scholarly journals Evaluation of Retinal Structure and Optic Nerve Function Changes in Multiple Sclerosis: Longitudinal Study with 1-Year Follow-Up

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Riwanti Estiasari ◽  
Adisresti Diwyacitta ◽  
Muhammad Sidik ◽  
Ni Nengah Rida Ariarini ◽  
Freddy Sitorus ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Contrast Sensitivity ◽  
Disease Duration ◽  
Nerve Function ◽  
P100 Latency ◽  
Rnfl Thickness ◽  
Degree Of Disability ◽  
Retinal Structure

Background. Multiple sclerosis (MS) is an autoimmune disease characterized by inflammation and demyelination of the central nervous system which often involves the optic nerve even though only 20% of the patients experience optic neuritis (ON). Objective. This study aims to compare the retinal structure and optic nerve function between patients with MS and healthy controls (HCs), evaluate optic nerve alterations in MS over 1-year follow-up, and analyze its correlations with disease duration, number of relapses, degree of disability, and different subtypes. Methods. This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated with best-corrected visual acuity (BCVA), contrast sensitivity, and P100 latency, while the retinal structure was evaluated from the GCIPL and RNFL thickness measured with optical coherence tomography (OCT) and fundus photography. Results. The MS group had lower BCVA ( p = 0.001 ), contrast sensitivity ( p < 0.001 ), mean GCIPL thickness ( p < 0.001 ), and mean RNFL thickness ( p < 0.001 ) than HC. At 6 and 12 months of observations, GCIPL and RNFL (nasal quadrant) of MS patients decreased significantly ( p = 0.007 and p = 0.004 , respectively). Disease duration and the number of relapses correlated with delayed P100 latency (r = −0.61, p < 0.001 and r = −0.46, p = 0.02 ). GCIPL and RNFL in the SPMS subtype were thinner than in RRMS. Conclusions. The retinal structure and optic nerve function of MS patients are worse than those of normal individuals. GCIPL and RNFL thinning occurs at 6 and 12 months but do not correlate with disease duration, the number of relapses, and degree of disability.

Brain atrophy evolution and lesion load accrual in multiple sclerosis: a 2-year follow-up study

2008 ◽  
Vol 15 (2) ◽  
pp. 204-211 ◽  
Author(s):  
G Tedeschi ◽  
D Dinacci ◽  
M Comerci ◽  
L Lavorgna ◽  
G Savettieri ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Disease Progression ◽  
Gray Matter ◽  
Brain Atrophy ◽  
Disease Duration ◽  
Lesion Load ◽  
Whole Brain ◽  
Gray Matter Atrophy

Background To investigate in a large cohort of patients with multiple sclerosis (MS), lesion load and atrophy evolution, and the relationship between clinical and magnetic resonance imaging (MRI) correlates of disease progression. Methods Two hundred and sixty-seven patients with MS were studied at baseline and two years later using the same MRI protocol. Abnormal white matter fraction, normal appearing white matter fraction, global white matter fraction, gray matter fraction and whole brain fraction, T2-hyperintense, and T1-hypointense lesions were measured at both time points. Results The majority of patients were clinically stable, whereas MRI-derived brain tissue fractions were significantly different after 2 years. The correlation between MRI data at baseline and their variation during the follow-up showed that lower basal gray matter atrophy was significantly related with higher progression of gray matter atrophy during follow-up. The correlation between MRI parameters and disease duration showed that gray matter atrophy rate decreased with increasing disease duration, whereas the rate of white matter atrophy had a constant pattern. Lower basal gray matter atrophy was associated with increased probability of developing gray matter atrophy at follow-up, whereas gray matter atrophy progression over 2 years and new T2 lesion load were risk factors for whole brain atrophy progression. Conclusions In MS, brain atrophy occurs even after a relatively short period of time and in patients with limited progression of disability. Short-term brain atrophy progression rates differ across tissue compartments, as gray matter atrophy results more pronounced than white matter atrophy and appears to be a early phenomenon in the MS-related disease progression.

