{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T09:56:46Z","timestamp":1775728606786,"version":"3.50.1"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:00:00Z","timestamp":1775606400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Visual evoked potentials (VEPs) are a simple, noninvasive method for detecting subclinical visual pathway involvement in multiple sclerosis. This study investigated the frequency of VEP abnormalities and their associations with baseline clinical, radiological, and cerebrospinal fluid (CSF) features in treatment-na\u00efve patients with clinically isolated syndrome (CIS) or early relapsing-remitting multiple sclerosis (RRMS) without prior optic neuritis. Materials and Methods: We retrospectively reviewed newly diagnosed, treatment-na\u00efve CIS\/early RRMS patients evaluated between January 2022 and July 2024 who underwent CSF analysis. Pattern-reversal VEPs were recorded under standardized conditions. VEP abnormalities were analyzed as any or bilateral, and associations were assessed using group comparisons and multivariable logistic regression. Results: In 101 patients (mean age 31.8 \u00b1 9.7 years; 72% female; median EDSS 1.0), latency prolongation occurred in 69 (42 any,27 bilateral) and amplitude reduction in 33 (22 any, 11 bilateral). Among patients with latency prolongation, both the number of OCB bands and the IgG index were higher (bilateral p = 0.032; any p = 0.007). In multivariable analysis, male sex (p = 0.032) and pyramidal\/brainstem-onset presentation (p = 0.006) were independently associated with any amplitude reduction; neither was associated with latency abnormalities. Conclusions: VEP abnormalities are common early in the disease, even without a history of optic neuritis. Male sex and pyramidal\/brainstem-onset presentation were associated with reduced amplitude, suggesting that amplitude decrease may reflect early tissue dysfunction and may be related to adverse baseline clinical features. Associations between intrathecal immune activation and prolonged latency may indicate subclinical demyelination of the visual pathways related to inflammatory activity. Larger longitudinal studies are needed to clarify the clinical significance of VEP abnormalities in early RRMS.<\/jats:p>","DOI":"10.3390\/medicina62040713","type":"journal-article","created":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T07:48:07Z","timestamp":1775720887000},"page":"713","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["VEP Abnormalities in Treatment-Na\u00efve CIS\/Early RRMS Without Prior Optic Neuritis: Clinical, Radiological, and CSF Associations"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5945-2317","authenticated-orcid":false,"given":"Furkan","family":"Sar\u0131da\u015f","sequence":"first","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6649-9287","authenticated-orcid":false,"given":"Rifat","family":"\u00d6zpar","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0465-4218","authenticated-orcid":false,"given":"Emel","family":"O\u011fuz Akarsu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0342-5939","authenticated-orcid":false,"given":"Yasemin","family":"Din\u00e7","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0297-846X","authenticated-orcid":false,"given":"G\u00fcven","family":"\u00d6zkaya","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Faculty of Medicine, Bursa Uluda\u011f University,  16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0264-7284","authenticated-orcid":false,"given":"Emine Rabia","family":"Ko\u00e7","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3425-0740","authenticated-orcid":false,"given":"Bahattin","family":"Hakyemez","sequence":"additional","affiliation":[{"name":"Department of Radiology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6752-1519","authenticated-orcid":false,"given":"\u00d6mer Faruk","family":"Turan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Faculty of Medicine, Bursa Uluda\u011f University, 16059 Bursa, T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/S0140-6736(23)01473-3","article-title":"Multiple sclerosis","volume":"403","author":"Jakimovski","year":"2024","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1212\/WNL.0b013e31824f7fdd","article-title":"Randomized controlled trial of atorvastatin in clinically isolated syndrome: The STAyCIS study","volume":"78","author":"Waubant","year":"2012","journal-title":"Neurology"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/S1474-4422(17)30470-2","article-title":"Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria","volume":"17","author":"Thompson","year":"2018","journal-title":"Lancet Neurol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1177\/1352458515588583","article-title":"Conversion from clinically isolated syndrome to multiple sclerosis: A large multicentre study","volume":"21","author":"Ciccarelli","year":"2015","journal-title":"Mult. 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