Renata Silva1, Pedro Coelho2, Mafalda Seabra3, Inês Laranjinha4, Daniela Vieira5, Octávia Costa6, Jennifer Jesus1, Ana Cláudia Fonseca2, Sónia Costa3, Inês Ferreira4, João Lemos5,7, Cláudia Sousa3, José Vale8, Maria José Sá3,9, Luís Ruano10,11,12. 1. Centro Hospitalar de Entre Douro E Vouga, Santa Maria da Feira, Portugal. 2. Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal. 3. Centro Hospitalar E Universitário de São João, Porto, Portugal. 4. Centro Hospitalar E Universitário Do Porto, Porto, Portugal. 5. Centro Hospitalar E Universitário de Coimbra, Coimbra, Portugal. 6. Hospital de Braga, Braga, Portugal. 7. Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal. 8. Hospital Beatriz Ângelo, Loures, Portugal. 9. Universidade Fernando Pessoa, Porto, Portugal. 10. Centro Hospitalar Universitário Lisboa Norte, Lisboa, Portugal. lmruano@gmail.com. 11. Faculdade de Medicina da Universidade Do Porto, Porto, Portugal. lmruano@gmail.com. 12. EPIUnit - Institute of Public Health, University of Porto, Rua das Taipas 135-139, 4050-600, Porto, Portugal. lmruano@gmail.com.
Abstract
INTRODUCTION: Cognitive impairment and retinal atrophy have been proposed as two potential markers of neurodegeneration in multiple sclerosis (MS). We aimed at assessing the relation between peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell layer (mGCL) atrophy and cognitive performance in early MS. METHODS: This is a multicenter cross-sectional study on patients with early MS (clinically isolated syndrome and relapsing-remitting MS), with an EDSS score ≤ 3.0. Patients with previous optic neuritis, other ocular diseases, psychiatric illness, or recent relapse were excluded. All patients underwent standardized optical coherence tomography (OCT) and neuropsychological evaluation with validated tests for MS patients. Cognitive impairment was defined as having two cognitive tasks below age- and education-adjusted norms. RESULTS: We recruited 52 patients with early MS, with an average age of 37 years (SD = 10.5), an average disease duration of 3.69 years (SD = 2.3), and a median EDSS of 1.0 (IQR = 0.5). In this sample, 15/52 patients presented cognitive impairment. Regarding OCT measurements, 7/52 patients had an average pRNFL below the 5th percentile and 2/52 had an average mGCL below the 5th percentile. The average pRNFL thickness was comparable in cognitively impaired and cognitively preserved patients (100.3 μm vs 103.1 μm, p = 0.52); the average mGCL thickness had also similar values between groups (50.5 μm vs 53 μm, p = 0.38). CONCLUSIONS: Cognitive impairment was frequent in our sample of early MS. However, no association with reduced pRNFL or mGCL thickness was found. When compared to OCT, cognitive assessment could provide an earlier marker of neurodegeneration in MS.
INTRODUCTION: Cognitive impairment and retinal atrophy have been proposed as two potential markers of neurodegeneration in multiple sclerosis (MS). We aimed at assessing the relation between peripapillary retinal nerve fiber layer (pRNFL) and macular ganglion cell layer (mGCL) atrophy and cognitive performance in early MS. METHODS: This is a multicenter cross-sectional study on patients with early MS (clinically isolated syndrome and relapsing-remitting MS), with an EDSS score ≤ 3.0. Patients with previous optic neuritis, other ocular diseases, psychiatric illness, or recent relapse were excluded. All patients underwent standardized optical coherence tomography (OCT) and neuropsychological evaluation with validated tests for MS patients. Cognitive impairment was defined as having two cognitive tasks below age- and education-adjusted norms. RESULTS: We recruited 52 patients with early MS, with an average age of 37 years (SD = 10.5), an average disease duration of 3.69 years (SD = 2.3), and a median EDSS of 1.0 (IQR = 0.5). In this sample, 15/52 patients presented cognitive impairment. Regarding OCT measurements, 7/52 patients had an average pRNFL below the 5th percentile and 2/52 had an average mGCL below the 5th percentile. The average pRNFL thickness was comparable in cognitively impaired and cognitively preserved patients (100.3 μm vs 103.1 μm, p = 0.52); the average mGCL thickness had also similar values between groups (50.5 μm vs 53 μm, p = 0.38). CONCLUSIONS: Cognitive impairment was frequent in our sample of early MS. However, no association with reduced pRNFL or mGCL thickness was found. When compared to OCT, cognitive assessment could provide an earlier marker of neurodegeneration in MS.
Authors: Timm Oberwahrenbrock; Sven Schippling; Marius Ringelstein; Falko Kaufhold; Hanna Zimmermann; Nazmiye Keser; Kim Lea Young; Jens Harmel; Hans-Peter Hartung; Roland Martin; Friedemann Paul; Orhan Aktas; Alexander U Brandt Journal: Mult Scler Int Date: 2012-07-25