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Lin TY, Motamedi S, Asseyer S, Chien C, Saidha S, Calabresi PA, Fitzgerald KC, Samadzadeh S, Villoslada P, Llufriu S, Green AJ, Preiningerova JL, Petzold A, Leocani L, Garcia-Martin E, Oreja-Guevara C, Outteryck O, Vermersch P, Balcer LJ, Kenney R, Albrecht P, Aktas O, Costello F, Frederiksen J, Uccelli A, Cellerino M, Frohman EM, Frohman TC, Bellmann-Strobl J, Schmitz-Hübsch T, Ruprecht K, Brandt AU, Zimmermann HG, Paul F. Individual Prognostication of Disease Activity and Disability Worsening in Multiple Sclerosis With Retinal Layer Thickness z Scores. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2024; 11:e200269. [PMID: 38941572 PMCID: PMC11214150 DOI: 10.1212/nxi.0000000000200269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/06/2024] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Retinal optical coherence tomography (OCT) provides promising prognostic imaging biomarkers for future disease activity in multiple sclerosis (MS). However, raw OCT-derived measures have multiple dependencies, supporting the need for establishing reference values adjusted for possible confounders. The purpose of this study was to investigate the capacity for age-adjusted z scores of OCT-derived measures to prognosticate future disease activity and disability worsening in people with MS (PwMS). METHODS We established age-adjusted OCT reference data using generalized additive models for location, scale, and shape for peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell-inner plexiform layer (GCIP) thicknesses, involving 910 and 423 healthy eyes, respectively. Next, we transformed the retinal layer thickness of PwMS from 3 published studies into age-adjusted z scores (pRNFL-z and GCIP-z) based on the reference data. Finally, we investigated the association of pRNFL-z or GCIP-z as predictors with future confirmed disability worsening (Expanded Disability Status Scale score increase) or disease activity (failing of the no evidence of disease activity [NEDA-3] criteria) as outcomes. Cox proportional hazards models or logistic regression analyses were applied according to the original studies. Optimal cutoffs were identified using the Akaike information criterion as well as location with the log-rank and likelihood-ratio tests. RESULTS In the first cohort (n = 863), 172 PwMS (24%) had disability worsening over a median observational period of 2.0 (interquartile range [IQR]:1.0-3.0) years. Low pRNFL-z (≤-2.04) were associated with an increased risk of disability worsening (adjusted hazard ratio (aHR) [95% CI] = 2.08 [1.47-2.95], p = 3.82e-5). In the second cohort (n = 170), logistic regression analyses revealed that lower pRNFL-z showed a higher likelihood for disability accumulation at the two-year follow-up (reciprocal odds ratio [95% CI] = 1.51[1.06-2.15], p = 0.03). In the third cohort (n = 78), 46 PwMS (59%) did not maintain the NEDA-3 status over a median follow-up of 2.0 (IQR: 1.9-2.1) years. PwMS with low GCIP-z (≤-1.03) had a higher risk of showing disease activity (aHR [95% CI] = 2.14 [1.03-4.43], p = 0.04). Compared with raw values with arbitrary cutoffs, applying the z score approach with optimal cutoffs showed better performance in discrimination and calibration (higher Harrell's concordance index and lower integrated Brier score). DISCUSSION In conclusion, our work demonstrated reference cohort-based z scores that account for age, a major driver for disease progression in MS, to be a promising approach for creating OCT-derived measures useable across devices and toward individualized prognostication.
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Affiliation(s)
- Ting-Yi Lin
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Seyedamirhosein Motamedi
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Susanna Asseyer
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Claudia Chien
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Shiv Saidha
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Peter A Calabresi
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Kathryn C Fitzgerald
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Sara Samadzadeh
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Pablo Villoslada
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Sara Llufriu
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Ari J Green
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Jana Lizrova Preiningerova
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Axel Petzold
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Letizia Leocani
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Elena Garcia-Martin
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Celia Oreja-Guevara
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Olivier Outteryck
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Patrick Vermersch
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Laura J Balcer
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Rachel Kenney
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Philipp Albrecht
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Orhan Aktas
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Fiona Costello
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Jette Frederiksen
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Antonio Uccelli
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Maria Cellerino
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Elliot M Frohman
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Teresa C Frohman
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Judith Bellmann-Strobl
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Tanja Schmitz-Hübsch
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Klemens Ruprecht
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Alexander U Brandt
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Hanna G Zimmermann
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
| | - Friedemann Paul
- From the Charité - Universitätsmedizin Berlin (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Experimental and Clinical Research Center (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.), a cooperation between the Max Delbrück Center for Molecular Medicine in the Helmholtz Association and Charité - Universitätsmedizin Berlin; Max-Delbrück Center for Molecular Medicine in the Helmholtz Association (MDC) (T.-Y.L., S.M., S.A., C.C., S. Samadzadeh, J.B.-S., T.S.-H., A.U.B., H.G.Z., F.P.); Neuroscience Clinical Research Center (S.M., S.A., C.C., J.B.-S., T.S.-H., H.G.Z., F.P.); Department of Psychiatry and Psychotherapy (C.C.), Charité - Universitätsmedizin Berlin, Germany; Department of Neurology (S. Saidha, P.A.C., K.C.F.); Department of Epidemiology (K.C.F.), Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Regional Health Research and Molecular Medicine (S. Samadzadeh), University of Southern Denmark, Odense; Department of Neurology (S. Samadzadeh), Slagelse Hospital, Denmark; Department of Neurology (P. Villoslada), Hospital Del Mar - Pompeu Fabra University; Neuroimmunology and Multiple Sclerosis Unit (S.L.), Hospital Clinic Barcelona and IDIBAPS, Barcelona, Spain; Department of Neurology (A.J.G.), University of California San Francisco; Department of Neurology (J.L.P.), Charles University in Prague, Czech Republic; Moorfield's Eye Hospital (A.P.), The National Hospital for Neurology and Neurosurgery, Queen Square Institute of Neurology, University College London, United Kingdom; Neuro-ophthalmology Expert Center (A.P.), Amsterdam UMC, Netherlands; Experimental Neurophysiology Unit (L.L.), Institute of Experimental Neurology (INSPE), San Raffaele Scientific Institute; Vita-Salute San Raffaele University (L.L.), Milan, Italy; Miguel Servet University Hospital (E.G.-M.), Zaragoza; Department of Neurology (C.O.-G.), Hospital Clínico Universitario San Carlos, Madrid, Spain; Department of Neurology (O.O., P. Vermersch); Department of Neuroradiology (O.O., P. Vermersch), Centre Hospitalier Universitaire de Lille, France; Departments of Neurology (L.J.B., R.K.), Population Health and Ophthalmology, NYU Grossman School of Medicine, NY; Department of Neurology (P.A., O.A.), Heinrich-Heine-University, Düsseldorf, Germany; Departments of Clinical Neurosciences and Surgery Cumming School of Medicine (F.C.), University of Calgary, Alberta, Canada; Clinic of Optic Neuritis and Clinic of Multiple Sclerosis (J.F.), Department of Neurology, Rigshospitalet - Glostrup, Denmark; Department of Neurosciences (A.U., M.C.), Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy; Laboratory of Neuroimmunology (E.M.F., T.C.F.), Professor Lawrence Steinman, Stanford University School of Medicine, Palo Alto, CA; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin; and Einstein Center Digital Future (H.G.Z.), Berlin, Germany
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Bsteh G, Hegen H, Krajnc N, Föttinger F, Altmann P, Auer M, Berek K, Kornek B, Leutmezer F, Macher S, Monschein T, Ponleitner M, Rommer P, Schmied C, Zebenholzer K, Zulehner G, Zrzavy T, Deisenhammer F, Di Pauli F, Pemp B, Berger T. Retinal layer thinning for monitoring disease-modifying treatment in relapsing multiple sclerosis-Evidence for applying a rebaselining concept. Mult Scler 2024; 30:1128-1138. [PMID: 39109593 DOI: 10.1177/13524585241267257] [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] [Indexed: 08/30/2024]
Abstract
BACKGROUND Employing a rebaselining concept may reduce noise in retinal layer thinning measured by optical coherence tomography (OCT). METHODS From an ongoing prospective observational study, we included patients with relapsing multiple sclerosis (RMS), who had OCT scans at disease-modifying treatment (DMT) start (baseline), 6-12 months after baseline (rebaseline), and ⩾12 months after rebaseline. Mean annualized percent loss (aL) rates (%/year) were calculated both from baseline and rebaseline for peripapillary-retinal-nerve-fiber-layer (aLpRNFLbaseline/aLpRNFLrebaseline) and macular-ganglion-cell-plus-inner-plexiform-layer (aLGCIPLbaseline/aLGCIPLrebaseline) by mixed-effects linear regression models. RESULTS We included 173 RMS patients (mean age 31.7 years (SD 8.8), 72.8% female, median disease duration 15 months (12-94) median baseline-to-last-follow-up-interval 37 months (18-71); 56.6% moderately effective DMT (M-DMT), 43.4% highly effective DMT (HE-DMT)). Both mean aLpRNFLbaseline and aLGCIPLbaseline significantly increased in association with relapse (0.51% and 0.26% per relapse, p < 0.001, respectively) and disability worsening (1.10% and 0.48%, p < 0.001, respectively) before baseline, but not with DMT class. Contrarily, neither aLpRNFLrebaseline nor aLGCIPLrebaseline was dependent on relapse or disability worsening before baseline, while HE-DMT significantly lowered aLpRNFLrebaseline (by 0.31%, p < 0.001) and aLGCIPLrebaseline (0.25%, p < 0.001) compared with M-DMT. CONCLUSIONS Applying a rebaselining concept significantly improves differentiation of DMT effects on retinal layer thinning by avoiding carry-over confounding from previous disease activity.
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Affiliation(s)
- Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Harald Hegen
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Nik Krajnc
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Fabian Föttinger
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Patrick Altmann
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Michael Auer
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Klaus Berek
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Kornek
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Fritz Leutmezer
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Stefan Macher
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Tobias Monschein
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Markus Ponleitner
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Paulus Rommer
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Christiane Schmied
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Karin Zebenholzer
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Gudrun Zulehner
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | - Tobias Zrzavy
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
| | | | - Franziska Di Pauli
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Berthold Pemp
- Department of Ophthalmology and Optometry, Medical University of Vienna, Vienna, Austria
| | - Thomas Berger
- Department of Neurology, Medical University of Vienna, Vienna, Austria; Comprehensive Center for Clinical Neurosciences and Mental Health, Medical University of Vienna, Vienna, Austria
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Boudriot E, Gabriel V, Popovic D, Pingen P, Yakimov V, Papiol S, Roell L, Hasanaj G, Xu S, Moussiopoulou J, Priglinger S, Kern C, Schulte EC, Hasan A, Pogarell O, Falkai P, Schmitt A, Schworm B, Wagner E, Keeser D, Raabe FJ. Signature of Altered Retinal Microstructures and Electrophysiology in Schizophrenia Spectrum Disorders Is Associated With Disease Severity and Polygenic Risk. Biol Psychiatry 2024:S0006-3223(24)01262-9. [PMID: 38679358 DOI: 10.1016/j.biopsych.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/30/2024] [Accepted: 04/14/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Optical coherence tomography and electroretinography studies have revealed structural and functional retinal alterations in individuals with schizophrenia spectrum disorders (SSDs). However, it remains unclear which specific retinal layers are affected; how the retina, brain, and clinical symptomatology are connected; and how alterations of the visual system are related to genetic disease risk. METHODS Optical coherence tomography, electroretinography, and brain magnetic resonance imaging were applied to comprehensively investigate the visual system in a cohort of 103 patients with SSDs and 130 healthy control individuals. The sparse partial least squares algorithm was used to identify multivariate associations between clinical disease phenotype and biological alterations of the visual system. The association of the revealed patterns with individual polygenic disease risk for schizophrenia was explored in a post hoc analysis. In addition, covariate-adjusted case-control comparisons were performed for each individual optical coherence tomography and electroretinography parameter. RESULTS The sparse partial least squares analysis yielded a phenotype-eye-brain signature of SSDs in which greater disease severity, longer duration of illness, and impaired cognition were associated with electrophysiological alterations and microstructural thinning of most retinal layers. Higher individual loading onto this disease-relevant signature of the visual system was significantly associated with elevated polygenic risk for schizophrenia. In case-control comparisons, patients with SSDs had lower macular thickness, thinner retinal nerve fiber and inner plexiform layers, less negative a-wave amplitude, and lower b-wave amplitude. CONCLUSIONS This study demonstrates multimodal microstructural and electrophysiological retinal alterations in individuals with SSDs that are associated with disease severity and individual polygenic burden.
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Affiliation(s)
- Emanuel Boudriot
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Vanessa Gabriel
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - David Popovic
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany
| | - Pauline Pingen
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Vladislav Yakimov
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Sergi Papiol
- Max Planck Institute of Psychiatry, Munich, Germany; Institute of Psychiatric Phenomics and Genomics, LMU Munich, Munich, Germany
| | - Lukas Roell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; NeuroImaging Core Unit Munich, LMU University Hospital, LMU Munich, Munich, Germany
| | - Genc Hasanaj
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Evidence-Based Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Simiao Xu
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Joanna Moussiopoulou
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Siegfried Priglinger
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Christoph Kern
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics, LMU Munich, Munich, Germany; Institute of Human Genetics, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany; Department of Psychiatry and Psychotherapy, University Hospital, Faculty of Medicine, University of Bonn, Bonn, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, Augsburg, Germany; German Center for Mental Health, partner site Munich-Augsburg, Germany
| | - Oliver Pogarell
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany; German Center for Mental Health, partner site Munich-Augsburg, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany; German Center for Mental Health, partner site Munich-Augsburg, Germany; Laboratory of Neurosciences (LIM-27), Institute of Psychiatry, University of São Paulo, São Paulo, Brazil
| | - Benedikt Schworm
- Department of Ophthalmology, LMU University Hospital, LMU Munich, Munich, Germany
| | - Elias Wagner
- Evidence-Based Psychiatry and Psychotherapy, Faculty of Medicine, University of Augsburg, Augsburg, Germany; Department of Psychiatry, Psychotherapy, and Psychosomatics, Faculty of Medicine, University of Augsburg, Augsburg, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; NeuroImaging Core Unit Munich, LMU University Hospital, LMU Munich, Munich, Germany; Munich Center for Neurosciences, LMU Munich, Planegg-Martinsried, Germany
| | - Florian J Raabe
- Department of Psychiatry and Psychotherapy, LMU University Hospital, LMU Munich, Munich, Germany; Max Planck Institute of Psychiatry, Munich, Germany.
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Huang SC, Pisa M, Guerrieri S, Dalla Costa G, Comi G, Leocani L. Optical coherence tomography with voxel-based morphometry: a new tool to unveil focal retinal neurodegeneration in multiple sclerosis. Brain Commun 2023; 6:fcad249. [PMID: 38328398 PMCID: PMC10847824 DOI: 10.1093/braincomms/fcad249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/25/2023] [Accepted: 09/25/2023] [Indexed: 02/09/2024] Open
Abstract
Neurodegeneration is the main contributor to disability accumulation in multiple sclerosis. Previous studies in neuro-ophthalmology have revealed that neurodegeneration in multiple sclerosis also affects the neuro-retina. Optical coherence tomography has been used to measure thinning of retinal layers, which correlates with several other markers for axonal/neuronal loss in multiple sclerosis. However, the existing analytical tools have limitations in terms of sensitivity and do not provide topographical information. In this study, we aim to evaluate whether voxel-based morphometry can increase sensitivity in detecting neuroaxonal degeneration in the retina and offer topographical information. A total of 131 people with multiple sclerosis (41 clinically isolated syndrome, 53 relapsing-remitting and 37 progressive multiple sclerosis) and 50 healthy subjects were included. Only eyes with normal global peripapillary retinal nerve fibre layer thickness and no history of optic neuritis were considered. Voxel-based morphometry and voxel-wise statistical comparisons were performed on the following: (i) patients at different disease stages and 2) patients who experienced the first demyelination attack without subclinical optic neuritis, assessed by visual evoked potentials. Standard parameters failed to discern any differences; however, voxel-based morphometry-optical coherence tomography successfully detected focal macular atrophy of retinal nerve fibre layer and ganglion cell/inner plexiform layer, along with thickening of inner nuclear layer in patients who experienced the first demyelination attack (disease duration = 4.2 months). Notably, the atrophy pattern of the ganglion cell/inner plexiform layer was comparable across disease phenotypes. In contrast, the retinal nerve fibre layer atrophy spread from the optic nerve head to the fovea as the disease evolved towards the progressive phase. Furthermore, for patients who experienced the first neurological episode, the severity of retinal nerve fibre layer atrophy at entry could predict a second attack. Our results demonstrate that voxel-based morphometry-optical coherence tomography exhibits greater sensitivity than standard parameters in detecting focal retinal atrophy, even at clinical presentation, in eyes with no history of optic neuritis and with normal latency of visual evoked potentials. Thinning of the ganglion cell/inner plexiform layer primarily concentrated in nasal perifovea in all disease phenotypes, indicating selective vulnerability of retinal ganglion cells and their perifoveal axons. Conversely, the degree of retinal nerve fibre layer thinning seems to be related to the clinical course of multiple sclerosis. The findings suggest bidirectional neurodegeneration in the visual pathway. Voxel-based morphometry-optical coherence tomography shows potential as a valuable tool for monitoring neurodegeneration on a patient level and evaluating the efficacy of novel neuroprotective treatments.
