Visual deficits and cognitive assessment of multiple sclerosis: confounder, correlate, or both?
J Neurol
; 268(7): 2578-2588, 2021 Jul.
Article
in En
| MEDLINE
| ID: mdl-33590339
ABSTRACT
BACKGROUND:
The relationship between visual impairment and cognitive performance in multiple sclerosis (MS) remains poorly understood.OBJECTIVE:
To determine associations between visual acuity and optical coherence tomography (OCT) measures with cognitive performance of MS patients and healthy controls (HCs).METHODS:
141 MS patients (with and without MS optic neuritis; MSON) and 50 HCs underwent neuropsychological, visual, and OCT testing. California Verbal Learning Test (CVLT-II), Brief Visuospatial Memory Test (BVMT-R), and Symbol Digit Modalities Test (SDMT) were used. Patients with test performance below - 1.5 standard deviations of the mean HCs scores were labeled as cognitive impairment. Visual ability was assessed with 100%, 2.5%, and 1.25% low-contrast letter acuity (LCLA) charts. OCT-derived peripapillary retinal nerve fiber layer (pRNFL) thickness, macular volume (MV), macular ganglion cell inner plexiform (mGCIP) thickness (as a sum of GC and IP layers), and macular inner nuclear layer (mINL) were computed.RESULTS:
100% and 2.5% LCLA associated with SDMT in MS and HCs (p < 0.001; and p < 0.012, respectively). In MSON patients, visually demanding tests were explained by pRNFL and macular volume for SDMT (ß = 0.172, p = 0.039 and ß = 0.27, p = 0.001) and MV for BVMT-R (ß = 0.21, p = 0.012). In non-MSON, only mINL was predictor of CVLT-II. pRNFL and MV predicted cognitive impairment with an accuracy of 72.2% (Negelkerke R2 = 0.234). These findings were driven by associations within the progressive MS subgroup. HC's SDMT performance was explained by mGCIP (ß = 0.316, p = 0.001).CONCLUSIONS:
Both LCLA and OCT-based measures (pRNFL and macular volume) were associated with MS cognitive performance. OCT-based measures were also significant predictors of cognitive status in MS patients. mGCIP associated with cognitive performance in HCs.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Optic Neuritis
/
Multiple Sclerosis
Type of study:
Prognostic_studies
Limits:
Humans
Language:
En
Journal:
J Neurol
Year:
2021
Document type:
Article
Affiliation country: