances that preferentially affect myelin (Pohl, 2011).

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Multiple Sclerosis Research: Studying MS-like Disease in Mice