Differences in Age-Related Retinal and Cortical Atrophy Rates in Multiple Sclerosis

The timing of neurodegeneration in multiple sclerosis (MS) remains unclear. It is critical to understand the dynamics of neuroaxonal loss if we hope to prevent or forestall permanent disability in MS. We therefore used a deeply phenotyped longitudinal cohort to assess and compare rates of neurodegen...

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Published in:	Neurology Vol. 99; no. 15; pp. e1685 - e1693
Main Authors:	Cordano, Christian, Nourbakhsh, Bardia, Yiu, Hao H, Papinutto, Nico, Caverzasi, Eduardo, Abdelhak, Ahmed C, Cosima C Oertel, Frederike, Beaudry-Richard, Alexandra, Santaniello, Adam, Sacco, Simone, Bennett, Daniel J, Gomez, Apraham, Sigurdson, Christina J., Hauser, Stephen L., Magliozzi, Roberta, Campbell Cree, Bruce Anthony, Henry, Roland G., Green, Ari J.
Format:	Journal Article
Language:	English
Published:	United States Lippincott Williams & Wilkins 11-10-2022
Subjects:	Adult Atrophy - pathology Humans Infant Infant, Newborn Middle Aged Multiple Sclerosis - complications Multiple Sclerosis - diagnostic imaging Multiple Sclerosis - pathology Multiple Sclerosis, Relapsing-Remitting - complications Multiple Sclerosis, Relapsing-Remitting - diagnostic imaging Multiple Sclerosis, Relapsing-Remitting - pathology Neurodegenerative Diseases - pathology Retina - diagnostic imaging Retina - pathology Tomography, Optical Coherence
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Summary:	The timing of neurodegeneration in multiple sclerosis (MS) remains unclear. It is critical to understand the dynamics of neuroaxonal loss if we hope to prevent or forestall permanent disability in MS. We therefore used a deeply phenotyped longitudinal cohort to assess and compare rates of neurodegeneration in retina and brain throughout the MS disease course. We analyzed 597 patients with MS who underwent longitudinal optical coherence tomography imaging annually for 4.5 ± 2.4 years and 432 patients who underwent longitudinal MRI scans for 10 ± 3.4 years, quantifying macular ganglion cell-inner plexiform layer (GCIPL) volume and cortical gray matter (CGM) volume. The association between the slope of decline in the anatomical structure and the age of entry in the cohort (categorized by the MRI cohort's age quartiles) was assessed by hierarchical linear models. The rate of CGM volume loss declined with increasing age of study entry (1.3% per year atrophy for the age of entry in the cohort younger than 35 years; 1.1% for older than 35 years and younger than 41; 0.97% for older than 41 years and younger than 49; 0.9% for older than 49 years) while the rate of GCIPL thinning was highest in patients in the youngest quartile, fell by more than 50% in the following age quartile, and then stabilized (0.7% per year thinning for the age of entry in the cohort younger than 35 years; 0.29% for age older than 35 and younger than 41 years; 0.34% for older than 41 and younger than 49 years; 0.33% for age older than 49 years). An age-dependent reduction in retinal and cortical volume loss rates during relapsing-remitting MS suggests deceleration in neurodegeneration in the earlier period of disease and further indicates that the period of greatest adaptive immune-mediated inflammatory activity is also the period with the greatest neuroaxonal loss.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article. These authors are co-corresponding authors. These author contributed equally to this manuscript. Solicited and externally peer reviewed. The handling editor was Olga Ciccarelli, MD, PhD, FRCP.
ISSN:	0028-3878 1526-632X
DOI:	10.1212/WNL.0000000000200977