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Affiliation(s)
- Su-Chun Huang
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Marco Pisa
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Simone Guerrieri
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Gloria Dalla Costa
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan 20132, Italy
| | - Giancarlo Comi
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy
- Department of Neurorehabilitation Science, Casa di Cura Igea, Milan 20144, Italy
| | - Letizia Leocani
- Experimental Neurophysiology Unit, Institute of Experimental Neurology-INSPE, San Raffaele Scientific Institute, Milan 20132, Italy
- Faculty of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy
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Cagol A, Fuertes NC, Stoessel M, Barakovic M, Schaedelin S, D'Souza M, Würfel J, Brandt AU, Kappos L, Sprenger T, Naegelin Y, Kuhle J, Granziera C, Papadopoulou A. Optical coherence tomography reflects clinically relevant gray matter damage in patients with multiple sclerosis. J Neurol 2023; 270:2139-2148. [PMID: 36625888 PMCID: PMC10025239 DOI: 10.1007/s00415-022-11535-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Retinal degeneration leading to optical coherence tomography (OCT) changes is frequent in patients with multiple sclerosis (PwMS). OBJECTIVE To investigate associations among OCT changes, MRI measurements of global and regional brain volume loss, and physical and cognitive impairment in PwMS. METHODS 95 PwMS and 52 healthy controls underwent OCT and MRI examinations. Mean peripapillary retinal nerve fiber layer (pRNFL) thickness and ganglion cell/inner plexiform layer (GCIPL) volume were measured. In PwMS disability was quantified with the Expanded Disability Status Scale (EDSS) and Symbol Digit Modalities Test (SDMT). Associations between OCT, MRI, and clinical measures were investigated with multivariable regression models. RESULTS In PwMS, pRNFL and GCIPL were associated with the volume of whole brain (p < 0.04), total gray matter (p < 0.002), thalamus (p ≤ 0.04), and cerebral cortex (p ≤ 0.003) -both globally and regionally-, but not white matter. pRNFL and GCIPL were also inversely associated with T2-lesion volume (T2LV), especially in the optic radiations (p < 0.0001). The brain volumes associated with EDSS and SDMT significantly overlapped with those correlating with pRNFL and GCIPL. CONCLUSIONS In PwMS, pRNFL and GCIPL reflect the integrity of clinically-relevant gray matter structures, underling the value of OCT measures as markers of neurodegeneration and disability in multiple sclerosis.
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Affiliation(s)
- Alessandro Cagol
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Nuria Cerdá Fuertes
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Marc Stoessel
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Muhamed Barakovic
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Sabine Schaedelin
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Clinical Research, University Hospital and University of Basel, Basel, Switzerland
| | - Marcus D'Souza
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Würfel
- Medical Image Analysis Center and Department of Biomedical Engineering, University Basel, Basel, Switzerland
| | - Alexander U Brandt
- Experimental and Clinical Research Center Max Delbrueck Center for Molecular Medicine, Charité Universitätsmedizin Berlin, Berlin, Germany
- University of Irvine, Irvine, CA, USA
| | - Ludwig Kappos
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Till Sprenger
- Department of Neurology, DKD Helios Klinik Wiesbaden, Wiesbaden, Germany
| | - Yvonne Naegelin
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Jens Kuhle
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Cristina Granziera
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland
| | - Athina Papadopoulou
- Translational Imaging in Neurology (ThINK) Basel, Department of Biomedical Engineering, Faculty of Medicine, University Hospital Basel and University of Basel, Basel, Switzerland.
- Department of Neurology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
- Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel and University of Basel, Basel, Switzerland.
- Department of Clinical Research, University Hospital and University of Basel, Basel, Switzerland.
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Mittal P, Bhatnagar C. Effectual accuracy of OCT image retinal segmentation with the aid of speckle noise reduction and boundary edge detection strategy. J Microsc 2023; 289:164-179. [PMID: 36373509 DOI: 10.1111/jmi.13152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 09/19/2022] [Accepted: 10/13/2022] [Indexed: 11/16/2022]
Abstract
Optical coherence tomography (OCT) has shown to be a valuable imaging tool in the field of ophthalmology, and it is becoming increasingly relevant in the field of neurology. Several OCT image segmentation methods have been developed previously to segment retinal images, however sophisticated speckle noises with low-intensity restrictions, complex retinal tissues, and inaccurate retinal layer structure remain a challenge to perform effective retinal segmentation. Hence, in this research, complicated speckle noises are removed by using a novel far-flung ratio algorithm in which preprocessing has been done to treat the speckle noise thereby highly decreasing the speckle noise through new similarity and statistical measures. Additionally, a novel haphazard walk and inter-frame flattening algorithms have been presented to tackle the weak object boundaries in OCT images. These algorithms are effective at detecting edges and estimating minimal weighted paths to better diverge, which reduces the time complexity. In addition, the segmentation of OCT images is made simpler by using a novel N-ret layer segmentation approach that executes simultaneous segmentation of various surfaces, ensures unambiguous segmentation across neighbouring layers, and improves segmentation accuracy by using two grey scale values to construct data. Consequently, the novel work outperformed the OCT image segmentation with 98.5% of accuracy.
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Affiliation(s)
- Praveen Mittal
- Computer Engineering & Applications, GLA University, Mathura, UP, India
| | - Charul Bhatnagar
- Computer Engineering & Applications, GLA University, Mathura, UP, India
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Wang L, Tan H, Yu J, ZhangBao J, Huang W, Chang X, Zhou L, Lu C, Xiao Y, Lu J, Zhao C, Wang M, Wu X, Wu M, Dong Q, Ngew KY, Quan C. Baseline retinal nerve fiber layer thickness as a predictor of multiple sclerosis progression: New insights from the FREEDOMS II study. Eur J Neurol 2023; 30:443-452. [PMID: 36286605 DOI: 10.1111/ene.15612] [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: 08/01/2022] [Revised: 10/13/2022] [Accepted: 10/20/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE The aim was to evaluate the potential of retinal nerve fiber layer thickness (RNFLT) measured with optical coherence tomography in predicting disease progression in relapsing-remitting multiple sclerosis (RRMS). METHODS Analyses were conducted post hoc of this 24-month, phase III, double-blind study, in which RRMS patients were randomized (1:1:1) to once daily oral fingolimod 0.5 mg, 1.25 mg or placebo. The key outcomes were the association between baseline RNFLT and baseline clinical characteristics and clinical/imaging outcomes up to 24 months. Change of RNFLT with fingolimod versus placebo within 24 months and time to retinal nerve fiber layer (RNFL) thinning were evaluated. RESULTS Altogether 885 patients were included. At baseline, lower RNFLT was correlated with higher Expanded Disability Status Scale score (r = -1.085, p = 0.018), lower brain volume (r = 0.025, p = 0.006) and deep gray matter volume (r = 0.731, p < 0.0001), worse visual acuity (r = -19.846, p < 0.0001) and longer duration since diagnosis (r = -0.258, p = 0.018). At month 12, low baseline RNFLT (<86 μm) versus high baseline RNFLT (≥99 μm) was associated with a greater brain volume loss (percentage change -0.605% vs. -0.315%, p = 0.035) in patients without optic neuritis history. At month 24, low baseline RNFLT versus high baseline RNFLT was associated with a higher number of new or newly enlarged T2 lesions (mean number 4.0 vs. 2.8, p = 0.014) and a higher risk of subsequent RNFL thinning (hazard ratio 2.55; 95% confidence interval 1.84-3.53; p < 0.001). The atrophy of the RNFL in the inferior quadrant was alleviated with fingolimod 0.5 mg versus placebo at month 24 (Δ(least squares mean) = 1.8, p = 0.047). CONCLUSION Retinal nerve fiber layer thickness could predict disease progression in RRMS. TRIAL REGISTRATION Clinicaltrials.gov identifier: NCT00355134, https://clinicaltrials.gov/ct2/show/NCT00355134.
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Affiliation(s)
- Liang Wang
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Hongmei Tan
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Jian Yu
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jingzi ZhangBao
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Wenjuan Huang
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Xuechun Chang
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Lei Zhou
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Chuanzhen Lu
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yiqin Xiao
- Department of Ophthalmology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jiahong Lu
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Chongbo Zhao
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Min Wang
- Department of Ophthalmology and Vision Science, Eye and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xue Wu
- Novartis Pharmaceuticals, Shanghai, China
| | - Mengyun Wu
- Novartis Pharmaceuticals, Shanghai, China
| | - Qiang Dong
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Kok Yew Ngew
- Novartis Corporation (Malaysia) Sdn. Bhd., Petaling Jaya, Malaysia
| | - Chao Quan
- Department of Neurology and Rare Disease Center, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
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Optical coherence tomography as a prognostic tool for disability progression in MS: a systematic review. J Neurol 2023; 270:1178-1186. [PMID: 36372866 DOI: 10.1007/s00415-022-11474-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 10/30/2022] [Indexed: 11/15/2022]
Abstract
Since multiple sclerosis (MS) is characterized by an unpredictable disease course, accurate prognosis and personalized treatment constitute an important challenge in clinical practice. We performed a qualitative systematic review to assess the predictive value of retinal layer measurement by spectral-domain optical coherence tomography (SD-OCT) in MS patients. Longitudinal MS cohort studies that determined the risk of clinical deterioration based on peripapillary retinal nerve fiber layer (pRNFL) and/or macular ganglion cell-inner plexiform layer (mGCIPL) atrophy were included. Our search strategy and selection process yielded eight articles in total. Of those, five studies only focused on patients with a relapsing-remitting disease pattern (RRMS). After correction for confounders such as disease duration, we found that (1) cross-sectional measurement of pRNFL thickness ≤ 88 µm; (2) cross-sectional measurement of mGCIPL thickness < 77 µm; (3) longitudinal measurement of pRNFL thinning > 1.5 µm/year; and (4) longitudinal measurement of mGCIPL thinning ≥ 1.0 µm/year is associated with an increased risk for disability progression in subsequent years. Longitudinal mGCIPL assessment consistently resulted in the highest risk estimates in our analysis. Within these studies, inclusion and exclusion criteria accounted for the retinal degeneration inherent to (acute) optic neuritis (ON). This small systematic review provides additional evidence that OCT-measured pRNFL and/or mGCIPL atrophy can predict disability progression in RRMS patients. We therefore recommend close clinical follow-up or initiation/change of treatment in RRMS patients with increased risk for clinical deterioration based on retinal layer thresholds, in particular when other poor prognostic signs co-occur.
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Davion JB, Jougleux C, Lopes R, Leclerc X, Outteryck O. Relation between retina, cognition and brain volumes in MS: a consequence of asymptomatic optic nerve lesions. J Neurol 2023; 270:240-249. [PMID: 36018381 DOI: 10.1007/s00415-022-11348-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Asymptomatic optic nerve lesions are frequent in multiple sclerosis (MS) and their impact on cognition and/or brain volume has never been taken into account. PATIENTS AND METHODS We used the data from the cross-sectional Visual Ways in MS (VWIMS) study including relapsing remitting MS. All patients underwent brain and optic nerve Magnetic Resonance Imaging (MRI) including Double Inversion Recuperation (DIR) sequence, retinal OCT, and cognitive evaluation with the Brief International Cognitive Assessment in MS (BICAMS). We measured the association between OCT findings (thickness/volume of retinal layers) and extra-visual parameters (cerebral volumes and BICAMS scores) in optic nerves with and/or without the presence of DIR asymptomatic optic nerve hypersignal. RESULTS Between March and December 2017, we included 98 patients. Two patients were excluded. Over the 192 eyes, 73 had at least one clinical history of optic neuritis (ON-eyes) whereas 119 were asymptomatic (NON-eyes). Among the 119 NON-eyes, 58 had 3D-DIR optic nerve hypersignal (48.7%). We confirmed significant associations between some retinal OCT measures and some extra-visual parameters (cerebral volumes, cognitive scores) in NON-eyes. Unexpectedly, these associations were found when an asymptomatic optic nerve DIR-hypersignal was present on MRI, but not when it was absent. CONCLUSION Our study showed a relation between OCT measures and extra-visual parameters in NON-eyes MS patients. As a confusion factor, asymptomatic optic nerve lesions may be the explanation of the relation between OCT measures and extra-visual parameters. Retinal OCT seems to be far more a "window over the optic nerve" than a "window over the brain".
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Affiliation(s)
- Jean-Baptiste Davion
- Department of Neuroradiology, Univ. Lille, INSERM, CHU Lille, U1172, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France
| | - Caroline Jougleux
- Department of Neurology, Multiple Sclerosis Center of Lille, Univ. Lille, 59000, Lille, France
| | - Renaud Lopes
- Department of Neuroradiology, Univ. Lille, INSERM, CHU Lille, U1172, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France
| | - Xavier Leclerc
- Department of Neuroradiology, Univ. Lille, INSERM, CHU Lille, U1172, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France
| | - Olivier Outteryck
- Department of Neuroradiology, Univ. Lille, INSERM, CHU Lille, U1172, Degenerative and Vascular Cognitive Disorders, 59000, Lille, France.
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Eklund A, Huang-Link Y, Kovácsovics B, Dahle C, Vrethem M, Lind J. OCT and VEP correlate to disability in secondary progressive multiple sclerosis. Mult Scler Relat Disord 2022; 68:104255. [PMID: 36544315 DOI: 10.1016/j.msard.2022.104255] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/23/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The afferent visual pathway provides a unique opportunity to monitor clinical and subclinical optic neuritis and features of neuroaxonal degeneration in secondary progressive MS. OBJECTIVE To investigate the usefulness of visual evoked potentials (VEP) and optical coherence tomography (OCT) in evaluating SPMS, and the association between these modalities and clinical course and lesion load on the magnetic resonance imaging (MRI) in patients with SPMS with or without a history of optic neuritis (ON). METHODS SPMS patients (n = 27) underwent clinical assessment with Expanded Disability Status Scale (EDSS) grading, visual acuity, OCT, and VEP examination. MRI of the brain and spinal cord were evaluated. Ordinal scores of VEP and MRI findings were used in the statistical analyses. RESULTS The ganglion cell and inner plexiform layer (GCIPL) and retinal nerve fiber layer (RNFL) thickness correlated with VEP latency. VEP P100 score correlated with EDSS. Linear regression showed an association between GCIPL thickness and EDSS as well as VEP P100 latency and EDSS. The MRI analyses were negative. CONCLUSION VEP latency and GCIPL thickness correlated with disability measured as EDSS in patients with SPMS and are useful in monitoring SPMS patients.
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Affiliation(s)
- Anna Eklund
- Section of Neurology, Department of Internal Medicine, Jönköping County Hospital Ryhov, Jönköping S-551 85, Sweden.
| | - Yumin Huang-Link
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | | | - Charlotte Dahle
- Department of Biomedical and Clinical Sciences, Division of Neuro and Inflammation Sciences, Linköping University, Linköping, Sweden
| | - Magnus Vrethem
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, Sweden
| | - Jonas Lind
- Department of Biomedical and Clinical Sciences, Division of Neurobiology, Linköping University, Linköping, and Section of Neurology, Department of Internal Medicine, County Hospital Ryhov, Jönköping, Sweden
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Kenney R, Liu M, Hasanaj L, Joseph B, Al-Hassan AA, Balk L, Behbehani R, Brandt AU, Calabresi PA, Frohman EM, Frohman T, Havla J, Hemmer B, Jiang H, Knier B, Korn T, Leocani L, Martínez-Lapiscina EH, Papadopoulou A, Paul F, Petzold A, Pisa M, Villoslada P, Zimmermann H, Ishikawa H, Schuman JS, Wollstein G, Chen Y, Saidha S, Thorpe LE, Galetta SL, Balcer LJ. Normative Data and Conversion Equation for Spectral-Domain Optical Coherence Tomography in an International Healthy Control Cohort. J Neuroophthalmol 2022; 42:442-453. [PMID: 36049213 PMCID: PMC10350791 DOI: 10.1097/wno.0000000000001717] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Spectral-domain (SD-) optical coherence tomography (OCT) can reliably measure axonal (peripapillary retinal nerve fiber layer [pRNFL]) and neuronal (macular ganglion cell + inner plexiform layer [GCIPL]) thinning in the retina. Measurements from 2 commonly used SD-OCT devices are often pooled together in multiple sclerosis (MS) studies and clinical trials despite software and segmentation algorithm differences; however, individual pRNFL and GCIPL thickness measurements are not interchangeable between devices. In some circumstances, such as in the absence of a consistent OCT segmentation algorithm across platforms, a conversion equation to transform measurements between devices may be useful to facilitate pooling of data. The availability of normative data for SD-OCT measurements is limited by the lack of a large representative world-wide sample across various ages and ethnicities. Larger international studies that evaluate the effects of age, sex, and race/ethnicity on SD-OCT measurements in healthy control participants are needed to provide normative values that reflect these demographic subgroups to provide comparisons to MS retinal degeneration. METHODS Participants were part of an 11-site collaboration within the International Multiple Sclerosis Visual System (IMSVISUAL) consortium. SD-OCT was performed by a trained technician for healthy control subjects using Spectralis or Cirrus SD-OCT devices. Peripapillary pRNFL and GCIPL thicknesses were measured on one or both devices. Automated segmentation protocols, in conjunction with manual inspection and correction of lines delineating retinal layers, were used. A conversion equation was developed using structural equation modeling, accounting for clustering, with healthy control data from one site where participants were scanned on both devices on the same day. Normative values were evaluated, with the entire cohort, for pRNFL and GCIPL thicknesses for each decade of age, by sex, and across racial groups using generalized estimating equation (GEE) models, accounting for clustering and adjusting for within-patient, intereye correlations. Change-point analyses were performed to determine at what age pRNFL and GCIPL thicknesses exhibit accelerated rates of decline. RESULTS The healthy control cohort (n = 546) was 54% male and had a wide distribution of ages, ranging from 18 to 87 years, with a mean (SD) age of 39.3 (14.6) years. Based on 346 control participants at a single site, the conversion equation for pRNFL was Cirrus = -5.0 + (1.0 × Spectralis global value). Based on 228 controls, the equation for GCIPL was Cirrus = -4.5 + (0.9 × Spectralis global value). Standard error was 0.02 for both equations. After the age of 40 years, there was a decline of -2.4 μm per decade in pRNFL thickness ( P < 0.001, GEE models adjusting for sex, race, and country) and -1.4 μm per decade in GCIPL thickness ( P < 0.001). There was a small difference in pRNFL thickness based on sex, with female participants having slightly higher thickness (2.6 μm, P = 0.003). There was no association between GCIPL thickness and sex. Likewise, there was no association between race/ethnicity and pRNFL or GCIPL thicknesses. CONCLUSIONS A conversion factor may be required when using data that are derived between different SD-OCT platforms in clinical trials and observational studies; this is particularly true for smaller cross-sectional studies or when a consistent segmentation algorithm is not available. The above conversion equations can be used when pooling data from Spectralis and Cirrus SD-OCT devices for pRNFL and GCIPL thicknesses. A faster decline in retinal thickness may occur after the age of 40 years, even in the absence of significant differences across racial groups.
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Affiliation(s)
- Rachel Kenney
- Departments of Neurology (RK, LH, BJ, SLG, LJB) and Population Health (RK, ML, YC, LET, LJB), New York University Grossman School of Medicine, New York, New York; Al-Bahar Ophthalmology Center (AAA-H, RB), Ibn Sina Hospital, Kuwait City, Kuwait; Centre for Research on Sports in Society (LB), Mulier Institute, Utrecht, Netherlands; Experimental and Clinical Research Center (AUB, AP, FP, HZ), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Berlin, Germany; Department of Neurology (AUB), University of California, Irvine, California; Department of Neurology (PAC, SS), Johns Hopkins University, Baltimore, Maryland; Laboratory of Neuroimmunology (EMF, TF), Stanford University School of Medicine, Palo Alto, California; Institute of Clinical Neuroimmunology (JH), LMU Hospital, Ludwig Maximilians Universität München, Munich, Germany; Data Integration for Future Medicine consortium (DIFUTURE) (JH), Ludwig-Maximilians University, Munich, Germany; Department of Neurology (BH, BK, TK), Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy) (BH, TK), Munich, Germany; Department of Neurology (HJ), Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida; Vita-Salute University & Hospital San Raffaele (LL, MP), Milano, Italy; Center of Neuroimmunology and Department of Neurology (EHM-L, PV), Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain; Neurologic Clinic and Policlinic (AP), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience (RCN2NB) Basel, University Hospital Basel and University of Basel, Basel, Switzerland; NeuroCure Clinical Research Center (FP, HZ), Charité-Universitätsmedizin Berlin, Berlin, Germany; Moorfields Eye Hospital (AP), London, United Kingdom ; The National Hospital for Neurology and Neurosurgery (AP), Queen Square, UCL Institute of Neurology, London, United Kingdom; Dutch Neuro-Ophthalmology Expertise Centre (AP), Amsterdam UMC, Amsterdam, the Netherlands; Oregon Health and Science University (HI), Portland, Oregon; Department of Ophthalmology (JSS, GW, SLG, LJB), New York University Grossman School of Medicine, New York, New York; Departments of Biomedical Engineering and Electrical and Computer Engineering (JSS), Tandon School of Engineering, New York University, Brooklyn, New York; Center for Neural Science (JSS), NYU, New York, New York; and Neuroscience Institute (JSS), NYU Langone Health, New York, New York
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Yadav SK, Kafieh R, Zimmermann HG, Kauer-Bonin J, Nouri-Mahdavi K, Mohammadzadeh V, Shi L, Kadas EM, Paul F, Motamedi S, Brandt AU. Intraretinal Layer Segmentation Using Cascaded Compressed U-Nets. J Imaging 2022; 8:139. [PMID: 35621903 PMCID: PMC9146486 DOI: 10.3390/jimaging8050139] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/23/2022] [Accepted: 05/03/2022] [Indexed: 12/24/2022] Open
Abstract
Reliable biomarkers quantifying neurodegeneration and neuroinflammation in central nervous system disorders such as Multiple Sclerosis, Alzheimer's dementia or Parkinson's disease are an unmet clinical need. Intraretinal layer thicknesses on macular optical coherence tomography (OCT) images are promising noninvasive biomarkers querying neuroretinal structures with near cellular resolution. However, changes are typically subtle, while tissue gradients can be weak, making intraretinal segmentation a challenging task. A robust and efficient method that requires no or minimal manual correction is an unmet need to foster reliable and reproducible research as well as clinical application. Here, we propose and validate a cascaded two-stage network for intraretinal layer segmentation, with both networks being compressed versions of U-Net (CCU-INSEG). The first network is responsible for retinal tissue segmentation from OCT B-scans. The second network segments eight intraretinal layers with high fidelity. At the post-processing stage, we introduce Laplacian-based outlier detection with layer surface hole filling by adaptive non-linear interpolation. Additionally, we propose a weighted version of focal loss to minimize the foreground-background pixel imbalance in the training data. We train our method using 17,458 B-scans from patients with autoimmune optic neuropathies, i.e., multiple sclerosis, and healthy controls. Voxel-wise comparison against manual segmentation produces a mean absolute error of 2.3 μm, outperforming current state-of-the-art methods on the same data set. Voxel-wise comparison against external glaucoma data leads to a mean absolute error of 2.6 μm when using the same gold standard segmentation approach, and 3.7 μm mean absolute error in an externally segmented data set. In scans from patients with severe optic atrophy, 3.5% of B-scan segmentation results were rejected by an experienced grader, whereas this was the case in 41.4% of B-scans segmented with a graph-based reference method. The validation results suggest that the proposed method can robustly segment macular scans from eyes with even severe neuroretinal changes.
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Affiliation(s)
- Sunil Kumar Yadav
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
- Nocturne GmbH, 10119 Berlin, Germany;
| | - Rahele Kafieh
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
| | - Hanna Gwendolyn Zimmermann
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
| | - Josef Kauer-Bonin
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
- Nocturne GmbH, 10119 Berlin, Germany;
| | - Kouros Nouri-Mahdavi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (K.N.-M.); (V.M.); (L.S.)
| | - Vahid Mohammadzadeh
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (K.N.-M.); (V.M.); (L.S.)
| | - Lynn Shi
- Glaucoma Division, Stein Eye Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA; (K.N.-M.); (V.M.); (L.S.)
| | | | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
- Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10098 Berlin, Germany
| | - Seyedamirhosein Motamedi
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
| | - Alexander Ulrich Brandt
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 13125 Berlin, Germany; (S.K.Y.); (R.K.); (H.G.Z.); (J.K.-B.); (F.P.); (S.M.)
- Department of Neurology, University of California Irvine, Irvine, CA 92697, USA
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13
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Rezende Filho FM, Jurkute N, de Andrade JBC, Marianelli BF, Ferraz Sallum JM, Yu-Wai-Man P, Barsottini OG, Pedroso JL. Characterization of Retinal Architecture in Spinocerebellar Ataxia Type 3 and Correlation with Disease Severity. Mov Disord 2022; 37:758-766. [PMID: 34936137 DOI: 10.1002/mds.28893] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/01/2021] [Accepted: 11/24/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Neurodegeneration affects the brain and peripheral nervous system in spinocerebellar ataxia type 3 (SCA3). As the retina is also involved, studying the retinal architecture in a cohort of patients could reveal clinically relevant biomarkers. OBJECTIVE The aim is to investigate retinal architecture in SCA3 to identify potential biomarkers. METHODS We evaluated 38 patients with SCA3 and 25 healthy age-matched controls, who underwent visual acuity assessment, intraocular pressure measurement, and fundoscopy and macular and peripapillary spectral domain optical coherence tomography (SD-OCT). We measured the peripapillary retinal nerve fiber layer (pRNFL) thickness in each quadrant of the temporal-superior-nasal-inferior-temporal chart and the macular layer thicknesses in each sector of the inner circle of the Early Treatment Diabetic Retinopathy Study (IC-ETDRS) grid. Linear regression analysis was employed to test the associations between retinal parameters and age, disease duration, CAG repeats, and SARA (Scale of the Assessment and Rating of Ataxia) and ICARS (International Cooperative Ataxia Rating Scale) scores in SCA3. RESULTS In all sectors, except for the temporal quadrant, pRNFL was significantly thinner in SCA3 patients than in controls. Average total macular, ganglion cell layer (GCL), and inner plexiform layer (IPL) thicknesses were significantly decreased in SCA3 patients in comparison to controls. The average total macular thickness and the average thicknesses of RNFL, GCL, and IPL negatively correlated with ICARS scores, whereas average GCL and IPL thicknesses negatively correlated with SARA scores. CONCLUSIONS The retinal ganglion cells, their dendrites, and axons are selectively affected in SCA3 patients. The RNFL, GCL, and IPL thicknesses in SD-OCT correlate with the clinical phenotype and represent potential biomarkers for future clinical trials and natural history studies. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Flávio Moura Rezende Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - Neringa Jurkute
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
| | - João Brainer Clares de Andrade
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | | | | | - Patrick Yu-Wai-Man
- Moorfields Eye Hospital NHS Foundation Trust, London, United Kingdom
- Institute of Ophthalmology, University College London, London, United Kingdom
- Cambridge Centre for Brain Repair and MRC Mitochondrial Biology Unit, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
- Cambridge Eye Unit, Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, United Kingdom
| | - Orlando G Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil
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14
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Graves JS, Oertel FC, Van der Walt A, Collorone S, Sotirchos ES, Pihl-Jensen G, Albrecht P, Yeh EA, Saidha S, Frederiksen J, Newsome SD, Paul F. Leveraging Visual Outcome Measures to Advance Therapy Development in Neuroimmunologic Disorders. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 9:9/2/e1126. [PMID: 34955459 PMCID: PMC8711076 DOI: 10.1212/nxi.0000000000001126] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 11/04/2021] [Indexed: 12/19/2022]
Abstract
The visual system offers unparalleled precision in the assessment of neuroaxonal damage. With the majority of patients with multiple sclerosis (MS) experiencing afferent and efferent visual dysfunction, outcome measures capturing these deficits provide insight into neuroaxonal injury, even in those with minimal disability. Ideal for use in clinical trials, visual measures are generally inexpensive, accessible, and reproducible. Quantification of visual acuity, visual fields, visual quality of life, and electrophysiologic parameters allows assessment of function, whereas optical coherence tomography (OCT) provides reliable measures of the structural integrity of the anterior afferent visual pathway. The technology of oculomotor biometrics continues to advance, and discrete measures of fixation, smooth pursuit, and saccadic eye movement abnormalities are ready for inclusion in future trials of MS progression. Visual outcomes allow tracking of neuroaxonal injury and aid in distinguishing MS from diseases such as neuromyelitis optica spectrum disorder (NMOSD) or myelin oligodendrocyte glycoprotein antibody-associated diseases (MOGAD). OCT has also provided unique insights into pathophysiology, including the identification of foveal pitting in NMOSD, possibly from damage to Müller cells, which carry an abundance of aquaporin-4 channels. For some study designs, the cost-benefit ratio favors visual outcomes over more expensive MRI outcomes. With the next frontier of therapeutics focused on remyelination and neuroprotection, visual outcomes are likely to take center stage. As an international community of collaborative, committed, vision scientists, this review by the International MS Visual System Consortium (IMSVISUAL) outlines the quality standards, informatics, and framework needed to routinely incorporate vision outcomes into MS and NMOSD trials.
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Affiliation(s)
- Jennifer S Graves
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada.
| | - Frederike Cosima Oertel
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Anneke Van der Walt
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Sara Collorone
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Elias S Sotirchos
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Gorm Pihl-Jensen
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Philipp Albrecht
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - E Ann Yeh
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Shiv Saidha
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Jette Frederiksen
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Scott Douglas Newsome
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
| | - Friedemann Paul
- Department of Neurosciences (J.S.G.), University of California, San Diego; Experimental and Clinical Research Center (F.C.O., F.P.), Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin & NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of neuroscience (A.V.D.W.), Central Clinical School, Monash University, Melbourne, Australia; NMR Research Unit, Queen Square MS Centre, Department of Neuroinflammation (S.C.), UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, United Kingdom; Department of Neurology (E.S.S., S.S., S.D.N.), Johns Hopkins University School of Medicine, Baltimore, MD; Rigshospitalet (J.F.), Denmark; Department of Neurology (P.A.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Division of Neurology, Department of Pediatrics (E.A.Y.), Division of Neuroscience and Mental Health, Hospital for Sick Children, Hospital for Sick Children Research Institute, and University of Toronto, Toronto, Canada
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Lotz-Havla AS, Weiß K, Schiergens K, Regenauer-Vandewiele S, Parhofer KG, Christmann T, Böhm L, Havla J, Maier EM. Optical Coherence Tomography to Assess Neurodegeneration in Phenylalanine Hydroxylase Deficiency. Front Neurol 2021; 12:780624. [PMID: 34956063 PMCID: PMC8703042 DOI: 10.3389/fneur.2021.780624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 11/02/2021] [Indexed: 11/13/2022] Open
Abstract
In phenylalanine hydroxylase (PAH) deficiency, an easily feasible method to access the progression of neurodegeneration is warranted to contribute to current discussions on treatment indications and targets. The objective of the present study was to investigate whether optical coherence tomography (OCT) measures as markers of neurodegeneration differ between patients with PAH deficiency and healthy controls (HCs) according to phenotype and metabolic control. In this single-center cross-sectional study, 92 patients with different phenotypes of PAH deficiency [PAH deficiency not requiring treatment, early treated phenylketonuria (ETPKU), and late-diagnosed phenylketonuria (PKU)] compared with 76 HCs were examined using spectral-domain OCT. Indices of phenylalanine elevation and variability were correlated with OCT parameters. Late-diagnosed PKU patients showed reduced peripapillary retinal nerve fiber layer (pRNFL) thickness and combined ganglion cell and inner plexiform layer (GCIPL) volume. Adult ETPKU patients were found to have lower GCIPL volume (p = 0.016), which correlated with the indices of phenylalanine control. In pediatric ETPKU patients with poor metabolic control, pRNFL was significantly reduced (p = 0.004). Patients with PAH deficiency not requiring treatment did not exhibit retinal degeneration. Inner nuclear layer (INL) was significantly increased in the pediatric ETPKU patients, driven by those with current poor metabolic control (p = 0.006). Our data provide evidence of retinal neuroaxonal degeneration and INL swelling, depending on the phenotype, current age, and metabolic control. These findings suggest that OCT is suitable to investigate neurodegeneration in PKU and we propose OCT as a sensitive, reliable, safe, low-burden, and low-cost examination for future multicenter studies.
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Affiliation(s)
- Amelie S Lotz-Havla
- Dr. von Hauner Children's Hospital, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katharina Weiß
- Dr. von Hauner Children's Hospital, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Katharina Schiergens
- Dr. von Hauner Children's Hospital, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | | | - Klaus G Parhofer
- Medical Department IV - Grosshadern, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Tara Christmann
- Institute of Clinical Neuroimmunology, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Luise Böhm
- Institute of Clinical Neuroimmunology, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.,Data Integration for Future Medicine (DIFUTURE) Consortium, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Esther M Maier
- Dr. von Hauner Children's Hospital, LMU University Hospital, Ludwig-Maximilians-Universität München, Munich, Germany
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16
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Paul F, Calabresi PA, Barkhof F, Green AJ, Kardon R, Sastre-Garriga J, Schippling S, Vermersch P, Saidha S, Gerendas BS, Schmidt-Erfurth U, Agoropoulou C, Zhang Y, Seifer G, Petzold A. Optical coherence tomography in multiple sclerosis: A 3-year prospective multicenter study. Ann Clin Transl Neurol 2021; 8:2235-2251. [PMID: 34792863 PMCID: PMC8670323 DOI: 10.1002/acn3.51473] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/01/2021] [Accepted: 10/06/2021] [Indexed: 11/29/2022] Open
Abstract
Objective To evaluate changes over 3 years in the thickness of inner retinal layers including the peripapillary retinal nerve fiber layer (pRNFL), and combined macular ganglion cell and inner plexiform layers (mGCIPL), in individuals with relapsing‐remitting multiple sclerosis (RRMS) versus healthy controls; to determine whether optical coherence tomography (OCT) is sufficiently sensitive and reproducible to detect small degrees of neuroaxonal loss over time that correlate with changes in brain volume and disability progression as measured by the Expanded Disability Status Scale (EDSS). Methods Individuals with RRMS from 28 centers (n = 333) were matched with 64 healthy participants. OCT scans were performed on Heidelberg Spectralis machines (at baseline; 1 month; 6 months; 6‐monthly thereafter). Results OCT measurements were highly reproducible between baseline and 1 month (intraclass correlation coefficient >0.98). Significant inner retinal layer thinning was observed in individuals with multiple sclerosis (MS) compared with controls regardless of previous MS‐associated optic neuritis––group differences (95% CI) over 3 years: pRNFL: −1.86 (−2.54, −1.17) µm; mGCIPL: −2.03 (−2.78, −1.28) µm (both p < 0.0001; effect sizes 0.39 and 0.34). Greater inner retinal layer atrophy was observed in individuals diagnosed with RRMS <3 years versus >5 years (pRNFL: p < 0.05; mGCIPL: p < 0.01). Brain volume decreased by 1.3% in individuals with MS over 3 years compared to 0.5% in control subjects (effect size 0.76). mGCIPL atrophy correlated with brain atrophy (p < 0.0001). There was no correlation of OCT data with disability progression. Interpretation OCT has potential to estimate rates of neurodegeneration in the retina and brain. The effect size for OCT, smaller than for magnetic resonance imaging based on Heidelberg Spectralis data acquired in this study, was increased in early disease.
