OBJECTIVES: To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage. METHODS: Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function. RESULTS: Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome. INTERPRETATION: Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP).
OBJECTIVES: To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage. METHODS:Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function. RESULTS: Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome. INTERPRETATION: Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP).
Authors: Carmen Tur; Olivia Goodkin; Daniel R Altmann; Thomas M Jenkins; Katherine Miszkiel; Alessia Mirigliani; Camilla Fini; Claudia A M Gandini Wheeler-Kingshott; Alan J Thompson; Olga Ciccarelli; Ahmed T Toosy Journal: Brain Date: 2016-02-17 Impact factor: 13.501
Authors: Valentina Tomassini; Paul M Matthews; Alan J Thompson; Daniel Fuglø; Jeroen J Geurts; Heidi Johansen-Berg; Derek K Jones; Maria A Rocca; Richard G Wise; Frederik Barkhof; Jacqueline Palace Journal: Nat Rev Neurol Date: 2012-11-05 Impact factor: 42.937
Authors: Joachim Havla; Thivya Pakeerathan; Kevin Rostasy; Ilya Ayzenberg; Carolin Schwake; Jeffrey L Bennett; Ingo Kleiter; Ana Felipe-Rucián; Stephanie C Joachim; Amelie S Lotz-Havla; Tania Kümpfel; Markus Krumbholz; Eva M Wendel; Markus Reindl; Charlotte Thiels; Thomas Lücke; Kerstin Hellwig; Ralf Gold Journal: J Neuroinflammation Date: 2021-05-29 Impact factor: 8.322