1
|
Suh A, Hampel G, Vinjamuri A, Ong J, Kamran SA, Waisberg E, Paladugu P, Zaman N, Sarker P, Tavakkoli A, Lee AG. Oculomics analysis in multiple sclerosis: Current ophthalmic clinical and imaging biomarkers. Eye (Lond) 2024:10.1038/s41433-024-03132-y. [PMID: 38858520 DOI: 10.1038/s41433-024-03132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/18/2024] [Accepted: 05/07/2024] [Indexed: 06/12/2024] Open
Abstract
Multiple Sclerosis (MS) is a chronic autoimmune demyelinating disease of the central nervous system (CNS) characterized by inflammation, demyelination, and axonal damage. Early recognition and treatment are important for preventing or minimizing the long-term effects of the disease. Current gold standard modalities of diagnosis (e.g., CSF and MRI) are invasive and expensive in nature, warranting alternative methods of detection and screening. Oculomics, the interdisciplinary combination of ophthalmology, genetics, and bioinformatics to study the molecular basis of eye diseases, has seen rapid development through various technologies that detect structural, functional, and visual changes in the eye. Ophthalmic biomarkers (e.g., tear composition, retinal nerve fibre layer thickness, saccadic eye movements) are emerging as promising tools for evaluating MS progression. The eye's structural and embryological similarity to the brain makes it a potentially suitable assessment of neurological and microvascular changes in CNS. In the advent of more powerful machine learning algorithms, oculomics screening modalities such as optical coherence tomography (OCT), eye tracking, and protein analysis become more effective tools aiding in MS diagnosis. Artificial intelligence can analyse larger and more diverse data sets to potentially discover new parameters of pathology for efficiently diagnosing MS before symptom onset. While there is no known cure for MS, the integration of oculomics with current modalities of diagnosis creates a promising future for developing more sensitive, non-invasive, and cost-effective approaches to MS detection and diagnosis.
Collapse
Affiliation(s)
- Alex Suh
- Tulane University School of Medicine, New Orleans, LA, USA.
| | - Gilad Hampel
- Tulane University School of Medicine, New Orleans, LA, USA
| | | | - Joshua Ong
- Michigan Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Sharif Amit Kamran
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Ethan Waisberg
- University College Dublin School of Medicine, Belfield, Dublin, Ireland
| | - Phani Paladugu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Nasif Zaman
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Prithul Sarker
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Alireza Tavakkoli
- Human-Machine Perception Laboratory, Department of Computer Science and Engineering, University of Nevada, Reno, Reno, NV, USA
| | - Andrew G Lee
- Center for Space Medicine, Baylor College of Medicine, Houston, TX, USA
- Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA
- The Houston Methodist Research Institute, Houston Methodist Hospital, Houston, TX, USA
- Departments of Ophthalmology, Neurology, and Neurosurgery, Weill Cornell Medicine, New York, NY, USA
- Department of Ophthalmology, University of Texas Medical Branch, Galveston, TX, USA
- University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Texas A&M College of Medicine, Galveston, TX, USA
- Department of Ophthalmology, The University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| |
Collapse
|
2
|
Bistolfi F. Extremely Low-Frequency Pulsed Magnetic Fields and Multiple Sclerosis: Effects on Neurotransmission Alone or Also on Immunomodulation? Building a Working Hypothesis. Neuroradiol J 2016; 20:676-93. [DOI: 10.1177/197140090702000612] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2007] [Accepted: 09/17/2007] [Indexed: 11/15/2022] Open
Abstract
This paper outlines the current state of knowledge on the pathology and treatment of multiple sclerosis (MS) and critically analyses the vast clinical experience of Sandyk in the use of pulsed magnetic fields of 5 Hz at 7.5 pT to treat many symptoms of MS. A complete regression of symptoms, or at least a major improvement, is sometimes so rapid as to suggest that ELF fields exert a greater effect on axonal and synaptic neurotransmission than on the processes leading to demyelination. Pulsed magnetic fields of 50–100 Hz and a few mT (whose flux intensity is 109 times greater than that of the fields used by Sandyk) have been seen to induce profound morphological changes (the Marinozzi effect) in the plasma membrane of several cell types, including Raji human lymphoblastoid cells. These observations underlie the author's hypothesis on the possible use of such fields in the treatment of MS. Indeed, these fields should induce the functional arrest of the cells (B- and T-lymphocytes, macrophages, microglia, dendritic cells) of the MS plaque, thereby providing an ‘electromagnetic immunomodulatory boost’ to the effects of drug therapy. To test this working hypothesis, it is suggested that preliminary experimental research be carried out to ascertain: 1) the Marinozzi effect in vivo; 2) the Marinozzi effect on microglia and dendritic cells; and 3) the duration of the membrane changes and their relaxation rate. ELF magnetic fields in the picotesla and millitesla ranges are aimed at improving neurotransmission and correcting local immune pathology, respectively. Both types of field might find application in the treatment of MS patients who no longer respond to or tolerate currently used drugs.
Collapse
Affiliation(s)
- F. Bistolfi
- Radiotherapy Department, Galliera Hospital, Genoa, Italy
| |
Collapse
|
3
|
Stereoacuity testing discloses abnormalities in multiple sclerosis without optic neuritis. J Neuroophthalmol 2009; 29:197-202. [PMID: 19726941 DOI: 10.1097/wno.0b013e3181b56764] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND We aimed to determine the value of stereoacuity testing in detecting subclinical disease activity in patients with multiple sclerosis (MS) without a history or clinical evidence of optic neuritis. METHODS We enrolled 23 patients with MS and 23 age-matched and sex-matched healthy control subjects with Snellen acuities of 20/20 in both eyes. We recorded monocular pattern visual evoked potentials (PVEPs) to 60-minute and 15-minute check sizes and tested stereoacuity by the Randot stereoacuity (RSA) test. RESULTS The MS group showed delayed PVEP latencies to 60-minute and 15-minute patterns (P < 0.001 and 0.002). Stereoacuity by the RSA test was significantly worse in patients with MS than in control subjects (P < 0.001). In the MS group, the PVEP P100 latency and the RSA values showed significant positive correlations. There was no significant correlation between the time from MS diagnosis and the RSA and PVEP values. CONCLUSIONS Based on this study, patients with MS without optic neuritis have considerable abnormalities in stereopsis. RSA testing may be a useful marker of subclinical disease activity in this condition.
Collapse
|