Identification of two highly antigenic epitope markers predicting multiple sclerosis in optic neuritis patients

Background: The visual evoked potentials (VEP) is a valuable tool to document occult lesions of the central visual channels especially within the optic nerve. Objectives: The purpose of the present study was to observe the findings of first few cases of VEP done in the neurophysiology department of the National Institute of Neurosciences (NINS), Dhaka, Bangladesh. Methodology: This cross-sectional study was conducted in the Department of Neurophysiology at the National Institute of Neurosciences and Hospital, Dhaka, Bangladesh from September 2017 to March 2020. All patients referred to the Neurophysiology Department of NINS for VEP were included. Pattern reversal VEPs were done using standard protocol set by International Federation of Clinical Neurophysiology (IFCN). Results: The mean age of the study population was 30.70 (±12.11) years (6-68 years) with 31 (46.3%) male and 36 (53.7%) female patients. The mean duration of illness was 8.71 (±1.78) months (3 days- 120 months). Most common presenting symptom was blurring of vision (37.3%) and dimness of vision (32.8%). Patterned VEP revealed mixed type (both demyelinating and axonal) of abnormality in most cases [29(43.35)]. The most common clinical diagnosis was multiple sclerosis (29.85%) and optic neuropathy (26.87%). In the clinically suspected cases of multiple sclerosis, optic neuropathy and optic neuritis most of the cases of VEP were abnormal and the p value is 0.04 in optic neuropathy and optic neuritis. Conclusion: The commonest presentation of the patients in this series were blurring of vision and dimness of vision. The most common clinical diagnosis for which VEP was asked for, was optic neuritis and multiple sclerosis. Most abnormalities were of mixed pattern (demyelinating and axonal). Journal of National Institute of Neurosciences Bangladesh, 2020;6(2): 74-77

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Optic neuritis with multiple sclerosis (review of literature and own data)

POINT OF VIEW EAST – WEST ◽

10.25276/2410-1257-2018-2-112-115 ◽

2018 ◽

pp. 112-115 ◽

Cited By ~ 1

Author(s):

E.K. Eliseeva ◽

◽

V.V. Neroev ◽

M.V. Zueva ◽

I.V. Tsapenko ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Review Of Literature

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Faculty Opinions recommendation of Multiple sclerosis risk after optic neuritis: final optic neuritis treatment trial follow-up.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1116185.589077 ◽

2008 ◽

Author(s):

George Ebers ◽

Andrew Weir

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Treatment Trial ◽

Multiple Sclerosis Risk ◽

Optic Neuritis Treatment Trial

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An algorithm using clinical data to predict the optimal individual glucocorticoid dosage to treat multiple sclerosis relapses

Therapeutic Advances in Neurological Disorders ◽

10.1177/17562864211020074 ◽

2021 ◽

Vol 14 ◽

pp. 175628642110200

Author(s):

Judit Gili-Kovács ◽

Robert Hoepner ◽

Anke Salmen ◽

Maud Bagnoud ◽

Ralf Gold ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Immune Therapy ◽

Serum Vitamin ◽

Multivariate Regression Analysis ◽

Pulse Therapy ◽

Clinical Routine ◽

Hydroxyvitamin D ◽

Serum Vitamin D ◽

Magnetic Resonance Imaging Mri

Background: Glucocorticoid (GC) pulse therapy is used for multiple sclerosis (MS) relapse treatment; however, GC resistance is a common problem. Considering that GC dosing is individual with several response-influencing factors, establishing a predictive model, which supports clinicians to estimate the maximum GC dose above which no additional therapeutic value can be expected presents a huge clinical need. Method: We established two, independent retrospective cohorts of MS patients. The first was an explorative cohort for model generation, while the second was established for its validation. Using the explorative cohort, a multivariate regression analysis with the GC dose used as the dependent variable and serum vitamin D (25D) concentration, sex, age, EDSS, contrast enhancement on cranial magnetic resonance imaging (MRI), immune therapy, and the involvement of the optic nerve as independent variables was established. Results: In the explorative cohort, 113 MS patients were included. 25-hydroxyvitamin D (25D) serum concentration and the presence of optic neuritis were independent predictors of the GC dose needed to treat MS relapses [(25D): −25.95 (95% confidence interval (CI)): −47.40 to −4.49; p = 0.018; optic neuritis: 2040.51 (95% CI: 584.64–3496.36), p = 0.006]. Validation of the multivariate linear regression model was performed within a second cohort. Here, the predicted GC dose did not differ significantly from the dose administered in clinical routine (mean difference: −843.54; 95% CI: −2078.08–391.00; n = 30, p = 0.173). Conclusion: Our model could predict the GC dose given in clinical, routine MS relapse care, above which clinicians estimate no further benefit. Further studies should validate and improve our algorithm to help the implementation of predictive models in GC dosing.

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Serum neurofilament levels reflect outer retinal layer changes in multiple sclerosis

Therapeutic Advances in Neurological Disorders ◽

10.1177/17562864211003478 ◽

2021 ◽

Vol 14 ◽

pp. 175628642110034

Author(s):

Caspar B. Seitz ◽

Falk Steffen ◽

Muthuraman Muthuraman ◽

Timo Uphaus ◽

Julia Krämer ◽

...

Keyword(s):

Multiple Sclerosis ◽

Optic Neuritis ◽

Previous History ◽

Supervised Machine Learning ◽

Support Vector ◽

Retinal Layer ◽

Neurofilament Light Chain ◽

Neurofilament Light ◽

Retinal Layers ◽

History Of

Background: Serum neurofilament light chain (sNfL) and distinct intra-retinal layers are both promising biomarkers of neuro-axonal injury in multiple sclerosis (MS). We aimed to unravel the association of both markers in early MS, having identified that neurofilament has a distinct immunohistochemical expression pattern among intra-retinal layers. Methods: Three-dimensional (3D) spectral domain macular optical coherence tomography scans and sNfL levels were investigated in 156 early MS patients (female/male: 109/47, mean age: 33.3 ± 9.5 years, mean disease duration: 2.0 ± 3.3 years). Out of the whole cohort, 110 patients had no history of optic neuritis (NHON) and 46 patients had a previous history of optic neuritis (HON). In addition, a subgroup of patients ( n = 38) was studied longitudinally over 2 years. Support vector machine analysis was applied to test a regression model for significant changes. Results: In our cohort, HON patients had a thinner outer plexiform layer (OPL) volume compared to NHON patients ( B = −0.016, SE = 0.006, p = 0.013). Higher sNfL levels were significantly associated with thinner OPL volumes in HON patients ( B = −6.734, SE = 2.514, p = 0.011). This finding was corroborated in the longitudinal subanalysis by the association of higher sNfL levels with OPL atrophy ( B = 5.974, SE = 2.420, p = 0.019). sNfL levels were 75.7% accurate at predicting OPL volume in the supervised machine learning. Conclusions: In summary, sNfL levels were a good predictor of future outer retinal thinning in MS. Changes within the neurofilament-rich OPL could be considered as an additional retinal marker linked to MS neurodegeneration.

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