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Published on: April 14, 2014
Longitudinal optic neuritis-unrelated visual evoked potential changes in NMO spectrum disorders
Marius Ringelstein1, Jens Harmel1, Hanna Zimmermann1
1From the Department of Neurology, Medical Faculty (M.R., J. Harmel, J.G., H.-P.H., O.A., P.A.), and Department of Neurology, Center for Neurology and Neuropsychiatry, LVR-Klinikum (M.R.), Heinrich Heine University Düsseldorf; NeuroCure Clinical Research Center and Experimental and Clinical Research Center (H.Z., A.U.B., F.P.), Charité Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, and Max Delbrueck Center for Molecular Medicine, Germany; Department of Neurology (A.U.B.), University of California Irvine; Department of Neurology (A.H., M.B.), University of Würzburg; Department of Neurology (M.B.), Caritas Hospital, Bad Mergentheim; Clinical Neuroimmunology and Neurochemistry (M.W.H.), Department of Neurology (C.T.), Hannover Medical School; Department of Neurology (C.S., I.A., I.K., K.H.), St. Josef Hospital, Ruhr University Bochum, Germany; Department of Neurology (I.A.), Sechenov First Moscow State Medical University, Moscow, Russia; Marianne-Strauß-Klinik (I.K.), Behandlungszentrum Kempfenhausen für Multiple Sklerose Kranke, Berg; Institute of Clinical Neuroimmunology (J. Halva, T.K., H.P.), University Hospital, Ludwig-Maximilians University, Munich; Molecular Neuroimmunology Group, Department of Neurology (S.J., B.W.), University of Heidelberg, Germany; Department of Neurology (P.R.), Medical University of Vienna, Austria; Institute of Neuropathology (M.S.W.) and Department of Neurology (M.S.W., H.P., P.K.), University Medical Center Göttingen; Department of Neurology (L.R., C.G.), Jena University Hospital; Neuroimmunological Section, Department of Neurology (N.R., U.Z.), University of Rostock; Department of Neurology (M.D., L.K.), University of Münster; Department of Neurology and Institute of Neuroimmunology and MS (K.Y., J.-P.S.), University Medical Center Hamburg-Eppendorf; Department of Neurology (M.K., P.K.), Nordwest-Hospital Sanderbusch, Sande; Department of Neurology (W.M.), Helios Hanseklinikum Stralsund; Department of Neurology (F.L., H.T.), University of Ulm, Germany; and Faculty of Medicine and Health Sciences (A.K.), Macquarie University, Sydney, New South Wales, Australia.
Neuromyelitis optica spectrum disorder (NMOSD) patients show progressive visual pathway impairment, evidenced by delayed visual evoked potentials (VEP) latency, even without acute optic neuritis (ON). Further research is needed to confirm these findings and their clinical significance.
Area of Science:
- Neuroscience
- Ophthalmology
- Neurology
Background:
- Neuromyelitis optica spectrum disorder (NMOSD) is a severe autoimmune condition affecting the central nervous system.
- Visual pathway impairment is a common manifestation of NMOSD, often associated with optic neuritis (ON).
Purpose of the Study:
- To investigate subclinical visual pathway impairment in NMOSD patients independent of acute attacks.
- To analyze longitudinal changes in visual evoked potentials (VEP) in NMOSD patients.
Main Methods:
- Retrospective analysis of 548 full-field VEPs from 167 NMOSD patients across 16 centers.
- Evaluation of P100 latencies and P100-N140 amplitudes, analyzing rates of change (RCL and RCA) over time.
- Comparison of VEP changes using linear regression and generalized estimating equation models, considering intervals and history of ON.
Main Results:
- Progressive delay in P100 latencies (+1.951 ms/y) and decrease in P100-N140 amplitudes (-2.149 µV/y) were observed in NMOSD eyes without ON (≥3 months interval).
- Significant RCL (+1.768 ms/y) was noted for intervals ≥12 months, while RCA showed no significant change (p=0.111).
- Acute ON episodes during observation led to significant latency delays (+11.689 ms/y).
Conclusions:
- This study provides the first longitudinal evidence of progressive VEP latency delay in NMOSD patients, occurring independently of acute ON.
- Findings suggest subclinical visual pathway deterioration in NMOSD.
- Further prospective studies are recommended to validate these results and determine clinical relevance.
