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Inner nuclear layer and olfactory threshold are interlinked and reflect inflammatory activity in multiple sclerosis.

Gabriel Bsteh1, Harald Hegen2, Patrick Altmann1

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Summary

Retinal inner nuclear layer (INL) and olfactory threshold (OT) changes track short-term inflammation in multiple sclerosis (MS) relapses. These markers are linked and independent of relapse location, suggesting a central nervous system proinflammatory state.

Keywords:
Multiple sclerosisinner nuclear layerolfactory thresholdoptical coherence tomographyrelapse

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Area of Science:

  • Neuroscience
  • Ophthalmology
  • Immunology

Background:

  • Retinal inner nuclear layer (INL) thickness and olfactory threshold (OT) are linked to inflammatory activity in multiple sclerosis (MS).
  • Understanding the dynamic relationship between INL and OT in MS is crucial for monitoring disease activity.

Purpose of the Study:

  • To investigate the association between INL and OT in MS patients.
  • To determine if changes in INL and OT follow a specific time pattern relative to MS relapses.

Main Methods:

  • Utilized optical coherence tomography for INL assessment and Sniffin' Sticks for OT measurement.
  • Employed three cohorts: cross-sectional MS (n=260), longitudinal MS and controls (n=171 over 3 years), and longitudinal acute relapse MS and controls (n=55 over 24 weeks).

Main Results:

  • Cross-sectional analysis showed a strong correlation between INL, OT, and the number of previous relapses, with INL and OT being interdependent.
  • Longitudinal data revealed that INL thickness increased and OT scores decreased during relapse periods, independent of relapse location.
  • These alterations resolved within 12-24 weeks, particularly after escalating disease-modifying treatment.

Conclusions:

  • INL and OT serve as interconnected biomarkers for short-term inflammatory activity in MS.
  • Their temporal patterns are congruent and not influenced by relapse localization, indicating a potential systemic proinflammatory state.
  • These findings may offer novel insights into MS pathogenesis and monitoring.