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Abnormal eye movements predict disability in MS: two-year follow-up
Joy Derwenskus1, Janet C Rucker, Alessandro Serra
1Neurology Service, Louis Stokes Veterans Affairs Medical Center, 10701 East Boulevard, Cleveland OH 44106-1702, USA.
Annals of the New York Academy of Sciences
|April 14, 2005
Summary
Patients with multiple sclerosis (MS) and abnormal eye movements (AEM) showed significantly greater disability over two years. These AEM findings correlated with brainstem or cerebellar MRI abnormalities, indicating disease impact on motor and eye movement pathways.
Area of Science:
- Neurology
- Ophthalmology
- Neuroimaging
Background:
- Abnormal eye movements (AEM) in multiple sclerosis (MS) have been previously linked to increased disability.
- Understanding the long-term implications of AEM in MS is crucial for patient management.
Purpose of the Study:
- To investigate the association between AEM and general disability in MS patients over a two-year follow-up period.
- To explore the relationship between AEM, disability progression, and neuroimaging findings in MS.
Main Methods:
- A two-year prospective follow-up study involving 40 patients diagnosed with MS.
- Assessment of general disability using the Expanded Disability Status Scale (EDSS).
- Correlation analysis between eye movement status, EDSS scores, and Magnetic Resonance Imaging (MRI) findings in the brainstem and cerebellum.
Main Results:
- Patients exhibiting AEM (17 out of 40) demonstrated significantly higher disability levels (median EDSS 7.0) compared to those with normal eye movements (median EDSS 5.0) (p < .001).
- The presence of AEM and severe disability was strongly associated with abnormal MRI signals detected in the brainstem or cerebellum.
- These brain regions are critical for controlling eye movements and housing descending motor pathways.
Conclusions:
- Abnormal eye movements are a significant indicator of greater disability and disease burden in multiple sclerosis patients.
- MRI findings in the brainstem and cerebellum may explain the link between AEM and motor impairment in MS.
- AEM assessment and targeted neuroimaging can aid in evaluating disease severity and progression in MS.