Long-term Effect of Permanent Demyelination on Axonal Survival in Multiple Sclerosis.

Axons Evoked Potentials, Visual Humans Multiple Sclerosis Optic Neuritis Tomography, Optical Coherence

Journal

Neurology(R) neuroimmunology & neuroinflammation
ISSN: 2332-7812
Titre abrégé: Neurol Neuroimmunol Neuroinflamm
Pays: United States
ID NLM: 101636388

Informations de publication

Date de publication:
05 2022
Historique:
received: 10 10 2021
accepted: 24 01 2022
entrez: 4 3 2022
pubmed: 5 3 2022
medline: 28 4 2022
Statut: epublish

Résumé

To investigate the long-term effect of permanent demyelination on axonal attrition by examining an association between intereye asymmetry of the multifocal visual evoked potential (mfVEP) latency delay and subsequent thinning of retinal ganglion cell axons in patients with a long-standing history of unilateral optic neuritis (ON). Only patients with a significant degree of chronic demyelination (intereye latency asymmetry >5 ms) were included in this study. The level of optic nerve demyelination was estimated at baseline by the latency delay of mfVEP, while the degree of axonal loss was assessed by thinning of the retinal nerve fiber layer (RNFL) thickness between baseline and follow-up visits. Low-contrast visual acuity (LCVA) was also evaluated at baseline and follow-up. Patients were examined twice with an average interval of 6.1 ± 1.4 years. From 85 examined patients with multiple sclerosis, 28 satisfied inclusion criteria. Latency of the mfVEP was delayed, and RNFL thickness was reduced in ON eyes compared with fellow eyes at both visits. There was significant correlation between latency asymmetry and baseline or follow-up intereye RNFL thickness asymmetry. Intereye asymmetry of LCVA at baseline correlated with baseline latency asymmetry of mfVEP and baseline asymmetry of RNFL thickness. Latency of the mfVEP in ON eyes improved slightly during the follow-up period, whereas latency of the fellow eye remained stable. By contrast, RNFL thickness significantly declined in both ON and fellow eyes during the follow-up period. The rate of RNFL thinning in ON eyes, however, was more than 2 times faster compared with the fellow eyes ( Our study provides clear in vivo evidence that chronic demyelination significantly accelerates axonal loss. However, because this process is slow and its effect is mild, long-term monitoring is required to establish and confidently measure the neurodegenerative consequences of demyelination.

Sections du résumé

BACKGROUND AND OBJECTIVES
To investigate the long-term effect of permanent demyelination on axonal attrition by examining an association between intereye asymmetry of the multifocal visual evoked potential (mfVEP) latency delay and subsequent thinning of retinal ganglion cell axons in patients with a long-standing history of unilateral optic neuritis (ON).
METHODS
Only patients with a significant degree of chronic demyelination (intereye latency asymmetry >5 ms) were included in this study. The level of optic nerve demyelination was estimated at baseline by the latency delay of mfVEP, while the degree of axonal loss was assessed by thinning of the retinal nerve fiber layer (RNFL) thickness between baseline and follow-up visits. Low-contrast visual acuity (LCVA) was also evaluated at baseline and follow-up. Patients were examined twice with an average interval of 6.1 ± 1.4 years.
RESULTS
From 85 examined patients with multiple sclerosis, 28 satisfied inclusion criteria. Latency of the mfVEP was delayed, and RNFL thickness was reduced in ON eyes compared with fellow eyes at both visits. There was significant correlation between latency asymmetry and baseline or follow-up intereye RNFL thickness asymmetry. Intereye asymmetry of LCVA at baseline correlated with baseline latency asymmetry of mfVEP and baseline asymmetry of RNFL thickness. Latency of the mfVEP in ON eyes improved slightly during the follow-up period, whereas latency of the fellow eye remained stable. By contrast, RNFL thickness significantly declined in both ON and fellow eyes during the follow-up period. The rate of RNFL thinning in ON eyes, however, was more than 2 times faster compared with the fellow eyes (
DISCUSSION
Our study provides clear in vivo evidence that chronic demyelination significantly accelerates axonal loss. However, because this process is slow and its effect is mild, long-term monitoring is required to establish and confidently measure the neurodegenerative consequences of demyelination.

Identifiants

DOI: 10.1212/NXI.0000000000001155 PMID: 35241572 PMC: PMC8893590
pubmed: 35241572
pii: 9/3/e1155
doi: 10.1212/NXI.0000000000001155
pmc: PMC8893590
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

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Auteurs

Alexandr Klistorner (A)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia. sasha@eye.usyd.edu.au.

Samuel Klistorner (S)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia. sasha@eye.usyd.edu.au.
ORCID: 0000-0001-5761-5178

Yuyi You (Y)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia.

Stuart L Graham (SL)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia.

Con Yiannikas (C)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia.

John Parratt (J)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia.

Michael Barnett (M)

From the Save Sight Institute (A.K., S.K., and Y.Y.), Sydney Medical School, University of Sydney, New South Wales, Australia; Faculty of Medicine and Health Sciences (A.K., Y.Y., and S.L.G.), Macquarie University, Sydney, New South Wales, Australia; Royal North Shore Hospital (S.K., C.Y., and J.P.), Sydney, New South Wales, Australia; Brain and Mind Centre (M.B.), University of Sydney, New South Wales, Australia; and Sydney Neuroimaging Analysis Centre (M.B.), Camperdown, New South Wales, Australia.

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Classifications MeSH

questionsmedicales.fr › Cellules › Neurones › Neurofibres › Axones › Long-term Effect of Permanent Demyelination on...
questionsmedicales.fr › Phénomènes physiologiques oculaires › Potentiels évoqués visuels › Long-term Effect of Permanent Demyelination on...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Long-term Effect of Permanent Demyelination on...
questionsmedicales.fr › Maladies du système immunitaire › Maladies auto-immunes › Maladies auto-immunes du système nerveux › Maladies démyélinisantes auto-immunes du SNC › Sclérose en plaques › Long-term Effect of Permanent Demyelination on...
questionsmedicales.fr › Maladies de l'oeil › Atteintes du nerf optique › Névrite optique › Long-term Effect of Permanent Demyelination on...
questionsmedicales.fr › Techniques d'investigation › Imagerie optique › Tomographie optique › Tomographie par cohérence optique › Long-term Effect of Permanent Demyelination on...