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Affiliation(s)
- Friedemann Paul
- NeuroCure Clinical Research Center and Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Peter A Calabresi
- Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Frederik Barkhof
- Department of Radiology & Nuclear Medicine, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands.,Institutes of Neurology & Centre for Medical Image Computing, University College London, London, UK
| | - Ari J Green
- Department of Neurology, Multiple Sclerosis Center, University of California San Francisco, San Francisco, Califonia, USA
| | - Randy Kardon
- Iowa City VA Center for Prevention and Treatment of Visual Loss, Department of Veterans Affairs Hospital Iowa City, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA.,Department of Ophthalmology and Visual Sciences, University of Iowa Hospital and Clinics, Iowa City, Iowa, USA
| | - Jaume Sastre-Garriga
- Department of Neurology/Neuroimmunology, Multiple Sclerosis Centre of Catalonia (Cemcat), Hospital Universitari Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sven Schippling
- Neuroimmunology and Multiple Sclerosis Research Section, University Hospital Zurich, Zurich, Switzerland
| | | | - Shiv Saidha
- Department of Neurology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bianca S Gerendas
- Department of Ophthalmology, Vienna Reading Center, Medical University of Vienna, Vienna, Austria
| | | | | | - Ying Zhang
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
| | | | - Axel Petzold
- Moorfields Eye Hospital, The National Hospital for Neurology and Neurosurgery, London, UK.,Queen Square Institute of Neurology, University College London, London, UK.,MS Center Amsterdam, Amsterdam UMC (Locatie VUmc), Amsterdam, Netherlands
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17
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Lin TY, Chien C, Lu A, Paul F, Zimmermann HG. Retinal optical coherence tomography and magnetic resonance imaging in neuromyelitis optica spectrum disorders and MOG-antibody associated disorders: an updated review. Expert Rev Neurother 2021; 21:1101-1123. [PMID: 34551653 DOI: 10.1080/14737175.2021.1982697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Neuromyelitis optica spectrum disorders (NMOSD) and myelin oligodendrocyte glycoprotein IgG antibody-associated disorders (MOGAD) comprise two groups of rare neuroinflammatory diseases that cause attack-related damage to the central nervous system (CNS). Clinical attacks are often characterized by optic neuritis, transverse myelitis, and to a lesser extent, brainstem encephalitis/area postrema syndrome. Retinal optical coherence tomography (OCT) is a non-invasive technique that allows for in vivo thickness quantification of the retinal layers. Apart from OCT, magnetic resonance imaging (MRI) plays an increasingly important role in NMOSD and MOGAD diagnosis based on the current international diagnostic criteria. Retinal OCT and brain/spinal cord/optic nerve MRI can help to distinguish NMOSD and MOGAD from other neuroinflammatory diseases, particularly from multiple sclerosis, and to monitor disease-associated CNS-damage. AREAS COVERED This article summarizes the current status of imaging research in NMOSD and MOGAD, and reviews the clinical relevance of OCT, MRI and other relevant imaging techniques for differential diagnosis, screening and monitoring of the disease course. EXPERT OPINION Retinal OCT and MRI can visualize and quantify CNS damage in vivo, improving our understanding of NMOSD and MOGAD pathology. Further efforts on the standardization of these imaging techniques are essential for implementation into clinical practice and as outcome parameters in clinical trials.
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Affiliation(s)
- Ting-Yi Lin
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Claudia Chien
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Angelo Lu
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, Corporate Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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18
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Lin TY, Vitkova V, Asseyer S, Martorell Serra I, Motamedi S, Chien C, Ditzhaus M, Papadopoulou A, Benkert P, Kuhle J, Bellmann-Strobl J, Ruprecht K, Paul F, Brandt AU, Zimmermann HG. Increased Serum Neurofilament Light and Thin Ganglion Cell-Inner Plexiform Layer Are Additive Risk Factors for Disease Activity in Early Multiple Sclerosis. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2021; 8:8/5/e1051. [PMID: 34348969 PMCID: PMC8362351 DOI: 10.1212/nxi.0000000000001051] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
Objective To investigate the association of combined serum neurofilament light chain (sNfL) and retinal optical coherence tomography (OCT) measurements with future disease activity in patients with early multiple sclerosis (MS). Methods We analyzed sNfL by single molecule array technology and performed OCT measurements in a prospective cohort of 78 patients with clinically isolated syndrome and early relapsing-remitting MS with a median (interquartile range) follow-up of 23.9 (23.3–24.7) months. Patients were grouped into those with abnormal or normal sNfL levels, defined as sNfL ≥/<80th percentile of age-corrected reference values. Likewise, patients were grouped by a median split into those with thin or thick ganglion cell and inner plexiform layer (GCIP), peripapillary retinal nerve fiber layer, and inner nuclear layer in nonoptic neuritis eyes. Outcome parameters were violation of no evidence of disease activity (NEDA-3) criteria or its components. Results Patients with abnormal baseline sNfL had a higher risk of violating NEDA-3 (hazard ratio [HR] 2.28, 95% CI 1.27–4.09, p = 0.006) and developing a new brain lesion (HR 2.47, 95% CI 1.30–4.69, p = 0.006), but not for a new relapse (HR 2.21, 95% CI 0.97–5.03, p = 0.058). Patients with both abnormal sNfL and thin GCIP had an even higher risk for NEDA-3 violation (HR 3.61, 95% CI 1.77–7.36, p = 4.2e−4), new brain lesion (HR 3.19, 95% CI 1.51–6.76, p = 0.002), and new relapse (HR 5.38, 95% CI 1.61–17.98, p = 0.006) than patients with abnormal sNfL alone. Conclusions In patients with early MS, the presence of both abnormal sNfL and thin GCIP is a stronger risk factor for future disease activity than the presence of each parameter alone.
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Affiliation(s)
- Ting-Yi Lin
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Viktoriya Vitkova
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Susanna Asseyer
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Ivette Martorell Serra
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Seyedamirhosein Motamedi
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Claudia Chien
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Marc Ditzhaus
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Athina Papadopoulou
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Pascal Benkert
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Jens Kuhle
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Judith Bellmann-Strobl
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Klemens Ruprecht
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Friedemann Paul
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Alexander U Brandt
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Hanna G Zimmermann
- From the Experimental and Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Max-Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (T.-Y.L., V.V., S.A., I.M.S., S.M., C.C., A.P., J.B.-S., F.P., A.U.B., H.G.Z.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Psychiatry and Psychotherapy (C.C.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Department of Statistics (M.D.), TU Dortmund University, Germany; Neurology Clinic and Policlinic (A.P., J.K.), MS Center and Research Center for Clinical Neuroimmunology and Neuroscience Basel (RC2NB), University Hospital Basel; Clinical Trial Unit (P.B.), Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Neurology (K.R., F.P.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine.
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19
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Klumbies K, Rust R, Dörr J, Konietschke F, Paul F, Bellmann-Strobl J, Brandt AU, Zimmermann HG. Retinal Thickness Analysis in Progressive Multiple Sclerosis Patients Treated With Epigallocatechin Gallate: Optical Coherence Tomography Results From the SUPREMES Study. Front Neurol 2021; 12:615790. [PMID: 33995239 PMCID: PMC8113620 DOI: 10.3389/fneur.2021.615790] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 03/25/2021] [Indexed: 12/27/2022] Open
Abstract
Background: Epigallocatechin gallate (EGCG) is an anti-inflammatory agent and has proven neuroprotective properties in animal models of multiple sclerosis (MS). Optical coherence tomography (OCT) assessed retinal thickness analysis can reflect treatment responses in MS. Objective: To analyze the influence of EGCG treatment on retinal thickness analysis as secondary and exploratory outcomes of the randomized controlled Sunphenon in Progressive Forms of MS trial (SUPREMES, NCT00799890). Methods: SUPREMES patients underwent OCT with the Heidelberg Spectralis device at a subset of visits. We determined peripapillary retinal nerve fiber layer (pRNFL) thickness from a 12° ring scan around the optic nerve head and thickness of the ganglion cell/inner plexiform layer (GCIP) and inner nuclear layer (INL) within a 6 mm diameter grid centered on the fovea from a macular volume scan. Longitudinal OCT data were available for exploratory analysis from 31 SUPREMES participants (12/19 primary/secondary progressive MS (PPMS/SPMS); mean age 51 ± 7 years; 12 female; mean time since disease onset 16 ± 11 years). We tested the null hypothesis of no treatment*time interaction using nonparametric analysis of longitudinal data in factorial experiments. Results: After 2 years, there were no significant differences in longitudinal retinal thickness changes between EGCG treated and placebo arms in any OCT parameter (Mean change [confidence interval] ECGC vs. Placebo: pRNFL: -0.83 [1.29] μm vs. -0.64 [1.56] μm, p = 0.156; GCIP: -0.67 [0.67] μm vs. -0.14 [0.47] μm, p = 0.476; INL: -0.06 [0.58] μm vs. 0.22 [0.41] μm, p = 0.455). Conclusion: Retinal thickness analysis did not reveal a neuroprotective effect of EGCG. While this is in line with the results of the main SUPREMES trial, our study was probably underpowered to detect an effect. Clinical Trial Registration: www.ClinicalTrials.gov, identifier: NCT00799890.
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Affiliation(s)
- Katharina Klumbies
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Rebekka Rust
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Jan Dörr
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Neurology Department, Oberhavel Clinic, Hennigsdorf, Germany
| | - Frank Konietschke
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Judith Bellmann-Strobl
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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20
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Daqqaq TS. Identification of posterior visual pathway lesions and MRI burden in people with Multiple Sclerosis. ACTA ACUST UNITED AC 2021; 26:120-127. [PMID: 33814364 PMCID: PMC8024140 DOI: 10.17712/nsj.2021.2.20200048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 01/01/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVES This review systematically identifies posterior visual pathway lesions and MRI burden in people with multiple sclerosis (MS). METHODS The articles were searched through Web of Science, Medline, and Embase databases on January 2020, for English language articles from 2000 to 2019. RESULTS This review presents summary measures if related to MRI assessment to an overall measure of MS and visual pathway lesions. A total of 44 articles fulfilled all inclusion criteria, covering the period 2000-2019. Different atypical outcomes reveal a low risk for subsequent clinically predefined MS development, specifically in the presence of normal brain MRI. Several impairments related to quality of life have been identified as a result of the effect of retinal nerve fiber layer, ganglion cell layer, and inner plexiform layer. CONCLUSION The afferent visual system in MS offers unique accessibility and structure-related functions with further understanding offered by electrophysiology, considering vision as a useful framework for examining new multiple sclerosis therapies.
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Affiliation(s)
- Tareef S Daqqaq
- From the Department of Radiology, College of Medicine, Taibah University, Madinah, Kingdom of Saudi Arabia
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21
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Petzold A, Chua SYL, Khawaja AP, Keane PA, Khaw PT, Reisman C, Dhillon B, Strouthidis NG, Foster PJ, Patel PJ. Retinal asymmetry in multiple sclerosis. Brain 2021; 144:224-235. [PMID: 33253371 PMCID: PMC7880665 DOI: 10.1093/brain/awaa361] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 07/15/2020] [Accepted: 08/11/2020] [Indexed: 12/21/2022] Open
Abstract
The diagnosis of multiple sclerosis is based on a combination of clinical and paraclinical tests. The potential contribution of retinal optical coherence tomography (OCT) has been recognized. We tested the feasibility of OCT measures of retinal asymmetry as a diagnostic test for multiple sclerosis at the community level. In this community-based study of 72 120 subjects, we examined the diagnostic potential of the inter-eye difference of inner retinal OCT data for multiple sclerosis using the UK Biobank data collected at 22 sites between 2007 and 2010. OCT reporting and quality control guidelines were followed. The inter-eye percentage difference (IEPD) and inter-eye absolute difference (IEAD) were calculated for the macular retinal nerve fibre layer (RNFL), ganglion cell inner plexiform layer (GCIPL) complex and ganglion cell complex. Area under the receiver operating characteristic curve (AUROC) comparisons were followed by univariate and multivariable comparisons accounting for a large range of diseases and co-morbidities. Cut-off levels were optimized by ROC and the Youden index. The prevalence of multiple sclerosis was 0.0023 [95% confidence interval (CI) 0.00229–0.00231]. Overall the discriminatory power of diagnosing multiple sclerosis with the IEPD AUROC curve (0.71, 95% CI 0.67–0.76) and IEAD (0.71, 95% CI 0.67–0.75) for the macular GCIPL complex were significantly higher if compared to the macular ganglion cell complex IEPD AUROC curve (0.64, 95% CI 0.59–0.69, P = 0.0017); IEAD AUROC curve (0.63, 95% CI 0.58–0.68, P < 0.0001) and macular RNFL IEPD AUROC curve (0.59, 95% CI 0.54–0.63, P < 0.0001); IEAD AUROC curve (0.55, 95% CI 0.50–0.59, P < 0.0001). Screening sensitivity levels for the macular GCIPL complex IEPD (4% cut-off) were 51.7% and for the IEAD (4 μm cut-off) 43.5%. Specificity levels were 82.8% and 86.8%, respectively. The number of co-morbidities was important. There was a stepwise decrease of the AUROC curve from 0.72 in control subjects to 0.66 in more than nine co-morbidities or presence of neuromyelitis optica spectrum disease. In the multivariable analyses greater age, diabetes mellitus, other eye disease and a non-white ethnic background were relevant confounders. For most interactions, the effect sizes were large (partial ω2 > 0.14) with narrow confidence intervals. In conclusion, the OCT macular GCIPL complex IEPD and IEAD may be considered as supportive measurements for multiple sclerosis diagnostic criteria in a young patient without relevant co-morbidity. The metric does not allow separation of multiple sclerosis from neuromyelitis optica. Retinal OCT imaging is accurate, rapid, non-invasive, widely available and may therefore help to reduce need for invasive and more costly procedures. To be viable, higher sensitivity and specificity levels are needed.
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Affiliation(s)
- Axel Petzold
- Moorfields Eye Hospital and The National Hospital for Neurology and Neurosurgery, London, UK.,UCL Queen Square Institute of Neurology, London, UK.,Dutch Expertise Centre for Neuro-ophthalmology and MS Centre, Departments of Neurology and Ophthalmology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sharon Y L Chua
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Anthony P Khawaja
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Pearse A Keane
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Peng T Khaw
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Charles Reisman
- Topcon Healthcare Solutions Research and Development, Oakland, New Jersey, USA
| | - Baljean Dhillon
- Centre for Clinical Brain Sciences, School of Clinical Sciences, NHS Lothian, Edinburgh, UK
| | - Nicholas G Strouthidis
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Paul J Foster
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Praveen J Patel
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
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22
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Lee GI, Park KA, Oh SY, Kong DS, Hong SD. Inner and outer retinal layer thickness alterations in pediatric and juvenile craniopharyngioma. Sci Rep 2021; 11:2840. [PMID: 33531536 PMCID: PMC7854727 DOI: 10.1038/s41598-021-82107-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Accepted: 01/14/2021] [Indexed: 11/15/2022] Open
Abstract
We evaluated postoperative retinal thickness in pediatric and juvenile craniopharyngioma (CP) patients with chiasmal compression using optical coherence tomography (OCT) auto-segmentation. We included 18 eyes of 18 pediatric or juvenile patients with CP and 20 healthy controls. Each thickness of the macular retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer, outer plexiform layer, outer nuclear layer, and photoreceptor layer was compared between the CP patients and healthy controls. There was significant thinning in the macular RNFL (estimates [μm], superior, − 10.68; inferior, − 7.24; nasal, − 14.22), all quadrants of GCL (superior, − 16.53; inferior, − 14.37; nasal, − 24.34; temporal, − 9.91) and IPL (superior, − 11.45; inferior, − 9.76; nasal, − 15.25; temporal, − 4.97) in pediatric and juvenile CP patients postoperatively compared to healthy control eyes after adjusting for age and refractive errors. Thickness reduction in the average and nasal quadrant of RNFL, GCL, and IPL was associated with peripapillary RNFL thickness, and reduced nasal quadrant GCL and IPL thicknesses were associated with postoperative visual field defects. In pediatric and juvenile patients with CP, decreased inner retinal layer thickness following chiasmal compression was observed. The changes in retinal structures were closely related to peripapillary RNFL thinning and functional outcomes.
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Affiliation(s)
- Ga-In Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Doo-Sik Kong
- Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sang Duk Hong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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23
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Garcia-Martin E, Ortiz M, Boquete L, Sánchez-Morla EM, Barea R, Cavaliere C, Vilades E, Orduna E, Rodrigo MJ. Early diagnosis of multiple sclerosis by OCT analysis using Cohen's d method and a neural network as classifier. Comput Biol Med 2020; 129:104165. [PMID: 33302162 DOI: 10.1016/j.compbiomed.2020.104165] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/23/2020] [Accepted: 12/01/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND The consequences of inflammation, demyelination, axonal degeneration and neuronal loss in the central nervous system, typical of the development of multiple sclerosis (MS), are manifested in thinning of the retina and optic nerve. The purpose of this work is to diagnose early-stage MS patients based on analysis of retinal layer thickness obtained by swept-source optical coherence tomography (SS-OCT). METHOD OCT (Triton® SS-OCT device -Topcon, Tokyo, Japan-) recordings were obtained from 48 control subjects and 48 recently diagnosed MS patients. The following thicknesses were measured on a 45 × 60 grid: retinal nerve fibre layer (RNFL), ganglion cell layer (GCL+), GCL++, retinal thickness and choroid. Using Cohen's d effect size, it was determined the regions and layers with greatest capacity to discriminate between control subjects and patients. Points exceeding the threshold set were used as inputs for an automatic classifier: support vector machine and feed-forward neural network. RESULTS In MS at clinical onset the layer with greatest discriminant capacity is GCL++ [AUC = 0.83] which exhibits a horseshoe-like macular topographic distribution. It is followed by retina, GCL+ and RNFL; choroidal thicknesses do not provide discriminatory capacity. Using a neural network as a classifier between controls and MS patients, obtains sensitivity of 0.98 and specificity of 0.98. CONCLUSIONS This work suggest that OCT may serve as an important complementary role to other clinical tests, particularly regarding neurodegeneration. It is possible to characterise structural alterations in retina and diagnose early-stage MS with high degree of accuracy using OCT and artificial neural networks.
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Affiliation(s)
- E Garcia-Martin
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain
| | - M Ortiz
- School of Physics, University of Melbourne, VIC, 3010, Australia
| | - L Boquete
- RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain; Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E M Sánchez-Morla
- Department of Psychiatry, Hospital 12 de Octubre Research Institute (i+12), 28041, Madrid, Spain; Faculty of Medicine, Complutense University of Madrid, 28040, Madrid, Spain; CIBERSAM: Biomedical Research Networking Centre in Mental Health, 28029, Madrid, Spain
| | - R Barea
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - C Cavaliere
- Biomedical Engineering Group, Department of Electronics, University of Alcalá, Alcalá de Henares, Spain
| | - E Vilades
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
| | - E Orduna
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain
| | - M J Rodrigo
- Department of Ophthalmology, Miguel Servet University Hospital, Zaragoza, Spain; Aragon Institute for Health Research (IIS Aragon). Miguel Servet Ophthalmology Innovation and Research Group (GIMSO), University of Zaragoza, Spain; RETICS: Thematic Networks for Co-operative Research in Health for Ocular Diseases, Spain.
