Optical coherence tomography reflects brain atrophy in multiple sclerosis: A four-year study.

Autor: Saidha S; Department of Neurology, Johns Hopkins University, Baltimore, MD., Al-Louzi O; Department of Neurology, Johns Hopkins University, Baltimore, MD., Ratchford JN; Department of Neurology, Johns Hopkins University, Baltimore, MD., Bhargava P; Department of Neurology, Johns Hopkins University, Baltimore, MD., Oh J; Department of Neurology, Johns Hopkins University, Baltimore, MD., Newsome SD; Department of Neurology, Johns Hopkins University, Baltimore, MD., Prince JL; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD.; Department of Computer Science, Johns Hopkins University, Baltimore, MD.; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD., Pham D; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD.; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD.; Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD., Roy S; Department of Electrical and Computer Engineering, Johns Hopkins University, Baltimore, MD.; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD.; Center for Neuroscience and Regenerative Medicine, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD., van Zijl P; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD., Balcer LJ; Department of Neurology, New York University Langone Medical Center, New York, NY., Frohman EM; Department of Neurology and Ophthalmology, University of Texas Southwestern, Dallas, TX., Reich DS; Department of Neurology, Johns Hopkins University, Baltimore, MD.; Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, MD.; Department of Biostatistics, Johns Hopkins University, Baltimore, MD.; Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke, Bethesda, MD., Crainiceanu C; Department of Biostatistics, Johns Hopkins University, Baltimore, MD., Calabresi PA; Department of Neurology, Johns Hopkins University, Baltimore, MD.
Jazyk: angličtina
Zdroj: Annals of neurology [Ann Neurol] 2015 Nov; Vol. 78 (5), pp. 801-13. Date of Electronic Publication: 2015 Oct 01.
DOI: 10.1002/ana.24487
Abstrakt: Objective: The aim of this work was to determine whether atrophy of specific retinal layers and brain substructures are associated over time, in order to further validate the utility of optical coherence tomography (OCT) as an indicator of neuronal tissue damage in patients with multiple sclerosis (MS).
Methods: Cirrus high-definition OCT (including automated macular segmentation) was performed in 107 MS patients biannually (median follow-up: 46 months). Three-Tesla magnetic resonance imaging brain scans (including brain-substructure volumetrics) were performed annually. Individual-specific rates of change in retinal and brain measures (estimated with linear regression) were correlated, adjusting for age, sex, disease duration, and optic neuritis (ON) history.
Results: Rates of ganglion cell + inner plexiform layer (GCIP) and whole-brain (r = 0.45; p < 0.001), gray matter (GM; r = 0.37; p < 0.001), white matter (WM; r = 0.28; p = 0.007), and thalamic (r = 0.38; p < 0.001) atrophy were associated. GCIP and whole-brain (as well as GM and WM) atrophy rates were more strongly associated in progressive MS (r = 0.67; p < 0.001) than relapsing-remitting MS (RRMS; r = 0.33; p = 0.007). However, correlation between rates of GCIP and whole-brain (and additionally GM and WM) atrophy in RRMS increased incrementally with step-wise refinement to exclude ON effects; excluding eyes and then patients (to account for a phenotype effect), the correlation increased to 0.45 and 0.60, respectively, consistent with effect modification. In RRMS, lesion accumulation rate was associated with GCIP (r = -0.30; p = 0.02) and inner nuclear layer (r = -0.25; p = 0.04) atrophy rates.
Interpretation: Over time GCIP atrophy appears to mirror whole-brain, and particularly GM, atrophy, especially in progressive MS, thereby reflecting underlying disease progression. Our findings support OCT for clinical monitoring and as an outcome in investigative trials.
(© 2015 American Neurological Association.)
Databáze: MEDLINE
Externí odkaz: