Evidence map›Paper›PMID 40244940›Full record

Observational studyAnnals of clinical and translational neurology2025

Correspondence of MRI and nTMS With EDSS in Multiple Sclerosis: Longitudinal Follow-Up Study.

Antonia Bralić, Sanda Pavelin, Nikolina Pleić, Joško Šoda, Krešimir Dolić, Anita Markotić, Ana Ćurković Katić, Angela Mastelić, Nikolina Režić Mužinić, Jasna Duranović and 4 more

Registry-linked trialAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of clinical and translational neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04604041 (Investigation of Subclinical Markers of Multiple Sclerosis), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04604041 recruitingnot on this map

Investigation of Subclinical Markers of Multiple Sclerosis

TypeobservationalSponsorUniversity of Split, School of MedicineRan2020 to 2028Enrolled50ConditionsMultiple Sclerosis, Relapsing Remitting Multiple SclerosisArms1. Clinical testing, 2. Neurophysiological examination (TMS, EMNG), 3. Psychomotor examination, 4. Neuropsychological evaluation, 5. Flow cytometry
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Antonia BralićDepartment of Interventional and Diagnostic Radiology, University Hospital of Split, Split, Croatia.
Sanda PavelinDepartment of Neurology, University Hospital of Split, Split, Croatia.
Nikolina PleićDepartment of Medical Biology, School of Medicine, University of Split, Split, Croatia.
Joško ŠodaSignal Processing, Analysis, Advanced Diagnostics Research and Education Laboratory (SPAADREL), Faculty of Maritime Studies, Department for Marine Electrical Engineering and Information Technologies, University of Split, Split, Croatia.
Krešimir DolićDepartment of Interventional and Diagnostic Radiology, University Hospital of Split, Split, Croatia.
Anita MarkotićDepartment of Medical Chemistry and Biochemistry, School of Medicine, University of Split, Split, Croatia.
Ana Ćurković KatićDepartment of Neurology, University Hospital of Split, Split, Croatia.
Angela MastelićDepartment of Medical Chemistry and Biochemistry, School of Medicine, University of Split, Split, Croatia.
Nikolina Režić MužinićDepartment of Medical Chemistry and Biochemistry, School of Medicine, University of Split, Split, Croatia.
Jasna DuranovićLaboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.
Zlatko KljajićFaculty of Maritime Studies, University of Split, Split, Croatia.
Ivona Stipica SafićDepartment of Family Medicine, School of Medicine, University of Split, Split, Croatia.
Zoran ĐogašLaboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.
Maja Rogić VidakovićLaboratory for Human and Experimental Neurophysiology, Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.ORCID 0000-0001-8516-9718

Funding

Croatian Science Foundation HRZZ-IP-2022-10-6203
6 · The paper itself

Abstract

objectivesConsidering the characteristics of multiple sclerosis (MS) disease and its impact on motor disability, this study aims to assess the functional integrity of the corticospinal tract by examining motor evoked potentials (MEPs), Expanded Disability Status Scale (EDSS) scores, magnetic resonance imaging (MRI) lesion counts, and psychological and physical status reported by patients with relapsing-remitting MS (RRMS).

methodsIn 23 RRMS subjects (17 in the follow-up), the corticospinal tract for upper and lower extremity muscles was longitudinally studied over 2 years using navigated transcranial magnetic stimulation (nTMS) and MEP scoring. MRI parameters included lesion detection by applying McDonald's criteria and additional lesion detection of the corticospinal tract. EDSS scoring included evaluation of the EDSS general score, EDSS functional pyramidal score, and EDSS functional pyramidal score for each extremity. Longitudinal analyses of nTMS (MEP), EDSS, and MRI parameters were conducted using linear mixed models with time, sex, age, and disease duration as fixed effects and individual-specific random intercepts. The correspondence of MRI and nTMS scoring with the EDSS pyramidal scoring was tested using McNemar's or Fisher's exact test.

resultsRRMS patients with altered MEP latency had significantly higher general EDSS scores (β = -2.06, p = 0.006) and overall pyramid EDSS scores (β = -1.96, p = 0.002) compared to those with non-altered MEP latency. This difference was also observed in lower extremity pyramid EDSS scores, with higher scores in the right (β = -1.70, p = 0.001) and left leg (β = -1.50, p = 0.032) in the altered MEP latency group. RRMS patients with altered MEP latency had significantly more lesions in the corpus callosum (β = 2.38, p = 0.03) compared to subjects with non-altered MEP latency findings. The correspondence of MRI and nTMS (MEP latency) with EDSS scoring was confirmed.

interpretationRRMS subjects with altered MEP latency findings (prolonged MEP latency or absent MEP response) compared to subjects with non-altered MEP latency findings, had higher EDSS scores in lower extremity muscles as well as a higher number of lesions in the corpus callosum. This is the first longitudinal nTMS study to perform four-limb cortical mapping of corticospinal tract integrity in RRMS. The study opens perspectives for the nTMS as an objective method for longitudinally assessing MS motor disability.

trial registrationClinicalTrials.gov identifier: NCT04604041.

Indexed as

Disability EvaluationEvoked Potentials, MotorMagnetic Resonance ImagingMultiple Sclerosis, Relapsing-RemittingPyramidal TractsTranscranial Magnetic StimulationAdultFemaleFollow-Up StudiesHumansLongitudinal StudiesMaleMiddle AgedSeverity of Illness Indexcorticospinal tractmotor evoked potentialsmultiple sclerosisrelapsing remittingtranscranial magnetic stimulation

Identifiers

PMID40244940
PMCPMC12172135

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.