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24
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Borgström M, Tisell A, Link H, Wilhelm E, Lundberg P, Huang‐Link Y. Retinal thinning and brain atrophy in early MS and CIS. Acta Neurol Scand 2020; 142:418-427. [PMID: 32416627 DOI: 10.1111/ane.13282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 04/30/2020] [Accepted: 05/12/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Optical coherence tomography (OCT) could be complementary to magnetic resonance imaging (MRI) of the brain in monitoring course of multiple sclerosis (MS) and clinically isolated syndrome (CIS). Thinning of neurons in ganglion cell-inner plexiform layer (GCIPL) measured by OCT is assumed to be associated with brain atrophy. OBJECTIVES To evaluate association of GCIPL with brain parameters detected by quantitative MRI (qMRI) and MR-spectroscopy (MRS) in early MS and CIS. METHODS Seventeen newly diagnosed MS and 18 CIS patients were prospectively included. The patients were assessed at baseline as well as at 1 year follow-up by OCT, qMRI and MRS. Brain parenchymal and myelin volumes (BPV, MYV respectively) and the corresponding fractions (BPF, MYF) were measured with qMRI. Metabolites including myo-inositol (myo-Ins) were measured in the normal-appearing white matter (NAWM) using MRS. T-tests and ANOVA were used to analyze group differences, and linear regression models to evaluate association of GCIPL with BPV, MYV and myo-Ins after correlation analysis. RESULTS Disease activity reflected by lesions on MRI and presence of CSF oligoclonal IgG bands were more prominent in MS compared to CIS. GCIPL, BPV, MYV, BPF and MYF were reduced, while concentration of myo-Ins was increased in MS compared to CIS. Follow-up showed consistency of thinner GCIPL in MS compared to CIS. GCIPL thinning correlated with reduced BPV and MYV (P < .05 for both), but with increased myo-Ins (P < .01). CONCLUSIONS Significant GCIPL thinning occurs in early MS and is associated with enhanced brain inflammation and atrophy.
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Affiliation(s)
- Max Borgström
- Division of Neurology Department of Biomedical and Clinical Sciences Faculty of Medicine and Health Sciences Linköping University Linköping Sweden
| | - Anders Tisell
- Department of Radiation Physics Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
- Centre for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden
| | - Hans Link
- Department of Clinical Neuroscience Karolinska Institute Stockholm Sweden
| | - Elisabeth Wilhelm
- Division of Society and Health, Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
| | - Peter Lundberg
- Department of Radiation Physics Department of Health, Medicine and Caring Sciences Linköping University Linköping Sweden
- Centre for Medical Image Science and Visualization (CMIV) Linköping University Linköping Sweden
| | - Yumin Huang‐Link
- Division of Neurology Department of Biomedical and Clinical Sciences Faculty of Medicine and Health Sciences Linköping University Linköping Sweden
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25
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Specovius S, Zimmermann HG, Oertel FC, Chien C, Bereuter C, Cook LJ, Lana Peixoto MA, Fontenelle MA, Kim HJ, Hyun JW, Jung SK, Palace J, Roca-Fernandez A, Diaz AR, Leite MI, Sharma SM, Ashtari F, Kafieh R, Dehghani A, Pourazizi M, Pandit L, Dcunha A, Aktas O, Ringelstein M, Albrecht P, May E, Tongco C, Leocani L, Pisa M, Radaelli M, Martinez-Lapiscina EH, Stiebel-Kalish H, Hellmann M, Lotan I, Siritho S, de Seze J, Senger T, Havla J, Marignier R, Tilikete C, Cobo Calvo A, Bichuetti DB, Tavares IM, Asgari N, Soelberg K, Altintas A, Yildirim R, Tanriverdi U, Jacob A, Huda S, Rimler Z, Reid A, Mao-Draayer Y, de Castillo IS, Yeaman MR, Smith TJ, Brandt AU, Paul F. Cohort profile: a collaborative multicentre study of retinal optical coherence tomography in 539 patients with neuromyelitis optica spectrum disorders (CROCTINO). BMJ Open 2020; 10:e035397. [PMID: 33122310 PMCID: PMC7597491 DOI: 10.1136/bmjopen-2019-035397] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Optical coherence tomography (OCT) captures retinal damage in neuromyelitis optica spectrum disorders (NMOSD). Previous studies investigating OCT in NMOSD have been limited by the rareness and heterogeneity of the disease. The goal of this study was to establish an image repository platform, which will facilitate neuroimaging studies in NMOSD. Here we summarise the profile of the Collaborative OCT in NMOSD repository as the initial effort in establishing this platform. This repository should prove invaluable for studies using OCT to investigate NMOSD. PARTICIPANTS The current cohort includes data from 539 patients with NMOSD and 114 healthy controls. These were collected at 22 participating centres from North and South America, Asia and Europe. The dataset consists of demographic details, diagnosis, antibody status, clinical disability, visual function, history of optic neuritis and other NMOSD defining attacks, and OCT source data from three different OCT devices. FINDINGS TO DATE The cohort informs similar demographic and clinical characteristics as those of previously published NMOSD cohorts. The image repository platform and centre network continue to be available for future prospective neuroimaging studies in NMOSD. For the conduct of the study, we have refined OCT image quality criteria and developed a cross-device intraretinal segmentation pipeline. FUTURE PLANS We are pursuing several scientific projects based on the repository, such as analysing retinal layer thickness measurements, in this cohort in an attempt to identify differences between distinct disease phenotypes, demographics and ethnicities. The dataset will be available for further projects to interested, qualified parties, such as those using specialised image analysis or artificial intelligence applications.
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Affiliation(s)
- Svenja Specovius
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Frederike Cosima Oertel
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Claudia Chien
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Charlotte Bereuter
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Lawrence J Cook
- Department of Pediatrics, University of Utah, Salt Lake CIty, Utah, USA
| | | | | | - Ho Jin Kim
- Department of Neurology, National Cancer Center, Goyang, Republic of Korea
| | - Jae-Won Hyun
- Department of Neurology, National Cancer Center, Goyang, Republic of Korea
| | - Su-Kyung Jung
- Department of Ophthalmology, National Cancer Center, Goyang, Republic of Korea
| | - Jacqueline Palace
- Department of Neurology, Oxford University Hospitals, National Health Service Trust, Oxford, UK
| | | | - Alejandro Rubio Diaz
- Department of Neurology, Oxford University Hospitals, National Health Service Trust, Oxford, UK
| | - Maria Isabel Leite
- Department of Neurology, Oxford University Hospitals, National Health Service Trust, Oxford, UK
| | - Srilakshmi M Sharma
- Department of Ophthalmology, Oxford University Hospitals, National Health Service Trust, Oxford, UK
| | - Fereshte Ashtari
- Kashani MS Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Kafieh
- School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Dehghani
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohsen Pourazizi
- Department of Ophthalmology, Isfahan Eye Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Lekha Pandit
- Department of Neurology, KS Hegde Medical Academy, Nitte University, Mangalore, India
| | - Anitha Dcunha
- Department of Neurology, KS Hegde Medical Academy, Nitte University, Mangalore, India
| | - Orhan Aktas
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Marius Ringelstein
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
- Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Philipp Albrecht
- Department of Neurology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Eugene May
- Swedish Neuroscience Institute Neuro-Ophthalmology, Seattle, Washington, USA
| | - Caryl Tongco
- Swedish Neuroscience Institute Neuro-Ophthalmology, Seattle, Washington, USA
| | - Letizia Leocani
- Neurological Department and Institute of Experimental Neurology (INSPE) Scientific Institute, Hospital San Raffaele; and University Vita-Salute San Raffaele, Milan, Italy
| | - Marco Pisa
- Neurological Department and Institute of Experimental Neurology (INSPE) Scientific Institute, Hospital San Raffaele; and University Vita-Salute San Raffaele, Milan, Italy
| | - Marta Radaelli
- Neurological Department and Institute of Experimental Neurology (INSPE) Scientific Institute, Hospital San Raffaele; and University Vita-Salute San Raffaele, Milan, Italy
| | - Elena H Martinez-Lapiscina
- Hospital Clinic of Barcelona-Institut d'Investigacions, Biomèdiques August Pi Sunyer (IDIBAPS), Barcelona, Spain
| | - Hadas Stiebel-Kalish
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Neuro-Ophthalmology Division, Department of Ophthalmology, Rabin Medical Center, Petah Tikva, Israel
| | - Mark Hellmann
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Itay Lotan
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sasitorn Siritho
- Division of Neurology, Department of Medicine, Siriraj Hospital and Bumrungrad International Hospital, Bangkok, Thailand
| | - Jérôme de Seze
- Neurology Service, University Hospital of Strasbourg, Strasbourg, France
| | - Thomas Senger
- Neurology Service, University Hospital of Strasbourg, Strasbourg, France
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, University Hospital, Ludwig Maximilians University, Munich, Germany
| | - Romain Marignier
- Neurology, Multiple Sclerosis, Myelin Disorders and Neuroinflammation, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Lyon, France
| | - Caroline Tilikete
- Department of Neuro-Ophthalmology, Hospices Civils de Lyon, Lyon, France
| | - Alvaro Cobo Calvo
- Neurology, Multiple Sclerosis, Myelin Disorders and Neuroinflammation, Pierre Wertheimer Neurological Hospital, Hospices Civils de Lyon, Lyon, France
| | - Denis Bernardi Bichuetti
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ivan Maynart Tavares
- Department of Ophthalmology and Visual Sciences, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Nasrin Asgari
- Departments of Neurology, Slagelse Hospital, Slagelse, Denmark
- Institutes of Regional Health Research and Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Kerstin Soelberg
- Departments of Neurology, Slagelse Hospital, Slagelse, Denmark
- Institutes of Regional Health Research and Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Ayse Altintas
- Neurology Department, School of Medicine, Koc University and Istanbul University - Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Rengin Yildirim
- Department of Ophthalmology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Uygur Tanriverdi
- Neurology Department Istanbul, Istanbul University, Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Anu Jacob
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Saif Huda
- Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Zoe Rimler
- Department of Neurology, NYU Multiple Sclerosis Comprehensive Care Center, NYU School of Medicine, New York, New York, USA
| | - Allyson Reid
- Department of Neurology, NYU Multiple Sclerosis Comprehensive Care Center, NYU School of Medicine, New York, New York, USA
| | - Yang Mao-Draayer
- Department of Neurology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | | | - Michael R Yeaman
- Department of Medicine, Los Angeles Biomedical Research Institute at Harbor-University of California at Los Angeles (UCLA) Medical Center, Torrance, California, USA
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Terry J Smith
- Departments of Ophthalmology and Visual Sciences, Kellogg Eye Center, Ann Arbor, Michigan, USA
- Division of Metabolism, Endocrine and Diabetes, Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, University of California, Irvine, California, USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Lee GI, Son KY, Park KA, Kong DS, Oh SY. Longitudinal Changes in the Retinal Microstructures of Eyes With Chiasmal Compression. Neurology 2020; 96:e131-e140. [PMID: 33093228 DOI: 10.1212/wnl.0000000000011087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 08/20/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To test the hypothesis that there was a temporal change in the retinal microstructure after decompression surgery for chiasmal compression, the 1-year longitudinal changes in the inner and outer retinal thickness after decompression surgery were analyzed using spectral-domain optical coherence tomography (SD-OCT) with linear mixed-effects models. METHODS SD-OCT was obtained from 87 eyes with chiasmal compression and compared to 100 healthy controls. The preoperative and 1-year postoperative longitudinal changes in the retinal layer thickness were measured. The thickness of each of the following retinal layers was analyzed: the macular retinal nerve fiber layer (RNFL), the ganglion cell layer (GCL), the inner plexiform layer (IPL), the inner nuclear layer, the outer plexiform layer, the outer nuclear layer, and the photoreceptor layer. RESULTS The RNFL, GCL, and IPL showed thinning at a rate of 1.068 μm/y (95% confidence interval [CI], 0.523, 1.613), 1.189 μm/y (95% CI 0.452, 1.925), and 1.177 μm/y (95% CI 0.645, 1.709), respectively, after decompression surgery. The preoperative thickness of the intraretinal layer was associated with postoperative visual field recovery (RNFL, odds ratio [OR] 1.221, 95% CI 1.058, 1.410; GCL, OR 1.133, 95% CI 1.024, 1.254; and IPL, OR 1.174, 95% CI 1.002, 1.376). CONCLUSIONS The changes in retinal microstructure persisted and progressed in eyes with chiasmal compression after decompression surgery. The findings provide insight into the biological and anatomical sequelae following chiasmal compression. The preoperative thickness of the inner retinal layers was associated with postoperative visual field recovery.
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Affiliation(s)
- Ga-In Lee
- From the Department of Ophthalmology (G.-I.L., K.Y.S., K.-A.P., S.Y.O.) and Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center (D.-S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ki Young Son
- From the Department of Ophthalmology (G.-I.L., K.Y.S., K.-A.P., S.Y.O.) and Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center (D.-S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyung-Ah Park
- From the Department of Ophthalmology (G.-I.L., K.Y.S., K.-A.P., S.Y.O.) and Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center (D.-S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - Doo-Sik Kong
- From the Department of Ophthalmology (G.-I.L., K.Y.S., K.-A.P., S.Y.O.) and Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center (D.-S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sei Yeul Oh
- From the Department of Ophthalmology (G.-I.L., K.Y.S., K.-A.P., S.Y.O.) and Department of Neurosurgery, Endoscopic Skull Base Surgery Clinic, Brain Tumor Center (D.-S.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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27
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Lee Y, Park KA, Oh SY. Changes in the structure of retinal layers over time in non-arteritic anterior ischaemic optic neuropathy. Eye (Lond) 2020; 35:1748-1757. [PMID: 32873941 DOI: 10.1038/s41433-020-01152-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/16/2020] [Accepted: 08/14/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To examine structural changes in retinal layers over time in patients with non-arteritic anterior ischaemic optic neuropathy (NAION) and determine the layers that predict visual outcomes. METHODS The optical coherence tomography parameters in NAION eyes at <2 months, 2-5 months, and 6-18 months from the onset were compared to age-matched normal controls. Generalised estimating equation analysis was used to analyse the changes over time and regression analysis was performed to identify the layer that could predict visual field outcomes. RESULTS Less than 2 months from the onset, the peripapillary retinal nerve fibre layer (RNFL) (p = 0.001) and macular outer nuclear layer (ONL) (p = 0.024) were significantly thicker in the NAION eyes than in the control eyes. The average peripapillary RNFL, macular RNFL, and ganglion cell layer and inner plexiform layer (GCIPL) showed reductions in thickness within 2-5 months (peripapillary RNFL: -19.8 μm/month, p < 0.001, macular RNFL: -14.5 μm/month, p < 0.001, GCIPL: -26.8 μm/month, p < 0.001). The change of thickness in temporal and superior peripapillary RNFL, GCIPL, inner nuclear layer (INL), and ONL by 2-5 months was associated with the final visual field results (p = 0.018, p < 0.001, p = 0.040, p = 0.020, and p = 0.002, respectively). CONCLUSIONS The peripapillary RNFL swelling initially observed started to decrease within 2-5 months along with macular RNFL and GCIPL thinning. The rate of thickness changes in the peripapillary RNFL, GCIPL, INL, and ONL by 2-5 months was associated with visual field outcomes.
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Affiliation(s)
- Yumi Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.,Department of Ophthalmology, Chuncheon Sacred Heart Hospital, Hallym University Medical Center, Chuncheon, Republic of Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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28
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Berman S, Backner Y, Krupnik R, Paul F, Petrou P, Karussis D, Levin N, Mezer AA. Conduction delays in the visual pathways of progressive multiple sclerosis patients covary with brain structure. Neuroimage 2020; 221:117204. [PMID: 32745679 DOI: 10.1016/j.neuroimage.2020.117204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 01/24/2023] Open
Abstract
In developed countries, multiple sclerosis (MS) is the leading cause of non-traumatic neurological disability in young adults. MS is a chronic demyelinating disease of the central nervous system, in which myelin is attacked, changing white matter structure and leaving lesions. The demyelination has a direct effect on white matter conductivity. This effect can be examined in the visual system, where damage is highly prevalent in MS, leading to substantial delays in conduction, commonly measured with visual evoked potentials (VEPs). The structural damage to the visual system in MS is often estimated with MRI measurements in the white matter. Recent developments in quantitative MRI (qMRI) provide improved sensitivity to myelin content and new structural methods allow better modeling of the axonal structure, leading researchers to link white matter microstructure to conduction properties of action potentials along fiber tracts. This study attempts to explain the variance in conduction latencies down the visual pathway using structural measurements of both the retina and the optic radiation (OR). Forty-eight progressive MS patients, participants in a longitudinal stem-cell therapy clinical trial, were included in this study, three and six months post final treatment. Twenty-seven patients had no history of optic neuritis, and were the main focus of this study. All participants underwent conventional MRI scans, as well as diffusion MRI and qMRI sequences to account for white matter microstructure. Optical coherence tomography scans were also obtained, and peripapillary retinal nerve fiber layer (pRNFL) thickness and macular volume measurements were extracted. Finally, latencies of recorded VEPs were estimated. Our results show that in non-optic neuritis progressive MS patients there is a relationship between the VEP latency and both retinal damage and OR lesion load. In addition, we find that qMRI values, sampled along the OR, are also correlated with VEP latency. Finally, we show that combining these parameters using PCA we can explain more than 40% of the inter-subject variance in VEP latency. In conclusion, this study contributes to understanding the relationship between the structural properties and conduction in the visual system in disease. We focus on the visual system, where the conduction latencies can be estimated, but the conclusions could be generalized to other brain systems where the white matter structure can be measured. It also highlights the importance of having multiple parameters when assessing the clinical stages of MS patients, which could have major implications for future studies of other white matter diseases.
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Affiliation(s)
- Shai Berman
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Yael Backner
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ronnie Krupnik
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Panayiota Petrou
- The Multiple Sclerosis Center, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dimitrios Karussis
- The Multiple Sclerosis Center, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Netta Levin
- fMRI Unit, Neurology Department, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Aviv A Mezer
- Edmond and Lily Safra Center for Brain Sciences, The Hebrew University of Jerusalem, Jerusalem, Israel
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29
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Ihl T, Kadas EM, Oberwahrenbrock T, Endres M, Klockgether T, Schroeter J, Brandt AU, Paul F, Minnerop M, Doss S, Schmitz-Hübsch T, Zimmermann HG. Investigation of Visual System Involvement in Spinocerebellar Ataxia Type 14. CEREBELLUM (LONDON, ENGLAND) 2020; 19:469-482. [PMID: 32338350 PMCID: PMC7351844 DOI: 10.1007/s12311-020-01130-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Spinocerebellar ataxia type 14 (SCA-PRKCG, formerly SCA14) is a rare, slowly progressive disorder caused by conventional mutations in protein kinase Cγ (PKCγ). The disease usually manifests with ataxia, but previous reports suggested PRKCG variants in retinal pathology. To systematically investigate for the first time visual function and retinal morphology in patients with SCA-PRKCG. Seventeen patients with PRKCG variants and 17 healthy controls were prospectively recruited, of which 12 genetically confirmed SCA-PRKCG patients and 14 matched controls were analyzed. We enquired a structured history for visual symptoms. Vision-related quality of life was obtained with the National Eye Institute Visual Function Questionnaire (NEI-VFQ) including the Neuro-Ophthalmic Supplement (NOS). Participants underwent testing of visual acuity, contrast sensitivity, visual fields, and retinal morphology with optical coherence tomography (OCT). Measurements of the SCA-PRKCG group were analyzed for their association with clinical parameters (ataxia rating and disease duration). SCA-PRKCG patients rate their vision-related quality of life in NEI-VFQ significantly worse than controls. Furthermore, binocular visual acuity and contrast sensitivity were worse in SCA-PRKCG patients compared with controls. Despite this, none of the OCT measurements differed between groups. NEI-VFQ and NOS composite scores were related to ataxia severity. Additionally, we describe one patient with a genetic variant of uncertain significance in the catalytic domain of PKCγ who, unlike all confirmed SCA-PRKCG, presented with a clinically silent epitheliopathy. SCA-PRKCG patients had reduced binocular vision and vision-related quality of life. Since no structural retinal damage was found, the pathomechanism of these findings remains unclear.
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Affiliation(s)
- Thomas Ihl
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Ella M Kadas
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Timm Oberwahrenbrock
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Matthias Endres
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- German Center for Neurodegenerative Diseases (DZNE), partner site, Berlin, Germany
| | - Thomas Klockgether
- Department of Neurology, University Hospital of Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Jan Schroeter
- University Tissue Bank, Cornea Bank Berlin, Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, University of California, Irvine, CA, USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Martina Minnerop
- Institute of Neuroscience and Medicine (INM-1), Research Centre Juelich, Juelich, Germany
- Department of Neurology, Center for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
- Department of Neurology and Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Sarah Doss
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- Department of Neurological Sciences, Movement Disorders Section, University of Nebraska Medical Center, Omaha, NE, USA
| | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
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Motamedi S, Oertel FC, Yadav SK, Kadas EM, Weise M, Havla J, Ringelstein M, Aktas O, Albrecht P, Ruprecht K, Bellmann-Strobl J, Zimmermann HG, Paul F, Brandt AU. Altered fovea in AQP4-IgG-seropositive neuromyelitis optica spectrum disorders. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/5/e805. [PMID: 32576604 PMCID: PMC7413713 DOI: 10.1212/nxi.0000000000000805] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/16/2020] [Indexed: 12/22/2022]
Abstract
Objective To investigate disease-specific foveal shape changes in patients with neuromyelitis optica spectrum disorders (NMOSDs) using foveal morphometry. Methods This cross-sectional study included macular spectral domain optical coherence tomography scans of 52 eyes from 28 patients with aquaporin-4 immunoglobulin G (AQP4-IgG)-seropositive NMOSD, 116 eyes from 60 patients with MS, and 123 eyes from 62 healthy controls (HCs), retrospectively, and an independent confirmatory cohort comprised 33/33 patients with NMOSD/MS. The fovea was characterized using 3D foveal morphometry. We included peripapillary retinal nerve fiber layer (pRNFL) thickness and combined macular ganglion cell and inner plexiform layer (GCIPL) volume to account for optic neuritis (ON)-related neuroaxonal damage. Results Group comparison showed significant differences compared with HC in the majority of foveal shape parameters in NMOSD, but not MS. Pit flat disk area, average pit flat disk diameter, inner rim volume, and major slope disk length, as selected parameters, showed differences between NMOSD and MS (p value = 0.017, 0.002, 0.005, and 0.033, respectively). This effect was independent of ON. Area under the curve was between 0.7 and 0.8 (receiver operating characteristic curve) for discriminating between NMOSD and MS. Pit flat disk area and average pit flat disk diameter changes independent of ON were confirmed in an independent cohort. Conclusions Foveal morphometry reveals a wider and flatter fovea in NMOSD in comparison to MS and HC. Comparison to MS and accounting for ON suggest this effect to be at least in part independent of ON. This supports a primary retinopathy in AQP4-IgG–seropositive NMOSD.
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Affiliation(s)
- Seyedamirhosein Motamedi
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Frederike C Oertel
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Sunil K Yadav
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Ella M Kadas
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Margit Weise
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Joachim Havla
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Marius Ringelstein
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Orhan Aktas
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Philipp Albrecht
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Klemens Ruprecht
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Judith Bellmann-Strobl
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Hanna G Zimmermann
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Friedemann Paul
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine
| | - Alexander U Brandt
- From the Experimental and Clinical Research Center (S.M., F.C.O., J.B.-S., H.G.Z., F.P., A.U.B.), Max-Delbrück Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; NeuroCure Clinical Research Center (S.M., F.C.O., S.K.Y., E.M.K., J.B.-S., H.G.Z., F.P., A.U.B.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; Division of Neuroinflammation and Glial Biology (F.C.O.), University of California, San Francisco; Nocturne GmbH (S.K.Y., E.M.K.), Berlin; Department of Neurology (M.W., M.R., O.A., P.A.), Medical Faculty, Heinrich Heine University, Düsseldorf; Institute of Clinical Neuroimmunology (J.H.), LMU Hospital, Ludwig-Maximilians University, Munich; Department of Neurology (M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf; Department of Neurology (K.R., F.P.), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Department of Neurology (A.U.B.), University of California, Irvine.
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Kuchling J, Paul F. Visualizing the Central Nervous System: Imaging Tools for Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorders. Front Neurol 2020; 11:450. [PMID: 32625158 PMCID: PMC7311777 DOI: 10.3389/fneur.2020.00450] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/28/2020] [Indexed: 12/12/2022] Open
Abstract
Multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD) are autoimmune central nervous system conditions with increasing incidence and prevalence. While MS is the most frequent inflammatory CNS disorder in young adults, NMOSD is a rare disease, that is pathogenetically distinct from MS, and accounts for approximately 1% of demyelinating disorders, with the relative proportion within the demyelinating CNS diseases varying widely among different races and regions. Most immunomodulatory drugs used in MS are inefficacious or even harmful in NMOSD, emphasizing the need for a timely and accurate diagnosis and distinction from MS. Despite distinct immunopathology and differences in disease course and severity there might be considerable overlap in clinical and imaging findings, posing a diagnostic challenge for managing neurologists. Differential diagnosis is facilitated by positive serology for AQP4-antibodies (AQP4-ab) in NMOSD, but might be difficult in seronegative cases. Imaging of the brain, optic nerve, retina and spinal cord is of paramount importance when managing patients with autoimmune CNS conditions. Once a diagnosis has been established, imaging techniques are often deployed at regular intervals over the disease course as surrogate measures for disease activity and progression and to surveil treatment effects. While the application of some imaging modalities for monitoring of disease course was established decades ago in MS, the situation is unclear in NMOSD where work on longitudinal imaging findings and their association with clinical disability is scant. Moreover, as long-term disability is mostly attack-related in NMOSD and does not stem from insidious progression as in MS, regular follow-up imaging might not be useful in the absence of clinical events. However, with accumulating evidence for covert tissue alteration in NMOSD and with the advent of approved immunotherapies the role of imaging in the management of NMOSD may be reconsidered. By contrast, MS management still faces the challenge of implementing imaging techniques that are capable of monitoring progressive tissue loss in clinical trials and cohort studies into treatment algorithms for individual patients. This article reviews the current status of imaging research in MS and NMOSD with an emphasis on emerging modalities that have the potential to be implemented in clinical practice.
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Affiliation(s)
- Joseph Kuchling
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- NeuroCure Clinical Research Center, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Neurology, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt–Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Berlin Institute of Health, Berlin, Germany
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Bannai D, Lizano P. Identifying retinal layer endophenotypes for schizophrenia. Schizophr Res 2020; 220:25-26. [PMID: 32247746 PMCID: PMC7306439 DOI: 10.1016/j.schres.2020.03.055] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 03/25/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Deepthi Bannai
- Beth Israel Deaconess Medical Center, Psychiatry, Boston, MA
| | - Paulo Lizano
- Beth Israel Deaconess Medical Center, Psychiatry, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America.
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Bannai D, Lizano P, Kasetty M, Lutz O, Zeng V, Sarvode S, Kim LA, Hill S, Tamminga C, Clementz B, Gershon E, Pearlson G, Miller JB, Keshavan M. Retinal layer abnormalities and their association with clinical and brain measures in psychotic disorders: A preliminary study. Psychiatry Res Neuroimaging 2020; 299:111061. [PMID: 32145500 PMCID: PMC7183910 DOI: 10.1016/j.pscychresns.2020.111061] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 02/24/2020] [Accepted: 02/27/2020] [Indexed: 01/06/2023]
Abstract
Studies utilizing optical coherence tomography (OCT) in psychosis have identified abnormalities in retinal cytoarchitecture. We aim to analyze retinal layer topography in psychosis and its correlation with clinical and imaging parameters. Macular retinal images were obtained via OCT in psychosis probands (n = 25) and healthy controls (HC, n = 15). Clinical, cognitive and structural MRI data were collected from participants. No thinning was noted for the retinal nerve fiber, ganglion cell or inner plexiform layers. We found significant thinning in the right inner temporal, right central, and left inner superior quadrants of the outer nuclear layer (ONL) in probands compared to HC. Thickening of the outer plexiform layer (OPL) was observed in the right inner temporal, left inner superior, and left inner temporal quadrants. The right inner temporal and left inner superior quadrants of both the OPL and ONL showed significant inverse correlations. Retinal pigment epithelium thinning correlated with worse mania symptoms, and thinning in the ONL was associated with worse cognitive function. ONL thinning was also associated with smaller total brain and white matter volume. Our findings suggest that outer retinal layers may provide additional insights into the pathophysiology of psychosis, possibly reflecting synaptic or inflammatory aberrations that lead to retinal pathologies.
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Affiliation(s)
- Deepthi Bannai
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Paulo Lizano
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| | - Megan Kasetty
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA
| | - Olivia Lutz
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Victor Zeng
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Suraj Sarvode
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Leo A Kim
- Retina Service, Department of Opthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Scot Hill
- Department of Psychology, Rosalind Franklin University, Chicago, IL, USA
| | - Carol Tamminga
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
| | - Brett Clementz
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Elliot Gershon
- Department of Psychiatry and Behavioral Neurosciences, University of Chicago, IL, USA
| | | | - John B Miller
- Harvard Retinal Imaging Lab, Massachusetts Eye and Ear, Boston, MA, USA; Retina Service, Department of Opthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA
| | - Matcheri Keshavan
- Psychiatry, Beth Israel Deaconess Medical Center, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Abdelhak A, Huss A, Stahmann A, Senel M, Krumbholz M, Kowarik MC, Havla J, Kümpfel T, Kleiter I, Wüstinger I, Zettl UK, Schwartz M, Roesler R, Friede T, Ludolph AC, Ziemann U, Tumani H. Explorative study of emerging blood biomarkers in progressive multiple sclerosis (EmBioProMS): Design of a prospective observational multicentre pilot study. Contemp Clin Trials Commun 2020; 18:100574. [PMID: 32478196 PMCID: PMC7251538 DOI: 10.1016/j.conctc.2020.100574] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 05/04/2020] [Accepted: 05/17/2020] [Indexed: 11/18/2022] Open
Abstract
Background Defining clinical and subclinical progression in multiple sclerosis (MS) is challenging. Patient history, expanded disability status scale (EDSS), and magnetic resonance imaging (MRI) all have shortcomings and may underestimate disease dynamics. Emerging serum biomarkers such as glial fibrillary acidic protein (GFAP) and neurofilament light chain (NfL) proved useful in many cross-sectional studies. However, longitudinal data on patients with progressive MS is scarce. Objectives To assess whether the serum biomarkers GFAP and NfL might differentiate between patients with progressive vs. non-progressive disease stages and predict the disease course according to the Lublin criteria. Methods EmBioProMS is a pilot, observational, prospective, multicentric study funded by the German Multiple Sclerosis Society (DMSG). 200 patients with MS according to the 2017 McDonald criteria and history of relapse-independent progression at any time (progressive MS, PMS), younger than 65 years, and with EDSS ≤ 6.5 will be recruited in 6 centres in Germany. At baseline, month 6, and 18, medical history, EDSS, Nine-Hole-Peg-Test (9-HPT), Timed-25-Foot-Walk-Test (T-25FW), Symbol-Digit-Modalities-Test (SDMT), serum GFAP, and NfL, MRI (at least baseline and month 18) and optional optical coherence tomography (OCT) will be performed. Disease progression before and during the study is defined by confirmed EDSS progression, increase by ≥ 20% in 9-HPT or T-25FW time. Conclusions This longitudinal multicentre study will reveal to what extent the prediction of disease progression in patients with PMS will be improved by the analysis of serum biomarkers in conjunction with routine clinical data and neuroimaging measures.
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Affiliation(s)
- Ahmed Abdelhak
- Department of Neurology & Stroke, University Hospital of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- Department of Neurology, University Hospital of Ulm, Ulm, Germany
| | - Andre Huss
- Department of Neurology, University Hospital of Ulm, Ulm, Germany
| | - Alexander Stahmann
- MS Forschungs- und Projektentwicklungs-gGmbH, MS-Registry by the German MS-Society, Hanover, Germany
| | - Makbule Senel
- Department of Neurology, University Hospital of Ulm, Ulm, Germany
| | - Markus Krumbholz
- Department of Neurology & Stroke, University Hospital of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Markus C. Kowarik
- Department of Neurology & Stroke, University Hospital of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Joachim Havla
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany
| | - Tania Kümpfel
- Institute of Clinical Neuroimmunology, Ludwig-Maximilians University, Munich, Germany
| | - Ingo Kleiter
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
- St. Josef-Hospital, Department of Neurology, Ruhr-University, Bochum, Germany
| | - Isabella Wüstinger
- Marianne-Strauß-Klinik, Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke gGmbH, Berg, Germany
| | - Uwe K. Zettl
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| | - Margit Schwartz
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| | - Romy Roesler
- Fachklinik für Neurologie Dietenbronn, Schwendi, Germany
| | - Tim Friede
- Department of Medical Statistics, University Medical Centre Göttingen, Göttingen, Germany
| | | | - Ulf Ziemann
- Department of Neurology & Stroke, University Hospital of Tübingen, Tübingen, Germany
- Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Hayrettin Tumani
- Department of Neurology, University Hospital of Ulm, Ulm, Germany
- Fachklinik für Neurologie Dietenbronn, Schwendi, Germany
- Corresponding author. Universitäts- und Rehabilitationskliniken Ulm (RKU), Oberer Eselsberg 45, 89081, Ulm, Germany.
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35
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Tavazzi E, Jakimovski D, Kuhle J, Hagemeier J, Ozel O, Ramanathan M, Barro C, Bergsland N, Tomic D, Kropshofer H, Leppert D, Michalak Z, Lincoff N, Dwyer MG, Benedict RHB, Weinstock-Guttman B, Zivadinov R. Serum neurofilament light chain and optical coherence tomography measures in MS: A longitudinal study. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/4/e737. [PMID: 32424064 PMCID: PMC7251512 DOI: 10.1212/nxi.0000000000000737] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Accepted: 04/09/2020] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To study the association between serum neurofilament light chain (sNfL) and multiple optical coherence tomography (OCT) measures in patients with MS and healthy controls (HCs). METHODS In this prospective study, 110 patients with MS were recruited, together with 52 age- and sex-matched HCs. Clinical evaluation and spectral domain OCT and sNfL were obtained at baseline and after 5.5 years of follow-up. Nested linear mixed models were used to assess differences between MS vs HC and associations between sNfL and OCT measures. Partial correlation coefficients are reported, and p values were adjusted for the false discovery rate. RESULTS At baseline, peripapillary retinal nerve fiber layer thickness (pRNFLT) and macular ganglion cell and inner plexiform layer thickness (mGCIP) were significantly lower in MS than HC both in MS-associated optic neuritis (MSON) (p = 0.007, p = 0.001) and nonaffected MSON (n-MSON) eyes (p = 0.003, p = 0.018), along with total macular volume (TMV) in n-MSON eyes (p = 0.011). At follow-up, MS showed significantly lower pRNFLT, mGCIP, and TMV both in MSON and n-MSON eyes (p < 0.001) compared with HC. In MS n-MSON eyes, sNfL was significantly associated with baseline pRNFLT and mGCIP (q = 0.019). No significant associations were found in MSON eyes. CONCLUSIONS This study confirms the ability of sNfL to detect neurodegeneration in MS and advocates for the inclusion of sNfL and OCT measures in clinical trials. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that sNfL levels were associated with MS neurodegeneration measured by OCT.
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Affiliation(s)
- Eleonora Tavazzi
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Dejan Jakimovski
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Jens Kuhle
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Jesper Hagemeier
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Osman Ozel
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Murali Ramanathan
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Christian Barro
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Niels Bergsland
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Davorka Tomic
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Harald Kropshofer
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - David Leppert
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Zuzanna Michalak
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Norah Lincoff
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Michael G Dwyer
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Ralph H B Benedict
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Bianca Weinstock-Guttman
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York
| | - Robert Zivadinov
- From the Buffalo Neuroimaging Analysis Center (E.T., D.J., J.H., O.O., N.B., M.G.D., R.Z.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; IRCCS (N.B.), Fondazione Don Carlo Gnocchi, Milan, Italy; Neurologic Clinic and Policlinic (J.K., C.B., Z.M., N.L.), Departments of Medicine, Biomedicine and Clinical Research, University Hospital Basel, University of Basel, Switzerland; Department of Pharmaceutical Sciences (M.R.), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York; Novartis Pharma AG (D.T., H.K., D.L.), Basel, Switzerland; Jacobs MS Center (R.H.B.B., B.W.-G.), Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, and Center for Biomedical Imaging at Clinical Translational Science Institute (R.Z.), University at Buffalo, State University of New York.
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36
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Oertel FC, Zeitz O, Rönnefarth M, Bereuter C, Motamedi S, Zimmermann HG, Kuchling J, Grosch AS, Doss S, Browne A, Paul F, Schmitz-Hübsch T, Brandt AU. Functionally Relevant Maculopathy and Optic Atrophy in Spinocerebellar Ataxia Type 1. Mov Disord Clin Pract 2020; 7:502-508. [PMID: 32626794 PMCID: PMC7328427 DOI: 10.1002/mdc3.12949] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/19/2020] [Accepted: 03/08/2020] [Indexed: 12/16/2022] Open
Abstract
Background Spinocerebellar ataxia type 1 (SCA-ATXN1) is an inherited progressive ataxia disorder characterized by an adult-onset cerebellar syndrome combined with nonataxia signs. Retinal or optic nerve affection are not systematically described. Objectives To describe a retinal phenotype and its functional relevance in SCA-ATXN1. Methods We applied optical coherence tomography (OCT) in 20 index cases with SCA-ATXN1 and 22 healthy controls (HCs), investigating qualitative changes and quantifying the peripapillary retinal nerve fiber layer (pRNFL) thickness and combined ganglion cell and inner plexiform layer (GCIP) volume as markers of optic atrophy and outer retinal layers as markers of maculopathy. Visual function was assessed by high- (HC-VA) and low-contrast visual acuity (LC-VA) and the Hardy-Rand-Rittler pseudoisochromatic test for color vision. Results Five patients (25%) showed distinct maculopathies in the ellipsoid zone (EZ). Furthermore, pRNFL (P < 0.001) and GCIP (P = 0.002) were reduced in patients (pRNFL, 80.86 ± 9.49 μm; GCIP, 1.84 ± 0.16 mm3) compared with HCs (pRNFL, 97.02 ± 8.34 μm; GCIP, 1.98 ± 0.12 mm3). Outer macular layers were similar between groups, but reduced in patients with maculopathies. HC-VA (P = 0.002) and LC-VA (P < 0.001) were reduced in patients (HC-VA [logMAR]: 0.01 ± 010; LC-VA [logMAR]: 0.44 ± 0.16) compared with HCs (HC-VA [logMAR]: -0.12 ± 0.08; LC-VA [logMAR]: 0.25 ± 0.05). Color vision was abnormal in 2 patients with maculopathies. Conclusions A distinct maculopathy, termed EZ disruption, as well as optic atrophy add to the known nonataxia features in SCA-ATXN1. Whereas optic atrophy may be understood as part of a widespread neurodegeneration, EZ disruption may be explained by effects of ataxin-1 gene or protein on photoreceptors. Our findings extend the spectrum of nonataxia signs in SCA-ATXN1 with potential relevance for diagnosis and monitoring.
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Affiliation(s)
- Frederike Cosima Oertel
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Oliver Zeitz
- Department of Ophthalmology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Maria Rönnefarth
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Charlotte Bereuter
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Seyedamirhosein Motamedi
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Hanna G Zimmermann
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Joseph Kuchling
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Anne Sophie Grosch
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Sarah Doss
- Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Department of Neurological Sciences University of Nebraska Medical Center Nebraska Omaha USA
| | - Andrew Browne
- Department of Ophthalmology University of California Irvine Irvine California USA
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Tanja Schmitz-Hübsch
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin Humboldt-Universität zu Berlin, and Berlin Institute of Health Berlin Germany.,Department of Neurology University of California Irvine Irvine California USA
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Lee G, Park K, Son G, Kong D, Oh SY. Optical coherence tomography analysis of inner and outer retinal layers in eyes with chiasmal compression caused by suprasellar tumours. Acta Ophthalmol 2020; 98:e373-e380. [PMID: 31602819 DOI: 10.1111/aos.14271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 09/14/2019] [Indexed: 01/02/2023]
Abstract
PURPOSE To compare postoperative macular thickness measurements of inner and outer retinal layers in eyes of patients with chiasmal compression with or without visual field (VF) recovery and healthy controls using optical coherence tomography (OCT). METHODS Macular spectral-domain OCT has been used for the auto-segmentation of images obtained from 100 eyes affected with chiasmal compression compared with 100 healthy controls enrolled in this study. We have divided eyes with chiasmal compression into two groups: group 1 characterized by VF recovery after tumour excision and group 2 showing partial or no recovery of VF. The thickness of the macular retinal nerve fibre layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer (OPL), outer nuclear layer (ONL), photoreceptor layer (PRL), inner retinal layer (IRL) and outer retinal layer (ORL) was segmented. The correlation between macular RNFL (mRNFL) and functional parameters has been analysed. RESULTS Both groups 1 and 2 showed significant thinning of RNFL, GCL, IPL and IRL in all quadrants. However, no significant changes have been detected in PRL and ORL of patients in either group compared with healthy controls. A significant thickening was detected in INL and ONL of group 2 compared with healthy controls and group 1. Postoperative mRNFL thickness is significantly correlated with VF defects and visual acuity except temporal quadrant. CONCLUSIONS Eyes with chiasmal compression showed thinning of the inner retinal layers with thickening of the INL and ONL in patients with partial to no recovery of VF. The changes in retinal microstructures are well-correlated with functional recovery. Further studies are needed to reveal the clinical implications of these findings in patients with chiasmal compression.
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Affiliation(s)
- Ga‐In Lee
- Department of Ophthalmology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
| | - Kyung‐Ah Park
- Department of Ophthalmology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
| | - Giyoung Son
- Department of Ophthalmology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
| | - Doo‐Sik Kong
- Department of Neurosurgery Endoscopic Skull Base Surgery Clinic Brain Tumor Center Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
| | - Sei Yeul Oh
- Department of Ophthalmology Samsung Medical Center Sungkyunkwan University School of Medicine Seoul Korea
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Raeesmohammadi L, Esmaeili S, Abbasi MH, Mehrpour M, Mirzaasgari Z, Baradaran HR, Deilami P, Motamed MR. Transbulbar B-mode sonography in multiple sclerosis without optic neuritis; clinical relevance. Brain Res 2020; 1734:146723. [PMID: 32057807 DOI: 10.1016/j.brainres.2020.146723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 02/05/2020] [Accepted: 02/09/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Trans bulbar B-mode sonography (TBS) is a recently proposed method but there is little known about its diagnostic accuracy in patients with multiple sclerosis without acute optic neuritis. Therefore we assessed the correlation between OND, ONSD and OND/ONSD ratio with clinical/para clinical parameters. METHODS In a comparative study, we intended to examine possible differences in optic nerve diameter (OND) and optic nerve sheath diameter (ONSD) between 60 patients with multiple sclerosis (MS) and 60 individuals as matched healthy controls. RESULTS The OND, ONSD and OND/ONSD ratio in both eyes showed significantly lower amounts in patients compared to healthy controls (p < 0.05). There were no correlations, between either OND or ONSD and factors including gender, age, P100 amplitude, disease duration, history of optic neuritis and number of T2 lesions in MRI (P ≥ 0.05). Expanded disability status scale (EDSS) and p100 Latency were correlated with both OND and ONSD values (P < 0.05). CONCLUSIONS TBS showed significantly lower amounts of OND, ONSD and OND/ONSD ratio in MS patients without current attack compared to their healthy controls indicating a subclinical axonal loss over time. It is suggested that TBS could be an applicable tool for early detection of optic nerve damages along with clinical and para-clinical findings.
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Affiliation(s)
- Leila Raeesmohammadi
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Sara Esmaeili
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad Hossein Abbasi
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Masoud Mehrpour
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Zahra Mirzaasgari
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Hamid Reza Baradaran
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences(IUMS), Tehran, Iran
| | - Parvaneh Deilami
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Mohammad Reza Motamed
- Department of Neurology, Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
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Juenger V, Cooper G, Chien C, Chikermane M, Oertel FC, Zimmermann H, Ruprecht K, Jarius S, Siebert N, Kuchling J, Papadopoulou A, Asseyer S, Bellmann-Strobl J, Paul F, Brandt AU, Scheel M. Optic chiasm measurements may be useful markers of anterior optic pathway degeneration in neuromyelitis optica spectrum disorders. Eur Radiol 2020; 30:5048-5058. [PMID: 32335748 PMCID: PMC7431438 DOI: 10.1007/s00330-020-06859-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES We aimed to evaluate optic chiasm (OC) measures as potential imaging marker for anterior optic pathway damage assessment in the context of neuromyelitis optica spectrum disorders (NMOSD). MATERIALS AND METHOD This cross-sectional study included 39 patients exclusively with aquaporin 4-IgG seropositive NMOSD of which 25 patients had a history of optic neuritis (NMOSD-ON) and 37 age- and sex-matched healthy controls (HC). OC heights, width, and area were measured using standard 3D T1-weighted MRI. Sensitivity of these measures to detect neurodegeneration in the anterior optic pathway was assessed in receiver operating characteristics analyses. Correlation coefficients were used to assess associations with structural measures of the anterior optic pathway (optic nerve dimensions, retinal ganglion cell loss) and clinical measures (visual function and disease duration). RESULTS OC heights and area were significantly smaller in NMOSD-ON compared to HC (NMOSD-ON vs. HC p < 0.0001). An OC area smaller than 22.5 mm2 yielded a sensitivity of 0.92 and a specificity of 0.92 in separating chiasms of NMOSD-ON from HC. OC area correlated well with structural and clinical measures in NMOSD-ON: optic nerve diameter (r = 0.4, p = 0.047), peripapillary retinal nerve fiber layer thickness (r = 0.59, p = 0.003), global visual acuity (r = - 0.57, p = 0.013), and diseases duration (r = - 0.5, p = 0.012). CONCLUSION Our results suggest that OC measures are promising and easily accessible imaging markers for the assessment of anterior optic pathway damage. KEY POINTS • Optic chiasm dimensions were smaller in neuromyelitis optica spectrum disorder patients compared to healthy controls. • Optic chiasm dimensions are associated with retinal measures and visual dysfunction. • The optic chiasm might be used as an easily accessible imaging marker of neurodegeneration in the anterior optic pathway with potential functional relevance.
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Affiliation(s)
- Valentin Juenger
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Graham Cooper
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Einstein Center for Neurosciences, Berlin, Germany.,Department of Experimental Neurology and Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Claudia Chien
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Meera Chikermane
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Frederike Cosima Oertel
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Multiple Sclerosis Center, Dept. of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Hanna Zimmermann
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Klemens Ruprecht
- Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Sven Jarius
- Molecular Neuroimmunology Group, Department of Neurology, University of Heidelberg, Heidelberg, Germany
| | - Nadja Siebert
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Joseph Kuchling
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Athina Papadopoulou
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Neurologic Clinic and Policlinic, Departments of Medicine, Clinical Research and Biomedicine University Hospital Basel, Basel, Switzerland
| | - Susanna Asseyer
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Judith Bellmann-Strobl
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany. .,NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. .,Einstein Center for Neurosciences, Berlin, Germany. .,Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany.
| | - Alexander U Brandt
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neurology, University of California, Irvine, CA, USA
| | - Michael Scheel
- NeuroCure Clinical Research Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.,Department of Neuroradiology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
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Almonte MT, Capellàn P, Yap TE, Cordeiro MF. Retinal correlates of psychiatric disorders. Ther Adv Chronic Dis 2020; 11:2040622320905215. [PMID: 32215197 PMCID: PMC7065291 DOI: 10.1177/2040622320905215] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 01/08/2020] [Indexed: 12/27/2022] Open
Abstract
Diagnosis and monitoring of psychiatric disorders rely heavily on subjective self-reports of clinical symptoms, which are complicated by the varying consistency of accounts reported by patients with an impaired mental state. Hence, more objective and quantifiable measures have been sought to provide clinicians with more robust methods to evaluate symptomology and track progression of disease in response to treatments. Owing to the shared origins of the retina and the brain, it has been suggested that changes in the retina may correlate with structural and functional changes in the brain. Vast improvements in retinal imaging, namely optical coherence tomography (OCT) and electrodiagnostic technology, have made it possible to investigate the eye at a microscopic level, allowing for the investigation of potential biomarkers in vivo. This review provides a summary of retinal biomarkers associated with schizophrenia, bipolar disorder and major depression, demonstrating how retinal biomarkers may be used to complement existing methods and provide structural markers of pathophysiological mechanisms that underpin brain dysfunction in psychiatric disorders.
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Affiliation(s)
- Melanie T. Almonte
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
| | | | - Timothy E. Yap
- Western Eye Hospital, Imperial College Healthcare NHS Trust (ICHNT), London, UK
- Imperial College Ophthalmic Research Group (ICORG), Imperial College London, UK
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Zimmermann HG, Oertel FC. Understanding neurodegenerative changes of the afferent visual pathway in MS. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:e667. [PMID: 32229640 PMCID: PMC7051199 DOI: 10.1212/nxi.0000000000000667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hanna G Zimmermann
- From the Experimental and Clinical Research Center (H.G.Z., F.C.O.), Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; NeuroCure Clinical Research Center (H.G.Z., F.C.O.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Multiple Sclerosis Center (F.C.O.), Department of Neurology, University of California San Francisco.
| | - Frederike Cosima Oertel
- From the Experimental and Clinical Research Center (H.G.Z., F.C.O.), Max-Delbrück-Centrum für Molekulare Medizin and Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; NeuroCure Clinical Research Center (H.G.Z., F.C.O.), Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany; and Multiple Sclerosis Center (F.C.O.), Department of Neurology, University of California San Francisco
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42
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Albert C, Mikolajczak J, Liekfeld A, Piper SK, Scheel M, Zimmermann HG, Nowak C, Dörr J, Bellmann-Strobl J, Chien C, Brandt AU, Paul F, Hoffmann O. Fingolimod after a first unilateral episode of acute optic neuritis (MOVING) - preliminary results from a randomized, rater-blind, active-controlled, phase 2 trial. BMC Neurol 2020; 20:75. [PMID: 32126977 PMCID: PMC7052969 DOI: 10.1186/s12883-020-01645-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/17/2020] [Indexed: 12/19/2022] Open
Abstract
Background Neuroprotection and promotion of remyelination represent important therapeutic gaps in multiple sclerosis (MS). Acute optic neuritis (ON) is a frequent MS manifestation. Based on the presence and properties of sphingosine-1-phosphate receptors (S1PR) on astrocytes and oligodendrocytes, we hypothesized that remyelination can be enhanced by treatment with fingolimod, a S1PR modulator currently licensed for relapsing-remitting MS. Methods MOVING was an investigator-driven, rater-blind, randomized clinical trial. Patients with acute unilateral ON, occurring as a clinically isolated syndrome or MS relapse, were randomized to 6 months of treatment with 0.5 mg oral fingolimod or subcutaneous IFN-β 1b 250 μg every other day. The change in multifocal visual evoked potential (mfVEP) latency of the qualifying eye was examined as the primary (month 6 vs. baseline) and secondary (months 3, 6 and 12 vs. baseline) outcome. In addition, full field visual evoked potentials, visual acuity, optical coherence tomography as well as clinical relapses and measures of disability, cerebral MRI, and self-reported visual quality of life were obtained for follow-up. The study was halted due to insufficient recruitment (n = 15), and available results are reported. Results Per protocol analysis of the primary endpoint revealed a significantly larger reduction of mfVEP latency at 6 months compared to baseline with fingolimod treatment (n = 5; median decrease, 15.7 ms) than with IFN-β 1b treatment (n = 4; median increase, 8.15 ms) (p < 0.001 for interaction). Statistical significance was maintained in the secondary endpoint analysis. Descriptive results are reported for other endpoints. Conclusion Preliminary results of the MOVING trial argue in support of a beneficial effect of fingolimod on optic nerve remyelination when compared to IFN-β treatment. Interpretation is limited by the small number of complete observations, an unexpected deterioration of the control group and a difference in baseline mfVEP latencies. The findings need to be confirmed in larger studies. Trial registration The trial was registered as EUDRA-CT 2011–004787-30 on October 26, 2012 and as NCT01647880 on July 24, 2012.
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Affiliation(s)
- Christian Albert
- Department of Neurology, Alexianer St. Josefs-Krankenhaus Potsdam, Allee nach Sanssouci 7, 14471, Potsdam, Germany
| | - Janine Mikolajczak
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Anja Liekfeld
- Department of Ophthalmology, Klinikum Ernst von Bergmann, Potsdam, Germany
| | - Sophie K Piper
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | - Michael Scheel
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Hanna G Zimmermann
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | | | - Jan Dörr
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurology, Oberhavel-Kliniken Hennigsdorf, Hennigsdorf, Germany
| | | | - Claudia Chien
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany
| | - Alexander U Brandt
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany.,Department of Neurology, University of California, Irvine, CA, USA
| | - Friedemann Paul
- Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätmedizin Berlin, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrueck Center for Molecular Medicine and Charité-Universitätmedizin Berlin, Corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Olaf Hoffmann
- Department of Neurology, Alexianer St. Josefs-Krankenhaus Potsdam, Allee nach Sanssouci 7, 14471, Potsdam, Germany. .,Neurocure Clinical Research Center, Charite-Universitätsmedizin Berlin, Berlin, Germany.
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Pawlitzki M, Horbrügger M, Loewe K, Kaufmann J, Opfer R, Wagner M, Al-Nosairy KO, Meuth SG, Hoffmann MB, Schippling S. MS optic neuritis-induced long-term structural changes within the visual pathway. NEUROLOGY-NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:7/2/e665. [PMID: 32224498 PMCID: PMC7057062 DOI: 10.1212/nxi.0000000000000665] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 11/22/2019] [Indexed: 01/01/2023]
Abstract
Background The visual pathway is commonly involved in multiple sclerosis (MS), even in its early stages, including clinical episodes of optic neuritis (ON). The long-term structural damage within the visual compartment in patients with ON, however, is yet to be elucidated. Objective Our aim was to characterize visual system structure abnormalities using MRI along with optical coherence tomography (OCT) and pattern-reversal visual evoked potentials (VEPs) depending on a single history of ON. Methods Twenty-eight patients with clinically definitive MS, either with a history of a single ON (HON) or without such history and normal VEP findings (NON), were included. OCT measures comprised OCT-derived peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell/inner plexiform layer (GCIPL) thickness. Cortical and global gray and white matter, thalamic, and T2 lesion volumes were assessed using structural MRI. Diffusion-weighted MRI-derived measures included fractional anisotropy (FA), mean (MD), radial (RD), and axial (AD) diffusivity within the optic radiation (OR). Results Mean (SD) duration after ON was 8.3 (3.7) years. Compared with the NON group, HON patients showed significant RNFL (p = 0.01) and GCIPL thinning (p = 0.002). OR FA (p = 0.014), MD (p = 0.005), RD (p = 0.007), and AD (p = 0.004) were altered compared with NON. Global gray and white as well as other regional gray matter structures did not differ between the 2 groups. Conclusion A single history of ON induces long-term structural damage within the retina and OR suggestive of both retrograde and anterograde neuroaxonal degeneration.
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Affiliation(s)
- Marc Pawlitzki
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland.
| | - Marc Horbrügger
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Kristian Loewe
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Jörn Kaufmann
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Roland Opfer
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Markus Wagner
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Khaldoon O Al-Nosairy
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Sven G Meuth
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Michael B Hoffmann
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
| | - Sven Schippling
- From the Department of Neurology (M.P., M.H., K.L., J.K.), Otto von Guericke University, Magdeburg, Germany; Department of Neurology with Institute of Translational Neurology (M.P., S.G.M.), University Hospital Münster, Germany; Department of Computer Science (K.L.), Otto von Guericke University Magdeburg, Germany; Jung diagnostics GmbH (R.O.), Hamburg, Germany; Department of Ophthalmology (M.W., K.O.A.-N., M.B.H.), Otto von Guericke University, Magdeburg, Germany; Center of Behavioral Brain Sciences (M.B.H.), Magdeburg; Neuroimmunology and Multiple Sclerosis Research (R.O., S.S.), Department of Neurology, University Hospital Zurich, Switzerland; and Center for Neuroscience Zurich (S.S.), Federal Institute of Technology (ETH), Zurich, Switzerland
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Dalmau J, Dalakas MC, Kolson DL, Paul F, Zamvil SS. N2 year in review. NEUROLOGY(R) NEUROIMMUNOLOGY & NEUROINFLAMMATION 2020; 7:e644. [PMID: 31831570 PMCID: PMC6935839 DOI: 10.1212/nxi.0000000000000644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Josep Dalmau
- From the ICREA-IDIBAPS Hospital Clínic, University of Barcelona (J.D.), Spain; University of Pennsylvania (J.D., D.L.K.), Philadelphia; University of Athens Medical School (M.C.D.), Athens, Greece; Jefferson University (M.C.D.), Philadelphia, PA; Charite University Hospital (F.P.), Berlin, Germany; and Department of Neurology (S.S.Z.), University of California, San Francisco.
| | - Marinos C Dalakas
- From the ICREA-IDIBAPS Hospital Clínic, University of Barcelona (J.D.), Spain; University of Pennsylvania (J.D., D.L.K.), Philadelphia; University of Athens Medical School (M.C.D.), Athens, Greece; Jefferson University (M.C.D.), Philadelphia, PA; Charite University Hospital (F.P.), Berlin, Germany; and Department of Neurology (S.S.Z.), University of California, San Francisco
| | - Dennis L Kolson
- From the ICREA-IDIBAPS Hospital Clínic, University of Barcelona (J.D.), Spain; University of Pennsylvania (J.D., D.L.K.), Philadelphia; University of Athens Medical School (M.C.D.), Athens, Greece; Jefferson University (M.C.D.), Philadelphia, PA; Charite University Hospital (F.P.), Berlin, Germany; and Department of Neurology (S.S.Z.), University of California, San Francisco
| | - Friedemann Paul
- From the ICREA-IDIBAPS Hospital Clínic, University of Barcelona (J.D.), Spain; University of Pennsylvania (J.D., D.L.K.), Philadelphia; University of Athens Medical School (M.C.D.), Athens, Greece; Jefferson University (M.C.D.), Philadelphia, PA; Charite University Hospital (F.P.), Berlin, Germany; and Department of Neurology (S.S.Z.), University of California, San Francisco
| | - Scott S Zamvil
- From the ICREA-IDIBAPS Hospital Clínic, University of Barcelona (J.D.), Spain; University of Pennsylvania (J.D., D.L.K.), Philadelphia; University of Athens Medical School (M.C.D.), Athens, Greece; Jefferson University (M.C.D.), Philadelphia, PA; Charite University Hospital (F.P.), Berlin, Germany; and Department of Neurology (S.S.Z.), University of California, San Francisco
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Assessments of vessel density and foveal avascular zone metrics in multiple sclerosis: an optical coherence tomography angiography study. Eye (Lond) 2019; 34:771-778. [PMID: 31857713 DOI: 10.1038/s41433-019-0746-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/09/2019] [Accepted: 11/11/2019] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/OBJECTIVES To investigate optical coherence tomography angiography (OCT-A) findings of foveal avascular zone (FAZ) metrics and macular & peripapillary vessel densities (VD) in subjects with multiple sclerosis (MS). METHODS The study design was prospective and cross-sectional. FAZ metrics and VDs of the superficial capillary plexus (SCP), deep capillary plexus (DCP), retinal peripapillary capillary plexus (RPCP) along with the structural OCT measurements were scanned by using the Nidek's RS-3000 Advance in MS patients and healthy controls. All subject also underwent an assessment of visual evoked potentials (VEPs). The relationships between the OCT-A parameters with other clinical findings were analysed. RESULTS Forty-seven MS patients (94 eyes) and 61 healthy volunteers (122 eyes) were included in this study. Thirty-five eyes of the MS patients had an ON history. The structural OCT measurements were significantly differed between the groups (P < 0.001). All FAZ metrics were inversely correlated with central foveal thickness (CFT) (P < 0.001). The FAZ area and perimeter were inversely correlated with the VD of both SCP and DCP (P < 0.05). The VDs of SCP and DCP were significantly differed between the study groups (P < 0.001). The VEP latency was inversely correlated with the retinal nerve fibre layer, macular and ganglion cell layer thicknesses, the VD of SCP, and the VD of the DCP (P < 0.001). CONCLUSIONS Based on OCT angiography, VDs of macular and peripapillary area may be useful in detecting damage from ON in patients with MS.
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Segmented retinal layer analysis of chiasmal compressive optic neuropathy in pituitary adenoma patients. Graefes Arch Clin Exp Ophthalmol 2019; 258:419-425. [PMID: 31853626 DOI: 10.1007/s00417-019-04560-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/21/2019] [Accepted: 12/03/2019] [Indexed: 02/07/2023] Open
Abstract
AIMS To evaluate changes in the segmented retinal layers of pituitary adenoma (PA) patients and to identify the relationship between these changes and visual function. METHODS A total of 47 (PA patients) and 22 (healthy subjects) eyes were reviewed from the medical records. The PA patients performed a visual field (VF) test before surgery and 1 month after surgery. By optical coherence tomography scanning, eight retinal layers were measured: retinal nerve fiber layer (RNFL), ganglion cell layer (GCL), inner plexiform layer (IPL), inner nuclear layer (INL), outer plexiform layer, outer nuclear layer, retinal pigment epithelium, and photoreceptor layer. RESULTS The PA group showed reduced RNFL, GCL, and IPL thicknesses (p = 0.004,< 0.001,< 0.001) and thicker INL thickness (p = 0.012) than did the controls. The mean deviation of preoperative VF in the PA group was positively correlated with RNFL, GCL, and IPL thicknesses (R = 0.664, 0.720, 0.664; p < 0.001,< 0.001,< 0.001) and negatively correlated with the INL thickness (R = -0.400; p = 0.010). Among the 47 eyes, 32 eyes (68%) were included for subgroup analysis. Preoperative RNFL, GCL, and IPL thicknesses were thicker in the postoperatively improved VF group (p = 0.019, 0.009, 0.005). The preoperative cutoff values for visual recovery were 23.6 μm for RNFL thickness, 30.6 μm for GCL thickness, and 28.9 μm for IPL thickness. CONCLUSION During chiasmal compression, the thickening of the INL has presented in addition to thinning of the inner retinal layers. Also, changes in retinal anatomical structures are related to the extent of VF defect and can be used as a predictor of postoperative visual recovery.
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Gehr S, Kaiser T, Kreutz R, Ludwig WD, Paul F. Suggestions for improving the design of clinical trials in multiple sclerosis-results of a systematic analysis of completed phase III trials. EPMA J 2019; 10:425-436. [PMID: 31832116 PMCID: PMC6883016 DOI: 10.1007/s13167-019-00192-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/18/2019] [Indexed: 12/13/2022]
Abstract
This manuscript reviews the primary and secondary endpoints of pivotal phase III trials with immunomodulatory drugs in multiple sclerosis (MS). Considering the limitations of previous trial designs, we propose new standards for the planning of clinical trials, taking into account latest insights into MS pathophysiology and patient-relevant aspects. Using a systematic overview of published phase III (pivotal) trials performed as part of application for drug market approval, we evaluate the following characteristics: trial duration, number of trial participants, comparators, and endpoints (primary, secondary, magnetic resonance imaging outcome, and patient-reported outcomes). From a patient perspective, the primary and secondary endpoints of clinical trials are only partially relevant. High-quality trial data pertaining to efficacy and safety that stretch beyond the time frame of pivotal trials are almost non-existent. Understanding of long-term benefits and risks of disease-modifying MS therapy is largely lacking. Concrete proposals for the trial designs of relapsing (remitting) multiple sclerosis/clinically isolated syndrome, primary progressive multiple sclerosis, and secondary progressive multiple sclerosis (e.g., study duration, mechanism of action, and choice of endpoints) are presented based on the results of the systematic overview. Given the increasing number of available immunotherapies, the therapeutic strategy in MS has shifted from a mere "relapse-prevention" approach to a personalized provision of medical care as to the choice of the appropriate drugs and their sequential application over the course of the disease. This personalized provision takes patient preferences as well as disease-related factors into consideration such as objective clinical and radiographic findings but also very burdensome symptoms such as fatigue, depression, and cognitive impairment. Future trial designs in MS will have to assign higher relevance to these patient-reported outcomes and will also have to implement surrogate measures that can serve as predictive markers for individual treatment response to new and investigational immunotherapies. This is an indispensable prerequisite to maximize the benefit of individual patients when participating in clinical trials. Moreover, such appropriate trial designs and suitable enrolment criteria that correspond to the mode of action of the study drug will facilitate targeted prevention of adverse events, thus mitigating risks for individual study participants.
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Affiliation(s)
- Sinje Gehr
- Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Thomas Kaiser
- Institut für Qualität und Wirtschaftlichkeit im Gesundheitswesen (Institute for Quality and Efficiency in Health Care) (IQWiG), Im Mediapark 8, 50670 Köln, Germany
| | - Reinhold Kreutz
- Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Wolf-Dieter Ludwig
- Arzneimittelkommission der deutschen Ärzteschaft (Drug Commission of the German Medical Association), Herbert-Lewin-Platz 1, 10623 Berlin, Germany
| | - Friedemann Paul
- Charité Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
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48
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Motamedi S, Gawlik K, Ayadi N, Zimmermann HG, Asseyer S, Bereuter C, Mikolajczak J, Paul F, Kadas EM, Brandt AU. Normative Data and Minimally Detectable Change for Inner Retinal Layer Thicknesses Using a Semi-automated OCT Image Segmentation Pipeline. Front Neurol 2019; 10:1117. [PMID: 31824393 PMCID: PMC6886563 DOI: 10.3389/fneur.2019.01117] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Accepted: 10/07/2019] [Indexed: 01/12/2023] Open
Abstract
Neurodegenerative and neuroinflammatory diseases regularly cause optic nerve and retinal damage. Evaluating retinal changes using optical coherence tomography (OCT) in diseases like multiple sclerosis has thus become increasingly relevant. However, intraretinal segmentation, a necessary step for interpreting retinal changes in the context of these diseases, is not standardized and often requires manual correction. Here we present a semi-automatic intraretinal layer segmentation pipeline and establish normative values for retinal layer thicknesses at the macula, including dependencies on age, sex, and refractive error. Spectral domain OCT macular 3D volume scans were obtained from healthy participants using a Heidelberg Engineering Spectralis OCT. A semi-automated segmentation tool (SAMIRIX) based on an interchangeable third-party segmentation algorithm was developed and employed for segmentation, correction, and thickness computation of intraretinal layers. Normative data is reported from a 6 mm Early Treatment Diabetic Retinopathy Study (ETDRS) circle around the fovea. An interactive toolbox for the normative database allows surveying for additional normative data. We cross-sectionally evaluated data from 218 healthy volunteers (144 females/74 males, age 36.5 ± 12.3 years, range 18-69 years). Average macular thickness (MT) was 313.70 ± 12.02 μm, macular retinal nerve fiber layer thickness (mRNFL) 39.53 ± 3.57 μm, ganglion cell and inner plexiform layer thickness (GCIPL) 70.81 ± 4.87 μm, and inner nuclear layer thickness (INL) 35.93 ± 2.34 μm. All retinal layer thicknesses decreased with age. MT and GCIPL were associated with sex, with males showing higher thicknesses. Layer thicknesses were also positively associated with each other. Repeated-measurement reliability for the manual correction of automatic intraretinal segmentation results was excellent, with an intra-class correlation coefficient >0.99 for all layers. The SAMIRIX toolbox can simplify intraretinal segmentation in research applications, and the normative data application may serve as an expandable reference for studies, in which normative data cannot be otherwise obtained.
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Affiliation(s)
- Seyedamirhosein Motamedi
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kay Gawlik
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Noah Ayadi
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Hanna G Zimmermann
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanna Asseyer
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Charlotte Bereuter
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Janine Mikolajczak
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Friedemann Paul
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Ella Maria Kadas
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Alexander Ulrich Brandt
- NeuroCure Clinical Research Center, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Neurology, University of California, Irvine, Irvine, CA, United States
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Chien C, Oertel FC, Siebert N, Zimmermann H, Asseyer S, Kuchling J, Scheel M, Ruprecht K, Bellmann-Strobl J, Paul F, Brandt AU. Imaging markers of disability in aquaporin-4 immunoglobulin G seropositive neuromyelitis optica: a graph theory study. Brain Commun 2019; 1:fcz026. [PMID: 32954267 PMCID: PMC7425339 DOI: 10.1093/braincomms/fcz026] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/14/2019] [Accepted: 10/01/2019] [Indexed: 12/20/2022] Open
Abstract
Neuromyelitis optica spectrum disorders lack imaging biomarkers associated with disease course and supporting prognosis. This complex and heterogeneous set of disorders affects many regions of the central nervous system, including the spinal cord and visual pathway. Here, we use graph theory-based multimodal network analysis to investigate hypothesis-free mixed networks and associations between clinical disease with neuroimaging markers in 40 aquaporin-4-immunoglobulin G antibody seropositive patients (age = 48.16 ± 14.3 years, female:male = 36:4) and 31 healthy controls (age = 45.92 ± 13.3 years, female:male = 24:7). Magnetic resonance imaging measures included total brain and deep grey matter volumes, cortical thickness and spinal cord atrophy. Optical coherence tomography measures of the retina and clinical measures comprised of clinical attack types and expanded disability status scale were also utilized. For multimodal network analysis, all measures were introduced as nodes and tested for directed connectivity from clinical attack types and disease duration to systematic imaging and clinical disability measures. Analysis of variance, with group interactions, gave weights and significance for each nodal association (hyperedges). Connectivity matrices from 80% and 95% F-distribution networks were analyzed and revealed the number of combined attack types and disease duration as the most connected nodes, directly affecting changes in several regions of the central nervous system. Subsequent multivariable regression models, including interaction effects with clinical parameters, identified associations between decreased nucleus accumbens (β = −0.85, P = 0.021) and caudate nucleus (β = −0.61, P = 0.011) volumes with higher combined attack type count and longer disease duration, respectively. We also confirmed previously reported associations between spinal cord atrophy with increased number of clinical myelitis attacks. Age was the most important factor associated with normalized brain volume, pallidum volume, cortical thickness and the expanded disability status scale score. The identified imaging biomarker candidates warrant further investigation in larger-scale studies. Graph theory-based multimodal networks allow for connectivity and interaction analysis, where this method may be applied in other complex heterogeneous disease investigations with different outcome measures.
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Affiliation(s)
- Claudia Chien
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Frederike Cosima Oertel
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Nadja Siebert
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Hanna Zimmermann
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Susanna Asseyer
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Joseph Kuchling
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Michael Scheel
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neuroradiology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Klemens Ruprecht
- Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Judith Bellmann-Strobl
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Friedemann Paul
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neurology, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Alexander U Brandt
- Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,NeuroCure Clinical Research Center, Charité -Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.,Department of Neurology, University of California, Irvine, CA, USA
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Snow NJ, Wadden KP, Chaves AR, Ploughman M. Transcranial Magnetic Stimulation as a Potential Biomarker in Multiple Sclerosis: A Systematic Review with Recommendations for Future Research. Neural Plast 2019; 2019:6430596. [PMID: 31636661 PMCID: PMC6766108 DOI: 10.1155/2019/6430596] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 08/31/2019] [Indexed: 12/23/2022] Open
Abstract
Multiple sclerosis (MS) is a demyelinating disorder of the central nervous system. Disease progression is variable and unpredictable, warranting the development of biomarkers of disease status. Transcranial magnetic stimulation (TMS) is a noninvasive method used to study the human motor system, which has shown potential in MS research. However, few reviews have summarized the use of TMS combined with clinical measures of MS and no work has comprehensively assessed study quality. This review explored the viability of TMS as a biomarker in studies of MS examining disease severity, cognitive impairment, motor impairment, or fatigue. Methodological quality and risk of bias were evaluated in studies meeting selection criteria. After screening 1603 records, 30 were included for review. All studies showed high risk of bias, attributed largely to issues surrounding sample size justification, experimenter blinding, and failure to account for key potential confounding variables. Central motor conduction time and motor-evoked potentials were the most commonly used TMS techniques and showed relationships with disease severity, motor impairment, and fatigue. Short-latency afferent inhibition was the only outcome related to cognitive impairment. Although there is insufficient evidence for TMS in clinical assessments of MS, this review serves as a template to inform future research.
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Affiliation(s)
- Nicholas J. Snow
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Katie P. Wadden
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Arthur R. Chaves
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michelle Ploughman
- Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, Canada
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