Contributions
Abstract: P1083
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Previous studies demonstrated that brain MRI lesion load and evoked potential (EPs) abnormalities correlate with disability. Optical coherence tomography (OCT), with measurement of nervous layers, revealed useful in assessing axonal optic nerve damage and controversial studies suggest a correlation with disability. The present study aims at investigating, in early relapsing MS, correlation between RNFL and clinical and instrumental markers of nervous damage.
Methods: 110 patients (pts) affected by multiple sclerosis (MS) or clinical isolated syndromes suggestive of MS (CIS) were hospitalized at San Raffaele Hospital between June 2013 and March 2016 for neurological assessment and underwent contrast-enhanced MRI, multimodal EPs, OCT and cerebrospinal fluid examination with micovesicles count (MVs). RNFL was calculated as mean binocular value; only contralateral RNFL thickness was considered in pts with recent acute optic neuritis (< 6 months).
Results: Of 110 pts 71 were relapsing remitting MS, 39 were CIS. Mean age: 34 ± 12 yrs; mean disease duration: 1.8 ± 3.3; mean EDSS 1.45 ±0.97 yrs; 60 patients had a relapse within 3 months. RNFL was significantly associated with EDSS and disease duration (R -0,213 p=0,025 and R -0,244 p=0,01 respectively). It was also associated with the number of T2 white matter lesions (WML) evaluated into 3 classes: 0-2 lesions, 3-8 lesions and more than 8 lesions (ANOVA: F=11.3; p< 0,001), being lower in both moderate/high vs low lesion load group (post-hoc Ttest p< 0,001). RNFL was also associated with multimodal EPs, also considering only MEPs and SEPs. EPs were associated with EDSS. RNFL was not associated with concurrent disease activity, either as from brain gadolinium enhancing lesions and from microvesicles count in the cerebrospinal fluid, which are both considered as markers of inflammatory activity. On the other hand, microvesicles counts was significantly higher in the presence of gadolinium enhancing lesions (Mann-Whitney; p< 0,001) but not associated with WML.
Conclusions: The present study demonstrates that, even in early MS, RNFL is associated with the accumulation of nervous damage revealed by clinical, neurophysiological and neuroimaging measures, by reflecting parallel processes occurring in the optic pathways or transynaptic neuroaxonal loss. On the other hand, RNFL is not related to concurrent disease activity.
Disclosure: M. Pisa, T. Croese, S. Guerrieri, G. Di Maggio, S. Medaglini, U. Del Carro, R. Furlan: Nothing to disclosure
V. Martinelli received honoraria for consulting and speaking activities from Biogen, Merck-Serono, Bayer, TEVA, Novartis and Genzyme.
L. Moiola received honoraria for speaking at meetings or for attending to advisory board from Sanofi-Genzyme, Biogen-Idec, Novartis and TEVA.
G. Comi received honoraria for consulting services and for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, Forward Pharma
L. Leocani: has in the past year personal compensations from Biogen (Advisory Board); Almirall, Novartis (travel support). Biogen (travel support ), Merck Serono (research support).
Abstract: P1083
Type: Poster
Abstract Category: Pathology and pathogenesis of MS - OCT
Background: Previous studies demonstrated that brain MRI lesion load and evoked potential (EPs) abnormalities correlate with disability. Optical coherence tomography (OCT), with measurement of nervous layers, revealed useful in assessing axonal optic nerve damage and controversial studies suggest a correlation with disability. The present study aims at investigating, in early relapsing MS, correlation between RNFL and clinical and instrumental markers of nervous damage.
Methods: 110 patients (pts) affected by multiple sclerosis (MS) or clinical isolated syndromes suggestive of MS (CIS) were hospitalized at San Raffaele Hospital between June 2013 and March 2016 for neurological assessment and underwent contrast-enhanced MRI, multimodal EPs, OCT and cerebrospinal fluid examination with micovesicles count (MVs). RNFL was calculated as mean binocular value; only contralateral RNFL thickness was considered in pts with recent acute optic neuritis (< 6 months).
Results: Of 110 pts 71 were relapsing remitting MS, 39 were CIS. Mean age: 34 ± 12 yrs; mean disease duration: 1.8 ± 3.3; mean EDSS 1.45 ±0.97 yrs; 60 patients had a relapse within 3 months. RNFL was significantly associated with EDSS and disease duration (R -0,213 p=0,025 and R -0,244 p=0,01 respectively). It was also associated with the number of T2 white matter lesions (WML) evaluated into 3 classes: 0-2 lesions, 3-8 lesions and more than 8 lesions (ANOVA: F=11.3; p< 0,001), being lower in both moderate/high vs low lesion load group (post-hoc Ttest p< 0,001). RNFL was also associated with multimodal EPs, also considering only MEPs and SEPs. EPs were associated with EDSS. RNFL was not associated with concurrent disease activity, either as from brain gadolinium enhancing lesions and from microvesicles count in the cerebrospinal fluid, which are both considered as markers of inflammatory activity. On the other hand, microvesicles counts was significantly higher in the presence of gadolinium enhancing lesions (Mann-Whitney; p< 0,001) but not associated with WML.
Conclusions: The present study demonstrates that, even in early MS, RNFL is associated with the accumulation of nervous damage revealed by clinical, neurophysiological and neuroimaging measures, by reflecting parallel processes occurring in the optic pathways or transynaptic neuroaxonal loss. On the other hand, RNFL is not related to concurrent disease activity.
Disclosure: M. Pisa, T. Croese, S. Guerrieri, G. Di Maggio, S. Medaglini, U. Del Carro, R. Furlan: Nothing to disclosure
V. Martinelli received honoraria for consulting and speaking activities from Biogen, Merck-Serono, Bayer, TEVA, Novartis and Genzyme.
L. Moiola received honoraria for speaking at meetings or for attending to advisory board from Sanofi-Genzyme, Biogen-Idec, Novartis and TEVA.
G. Comi received honoraria for consulting services and for speaking activities from Novartis, Teva, Sanofi, Genzyme, Merck, Biogen, Excemed, Roche, Almirall, Chugai, Receptos, Forward Pharma
L. Leocani: has in the past year personal compensations from Biogen (Advisory Board); Almirall, Novartis (travel support). Biogen (travel support ), Merck Serono (research support).