Anterior Visual Pathway Measures and Cognition in MS

Optic Neuritis
Optic Neuritis
There was a significant association between the average GCIP thickness and MSFC scores.

Measurements of the anterior visual pathway are tied to cognitive function in multiple sclerosis  (MS) patients, particularly patients with relapsing-remitting MS (RRMS) without a history of optic neuritis, according to data presented at the 2016 CMSC Annual Meeting in National Harbor, MD.

Ganglion cell and inner plexiform layer (GCIP) thickness, a measurement of the anterior visual pathway, has been tied gray matter volume, visual function, and Expanded Disability Status Scale (EDSS) scores in patients with MS. It is not clear, however, if cognitive function in MS patients is also linked to GCIP thickness.

To investigate the relationship between visual function, GCIP thickness, and cognitive performance in MS, James V. Nguyen, of the Department Neurology at Johns Hopkins University in Baltimore, MD, and colleagues obtained Cirrus HD-optical coherence tomography (OCT), contrast letter acuity testing, and multiple cognitive assessments on 130 patients with MS. The participants included 33 patients with progressive MS and 97 patients with RRMS. Those with a history of acute optic neuritis in the prior 6 months were excluded from the study.

In patients with RRMS and no history of optic neuritis, there was a significant association between the average GCIP thickness and Multiple Sclerosis Functional Composite (MSFC) scores (P=.018). However, this association was not observed for patients with RRMS who had a history of optic neuritis (P=.392).

Likewise, the GCIP thickness in RRMS patients, but not progressive MS patients, was tied to Brief Visuospatial Memory Test-Revised (BVMT-R) scores (P=.015). This relationship was thought to be mostly driven by patients without a history of optic neuritis. RRMS patients without a history of optic neuritis  were also found to have an association between the MSFC scores and visual acuity on the 100%, 2.5%, and 1.25% contrast letter assessment  (P=.017, P=.004, and P=.017, respectively). Total and delayed recall BVMT-R scores were also found to be associated with 100%, 2.5%, and 1.25% contrast letter visual acuity  in MS patients with and without a history of optic neuritis (P<.002 for all).

The resutls suggest that GCIP thickness and contrast letter acuity testing have the potential to be used as outcomes in trials to assess neuroprotective treatments in MS, particularly RRMS patients with no history of optic neuritis.

Disclosures: Balcer, Frohman, Calabresi, and Saidha report financial disclosures related to pharmaceutical companies.

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Nguyen JV, Balcer LJ, Frohman EM, et al. Abstract CC02. Anterior Visual Pathway Measures Are Strongly Associated with Cognitive Function in Multiple Sclerosis. Presented at: 2016 CMSC Annual Meeting . June 1-4, 2016; National Harbor, MD.