scholarly journals Assessment of cognitive functions in patients with multiple sclerosis

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Tara A. Al-Falaki ◽  
Farqad B. Hamdan ◽  
Nawfal M. Sheaheed
Keyword(s):  
Multiple Sclerosis ◽  
Functional Disability ◽  
Disease Duration ◽  
Education Level ◽  
Cognitive Changes ◽  
Duration Of Illness ◽  
Disability Status ◽  
Visuospatial Learning ◽  
Degree Of Disability ◽  
Moca Score

Abstract Background About 40–70% of patients with multiple sclerosis (MS) develop cognitive impairment (CI) throughout their life. We aim to study the influence of MS on cognitive changes. This is a case–control study of fifty patients with MS who met the revised 2017 Mc Donald Criteria and fifty age- and sex-matched healthy subjects. The Expanded Disability Status Scale (EDSS) was used to assess the degree of disability, and the Montreal Cognitive Assessment (MoCA) scoring system was used to assess cognitive function. Results MS patients show low total MoCA score than the controls. Total MoCA scores were lower in patients with CI versus those with intact cognition. CI was higher in those with a longer duration of illness and a high EDSS. MoCA was positively correlated with education level but negatively with EDSS and disease duration. Conclusion MoCA scale has optimal psychometric properties for routine clinical use in patients with MS, even in those with mild functional disability. The longer the disease duration and the higher the EDSS, the lower the MoCA score and the higher the education level, the higher the MoCA score. As for the profile of cognitive dysfunction in patients with MS, the domains most frequently failed by the patients were memory, attention, visuospatial learning, and language.

scholarly journals Association of Gray Matter Atrophy Patterns With Clinical Phenotype and Progression in Multiple Sclerosis

Neurology ◽  
2021 ◽  
Vol 96 (11) ◽  
pp. e1561-e1573
Author(s):  
Maria A. Rocca ◽  
Paola Valsasina ◽  
Alessandro Meani ◽  
Claudio Gobbi ◽  
Chiara Zecca ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Odds Ratio ◽  
Disease Duration ◽  
Clinical Phenotype ◽  
Area Under The Curve ◽  
Disease Phenotypes ◽  
Relapsing Remitting ◽  
Almost All ◽  
Clinical Worsening

ObjectivesGay matter (GM) involvement is clinically relevant in multiple sclerosis (MS). Using source-based morphometry (SBM), we characterized GM atrophy and its 1-year evolution across different MS phenotypes.MethodsClinical and MRI data were obtained at 8 European sites from 170 healthy controls (HCs) and 398 patients with MS (34 with clinically isolated syndrome [CIS], 226 with relapsing-remitting MS [RRMS], 95 with secondary progressive MS [SPMS], and 43 with primary progressive MS [PPMS]). Fifty-seven HCs and 144 with MS underwent 1-year follow-up. Baseline GM loss, atrophy progression, and correlations with disability and 1-year clinical worsening were assessed.ResultsSBM identified 26 cerebellar, subcortical, sensory, motor, and cognitive GM components. GM atrophy was found in patients with MS vs HCs in almost all components (p range <0.001–0.04). Compared to HCs, patients with CIS showed circumscribed subcortical, cerebellar, temporal, and salience GM atrophy, while patients with RRMS exhibited widespread GM atrophy. Cerebellar, subcortical, sensorimotor, salience, and frontoparietal GM atrophy was found in patients with PPMS vs HCs and in patients with SPMS vs those with RRMS. At 1 year, 21 (15%) patients had clinically worsened. GM atrophy progressed in MS in subcortical, cerebellar, sensorimotor, and fronto-temporo-parietal components. Baseline higher disability was associated (R2 = 0.65) with baseline lower normalized brain volume (β = −0.13, p = 0.001), greater sensorimotor GM atrophy (β = −0.12, p = 0.002), and longer disease duration (β = 0.09, p = 0.04). Baseline normalized GM volume (odds ratio 0.98, p = 0.008) and cerebellar GM atrophy (odds ratio 0.40, p = 0.01) independently predicted clinical worsening (area under the curve 0.83).ConclusionGM atrophy differed across disease phenotypes and progressed at 1 year in MS. In addition to global atrophy measures, sensorimotor and cerebellar GM atrophy explained baseline disability and clinical worsening.

Effects of blunt trauma of eye on retinal nerve fibre layer

2021 ◽  
Vol 2 (4) ◽  
pp. 228-232
Author(s):  
Kumar Aalok ◽  
Keyword(s):  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Blunt Trauma ◽  
Color Vision ◽  
Control Groups ◽  
Rnfl Thickness ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
And Control

AIM: To study the effects of blunt trauma of eye on visual acuity and retinal nerve fiber layer (RNFL). METHODS: A prospective observational study was done on the patients of a road traffic accident (RTA) having blunt trauma injury of the eye from august 2018 to July 2019 at the Department of Ophthalmology, Hind Institute of Medical Sciences, Barabanki. Patients between the age group of 20 to 65 years undergoing RTA with ocular complaints were included in this study. Colour vision, contrast sensitivity, and best-corrected visual acuity (BCVA) were recorded, RNFL analysis was done through OCT. RESULTS: A total of 108 patients were enrolled in this study and were grouped as 54 cases and 54 controls. The mean age was 43±2.3 years with 11 (20.37%) females and 43 (79.6%) males in the case group. At initial visit after RTA, the difference between color vision, contrast sensitivity and BCVA between right and left eyes of cases and controls were significant. After a follow up of 3mo only significant difference was noted in contrast sensitivity between cases and control groups. Change in color vision and BCVA after 3mo was insignificant. Similarly, an initial significant difference was noted in mean RNFL thickness between cases and control groups, but after follow up of 3mo mean RNFL thickness difference was significant only in superior and temporal quadrants. CONCLUSION: RTA or blunt trauma of eye can lead to persistent RNFL thinning and decreased visual function.

scholarly journals Therapeutic plasma exchange in steroid-refractory multiple sclerosis relapses. A retrospective two-center study

2021 ◽  
Vol 14 ◽  
pp. 175628642097564
Author(s):  
Stephan Blechinger ◽  
Johannes Ehler ◽  
Gabriel Bsteh ◽  
Alexander Winkelmann ◽  
Fritz Leutmezer ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Plasma Exchange ◽  
Primary Outcome ◽  
Disease Duration ◽  
Therapeutic Plasma Exchange ◽  
Secondary Outcome ◽  
Sustained Effects ◽  
Mild Improvement ◽  
Disability Status

Background: Therapeutic plasma exchange (TPE) is frequently used in glucocorticosteroid (GCS)-refractory multiple sclerosis (MS) relapses. Data regarding predictors of treatment response are scarce. The objective of this study was to analyze predictive factors for response to TPE in GCS-refractory MS patients. Methods: A total of 118 MS patients in two tertiary MS centers were analyzed. Primary outcome was TPE response defined as marked, mild, or no improvement. Secondary outcome was change in expanded disability status scale (ΔEDSS). ΔEDSS and relapse activity within 6 months after TPE were studied. Results: Marked or mild improvement was observed in 78.8% of patients. ΔEDSS correlated significantly inversely with time from relapse to start of TPE (τ = –0.239, p = 0.001), age (τ = 0.182, p = 0.009) and disease duration (τ = –0.167, p = 0.017). In multivariate analysis, TPE response was predicted by diagnosis of relapsing MS [odds ratio (OR): 3.1], gadolinum-enhancement on magnetic resonance imaging (OR 3.2), age (OR 0.5 per 5 years older) and time from relapse onset to TPE (OR 0.7 per 7 days longer). Conclusion: Patients with longer disease duration and higher EDSS pre and post-TPE were more likely to show further disability progression or relapses within 6 months after TPE. No sustained effects were observed during the follow-up period.

Disability progression in aggressive multiple sclerosis

2016 ◽  
Vol 23 (3) ◽  
pp. 456-463 ◽  
Author(s):  
Suresh Menon ◽  
Feng Zhu ◽  
Afsaneh Shirani ◽  
Joel Oger ◽  
Mark S Freedman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Disease Duration ◽  
Patient Characteristics ◽  
Expanded Disability Status Scale ◽  
Disability Progression ◽  
Disease Modifying Drugs ◽  
Primary Progressive ◽  
Disability Status ◽  
The Mean

Objective: To examine disease progression in ‘aggressive’ multiple sclerosis (MS), British Columbia, Canada (1980–2009). Methods: Aggressive (or ‘malignant’) MS was defined as Expanded Disability Status Scale (EDSS) ⩾6 within 5 years from onset. The first EDSS ⩾6 was termed ‘baseline’. Within 2, 3 and 5 years post-baseline, patients were categorized as follows: ‘worsened’ or ‘improved’, relative to baseline EDSS (the remainder exhibited no change or had no new scores). The associations between patient characteristics (sex, relapsing onset/primary progressive, onset age, onset symptoms, disease duration, cumulative prior relapses and baseline EDSS) and worsening in disability were examined longitudinally using logistic regression. Results: Of the 225/4341 (5.2%) aggressive/malignant MS patients, 134 (59.6%) were female, 167 (74.2%) were relapsing onset, 94 (41.8%) had received disease-modifying drugs at some point and the mean follow-up was 8.7 years. The proportion of patients who ‘worsened’ increased from 40.4% to 57.8%, while those who ‘improved’ varied little (range, 8.9%–10.2%). The odds of worsening increased with disease duration (adjusted odds ratio (AOR) = 1.36; 95% confidence interval (CI) = 1.22–1.52) and the presence of primary progressive (vs relapsing-onset) MS (AOR = 1.85; 95% CI = 1.01–3.38). Conclusion: Apart from disease duration and a primary progressive course, no clinically useful associations of subsequent disease worsening in patients with aggressive/malignant MS were identified.

scholarly journals Retinal Nerve Fiber Layer Thickness in Multiple Sclerosis With and Without Optic Neuritis: a Four-year Follow-up Study

2021 ◽  
Author(s):  
Abdullah S. Al-Mujaini ◽  
Maiysa S. Al-Mujaini ◽  
Buthaina I. Sabt
Keyword(s):  
Multiple Sclerosis ◽  
Optic Neuritis ◽  
Nerve Fiber ◽  
Retinal Nerve Fiber Layer ◽  
Control Group ◽  
Healthy Controls ◽  
Fiber Layer ◽  
Nerve Fiber Layer ◽  
Rnfl Thickness

Abstract Background: Multiple sclerosis (MS) is an autoimmune disease that attacks the central nervous system, with optic neuritis (ON) being a common early manifestation. Retinal nerve fiber layer (RNFL) thickness may be a biomarker of neuroaxonal damage in MS patients. We sought to evaluate changes in RNFL thickness over four years in Omani MS patients with or without ON in comparison to a healthy control group. Methods: This retrospective case-control study involved 27 MS patients and 25 healthy controls. Optical coherence tomography was performed upon first diagnosis and at a four-year follow-up. Differences in mean RNFL thickness were calculated. Results: A total of 51 eyes from the MS group and 50 eyes from the control group were evaluated. There was a significant reduction in mean RNFL thickness among MS patients with ON at follow-up (81.21 versus 72.14 µm; P = .003), whereas no significant RNFL thinning was observed among MS patients without ON. However, there was a significant reduction in RNFL thickness among MS patients compared to healthy controls (76.79 versus 93.72 µm; P = .009), regardless of ON presence/absence. Conclusions: Axonal damage was seen in the optic nerves of Omani MS patients. Moreover, there was a significant reduction in RNFL thickness among MS patients with ON as the disease progressed; however, while there was evidence of RNFL thinning in MS patients without ON, this difference lacked statistical significance. Evaluation of RNFL thickness may represent a useful biomarker for monitoring disease progression in MS and its association with ON.

