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Suh A, Hampel G, Vinjamuri A, Ong J, Kamran SA, Waisberg E, Paladugu P, Zaman N, Sarker P, Tavakkoli A, Lee AG. Oculomics analysis in multiple sclerosis: Current ophthalmic clinical and imaging biomarkers. Eye (Lond) 2024:10.1038/s41433-024-03132-y. [PMID: 38858520 DOI: 10.1038/s41433-024-03132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/18/2024] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
Multiple Sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) characterized by inflammation, demyelination, and axonal damage. Early recognition and treatment are important for preventing or minimizing the long-term effects of the disease. Current gold standard modalities of diagnosis (e.g., CSF and MRI) are invasive and expensive in nature, warranting alternative methods of detection and screening. Oculomics, the interdisciplinary combination of ophthalmology, genetics, and bioinformatics to study the molecular basis of eye diseases, has seen rapid development through various technologies that detect structural, functional, and visual changes in the eye. Ophthalmic biomarkers (e.g., tear composition, retinal nerve fibre layer thickness, saccadic eye movements) are emerging as promising tools for evaluating MS progression. The eye's structural and embryological similarity to the brain makes it a potentially suitable assessment of neurological and microvascular changes in CNS. In the advent of more powerful machine learning algorithms, oculomics screening modalities such as optical coherence tomography (OCT), eye tracking, and protein analysis become more effective tools aiding in MS diagnosis. Artificial intelligence can analyse larger and more diverse data sets to potentially discover new parameters of pathology for efficiently diagnosing MS before symptom onset. While there is no known cure for MS, the integration of oculomics with current modalities of diagnosis creates a promising future for developing more sensitive, non-invasive, and cost-effective approaches to MS detection and diagnosis.
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Affiliation(s)
- Alex Suh
- Tulane University School of Medicine, New Orleans, LA, USA.
| | - Gilad Hampel
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Galveston, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
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Covey TJ, Golan D, Sergott R, Wilken J, Zarif M, Bumstead B, Buhse M, Kaczmarek O, Doniger GM, Penner IK, Hancock LM, Bogaardt H, Barrera MA, Morrow SA, Galetta S, Gudesblatt M. Peering further into the mind's eye: combining visual evoked potential and optical coherence tomography measures enhances insight into the variance in cognitive functioning in multiple sclerosis. J Neurol 2024; 271:658-673. [PMID: 38091086 DOI: 10.1007/s00415-023-12075-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/16/2023] [Accepted: 10/22/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Spectral Optical Coherence Tomography (OCT) and Visual Evoked Potentials (VEPs) have both emerged as potentially useful biomarkers of cognitive decline in people with multiple sclerosis (PwMS). Their combined use may provide additional predictive value for identifying disease impact, progression, and remyelination capacity above-and-beyond what is captured using either approach alone. OBJECTIVE We examined the relationship between OCT/VEP measures and cognitive functioning in 205 PwMS. OCT measures included Retinal Nerve Fiber Layer Volume (RNFLV), Papillo-Macular Bundle Volume (PBMV), and Macular Volume (MV). VEP measures included latency of the P100, and inter-ocular latency. Cognitive performance was evaluated across seven separate domains of performance, and for overall cognition, using the NeuroTrax computerized testing battery. RESULTS Both OCT and VEP measures were significantly correlated with cognitive performance across several domains. Linear regression models that controlled for the influence of visual acuity revealed (1) that reduced MV was significantly predictive of poorer visual-spatial functioning, and (2) that delayed VEP latency was significantly predictive of performance in global cognitive functioning and visual-spatial functioning, after controlling for multiple comparisons. Among PwMS with normal visual acuity, PwMS with a combination of both relatively low MV and delayed VEP latency tended to have poorer performance in the domains of global, executive, and visual-spatial functioning compared to PwMS with both high MV and normal VEP latency. CONCLUSION Approaches that combine the use of OCT and VEP measures can enhance insight into underlying factors that contribute to variance in cognitive functioning in PwMS.
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Affiliation(s)
- Thomas J Covey
- Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Sherman Hall Annex 114, Buffalo, NY, USA.
| | - Daniel Golan
- Multiple Sclerosis and Neuroimmunology Center, Clalit Health Services, Nazareth, Israel
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Robert Sergott
- Wills Eye Institute and the William H. Annesley EyeBrain Center, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jeffrey Wilken
- Washington Neuropsychology Research Group, Fairfax, VA, USA
- Department of Neurology, Georgetown University, Washington, DC, USA
| | - Myassar Zarif
- South Shore Neurologic Associates, New York University, Patchogue, New York, NY, USA
| | - Barbara Bumstead
- South Shore Neurologic Associates, New York University, Patchogue, New York, NY, USA
| | - MariJean Buhse
- South Shore Neurologic Associates, New York University, Patchogue, New York, NY, USA
| | - Olivia Kaczmarek
- South Shore Neurologic Associates, New York University, Patchogue, New York, NY, USA
| | - Glen M Doniger
- Department of Clinical Research, NeuroTrax Corporation, Modiin, Israel
| | - Iris-Katharina Penner
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Laura M Hancock
- Department of Neurology, University of Wisconsin School of Medicine, Madison, WI, USA
| | - Hans Bogaardt
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Marissa A Barrera
- Katz School of Science and Health, Yeshiva University, New York, NY, USA
| | - Sarah A Morrow
- London Health Sciences Centre, University of Western Ontario, Ontario, ON, Canada
| | - Steve Galetta
- Department of Neurology, New York University, New York, NY, USA
| | - Mark Gudesblatt
- South Shore Neurologic Associates, New York University, Patchogue, New York, NY, USA.
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