Static and dynamic pupillary characteristics in multiple sclerosis

2021 ◽  
pp. 112067212110443
Author(s):  
Ersin Muhafiz ◽  
Erdinç Bozkurt ◽  
Can Emre Erdoğan ◽  
Şerif Nizamoğulları ◽  
Mehmet Siraç Demir
Keyword(s):  
Multiple Sclerosis ◽  
Visual Acuity ◽  
Contrast Sensitivity ◽  
Control Group ◽  
Fiber Layer ◽  
Time Intervals ◽  
Rnfl Thickness ◽  
Significant Difference ◽  
Ophthalmologic Examination ◽  
And Control

Purpose: To examine the static and dynamic pupillary functions with automated pupillography in multiple sclerosis (MS) patients with preserved visual acuity. Methods: Forty-seven MS patients with preserved visual acuity were included in the study group and 43 healthy volunteers in the control group. The visual evoked potential of the patients was obtained. After routine ophthalmologic examination contrast sensitivity and the retinal nerve fiber layer (RNFL) thickness were measured. Finally scotopic, mesopic, and photopic pupillographies followed by dynamic pupillography were undertaken, and the pupillary dilatation speed was calculated. Results: The contrast sensitivity and RNFL thickness of the MS group were significantly lower than those of the control group ( p < 0.05; for both). In the MS and control groups, the scotopic pupil diameters were 5.48 ± 1.03 and 5.28 ± 0.78 mm, mesopic pupil diameters were 4.82 ± 0.83 and 4.48 ± 0.70 mm, and photopic pupil diameters were 3.84 ± 0.79 and 3.42 ± 0.49 mm, respectively ( p = 0.315, p = 0.044, and p = 0.004, respectively). In dynamic pupillography, the pupil in the MS group was more dilated than control group at all time sections examined except the sixth second ( p < 0.05; for all). Although the mean pupillary dilation speed in the first second was higher in the MS group ( p = 0.044), there was no significant difference between the groups for the other time intervals examined ( p > 0.05; for all). There was no correlation between pupillary parameters and P100-wave latency, RNFL thickness, or contrast sensitivity ( p > 0.05; for all). Conclusions: Static and dynamic pupillary functions may be affected in MS patients with preserved visual acuity. Although scotopic pupillary functions are preserved, mesopic, and photopic pupil functions are weakened.

The influence of coping styles on long-term employment in multiple sclerosis: A prospective study

2016 ◽  
Vol 23 (7) ◽  
pp. 1008-1017 ◽  
Author(s):  
Nina Grytten ◽  
Anne BR Skår ◽  
Jan Harald Aarseth ◽  
Jorg Assmus ◽  
Elisabeth Farbu ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Regression Analysis ◽  
Disease Duration ◽  
Coping Styles ◽  
Female Gender ◽  
Avoidant Coping ◽  
Predictive Values ◽  
Cox Regression Analysis

Background: The aim was to investigate predictive values of coping styles, clinical and demographic factors on time to unemployment in patients diagnosed with multiple sclerosis (MS) during 1998–2002 in Norway. Method: All patients ( N = 108) diagnosed with MS 1998–2002 in Hordaland and Rogaland counties, Western Norway, were invited to participate in the long-term follow-up study in 2002. Baseline recordings included disability scoring (Expanded Disability Status Scale (EDSS)), fatigue (Fatigue Severity Scale (FSS)), depression (Beck Depression Inventory (BDI)), and questionnaire assessing coping (the Dispositional Coping Styles Scale (COPE)). Logistic regression analysis was used to identify factors associated with unemployed at baseline, and Cox regression analysis to identify factors at baseline associated with time to unemployment during follow-up. Results: In all, 41 (44%) were employed at baseline. After 13 years follow-up in 2015, mean disease duration of 22 years, 16 (17%) were still employed. Median time from baseline to unemployment was 6 years (±5). Older age at diagnosis, female gender, and depression were associated with patients being unemployed at baseline. Female gender, long disease duration, and denial as avoidant coping strategy at baseline predicted shorter time to unemployment. Conclusion: Avoidant coping style, female gender, and longer disease duration were associated with shorter time to unemployment. These factors should be considered when advising patients on MS and future employment.

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