Contributions
Abstract: P833
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background and Purpose: Involvement of the anterior and posterior visual pathway occurs commonly in paediatric multiple sclerosis (MS). In our pilot work, we have found that despite reduced monocular or binocular acuity in some children with MS, the magnitude of binocular summation is preserved, suggesting retention of this compensatory mechanism. The purpose of this study was to explore performance on other visually-related cognitive tasks.
Methods: We evaluated 21 paediatric MS patients (onset < 18 years, mean age at testing 17, range 13-18 years; 12 female; 8 with a history of ON) and 15 paediatric healthy controls through high and low contrast acuity (1.25%) testing, the Beery-Buktenica Developmental Test of Visual Motor Integration (bVMI), the Woodcock Johnson Visual Matching (WJVM) subtest, and the Symbol Digit Modalities Test (SDMT written version). Total letters read using HCVA and LCVA charts by each eye and using binocular testing were recorded and mean counts compared between groups. Mean values of the standardized scores for the bVMI, WJVM and SDMT were compared between MS patients and controls using student t-tests. Pearson correlations were performed to determine the strength of associations between cognitive tests, as well as between each test and the magnitude of binocular summation.
Results: Of 42 pediatric MS eyes, monocular HCVA (mean 53 letters, 1.6 SD) and LCVA (mean 11 letters, 1.8 SD) differed from that of the 30 control eyes (mean 57 letters, 1.4 SD HCVA, mean 22 letters, 1.4 SD, LCVA). There was no difference in binocular summation between controls and MS patients (p=0.536). The mean standardized scores did not differ for the bVMI between pediatric MS subjects and healthy controls (p=0.8381). For the WJVM, paediatric MS patients scored 9-points lower than the control group, (p=0.057), and SDMT z-scores were significantly lower in MS patients (p= 0.006). The bVMI, WJVM and SDMT did not correlate with the magnitude of binocular summation. Within the MS group, the WJVM correlated with the SDMT (correlation coefficient 0.6093, p=0.001).
Conclusion: Children with MS have preserved magnitude of binocular summation and in general, perform well on tests of higher order visual processing. The correlation between the WJVM and SDMT favors a relationship with processing speed, rather than visual perception, which may reflect a more general disruption of white matter rather than a specific impairment in visual networks.
Disclosure: Krystle Karoscik: nothing to disclose
Amy Lavery: nothing to disclose
Ritobrato Datta: nothing to disclose
Allison Thomas: nothing to disclose
Brenda Banwell: Dr. Banwell serves as a consultant for Novartis, and as an unpaid advisor on clinical trial design for Sanofi, Teva Neuroscience, and Biogen IDEC.
Amy Waldman: Dr. Waldman is currently funded by the National Institutes of Health (USA) and receives research support from Biogen Idec. She is also the site-PI for a clinical trial sponsored by Novartis, who has also provided travel reimbursement for study meetings. Prior research funding was provided by the National Multiple Sclerosis Society and the American Brain Foundation.
Abstract: P833
Type: Poster
Abstract Category: Clinical aspects of MS - Paediatric MS
Background and Purpose: Involvement of the anterior and posterior visual pathway occurs commonly in paediatric multiple sclerosis (MS). In our pilot work, we have found that despite reduced monocular or binocular acuity in some children with MS, the magnitude of binocular summation is preserved, suggesting retention of this compensatory mechanism. The purpose of this study was to explore performance on other visually-related cognitive tasks.
Methods: We evaluated 21 paediatric MS patients (onset < 18 years, mean age at testing 17, range 13-18 years; 12 female; 8 with a history of ON) and 15 paediatric healthy controls through high and low contrast acuity (1.25%) testing, the Beery-Buktenica Developmental Test of Visual Motor Integration (bVMI), the Woodcock Johnson Visual Matching (WJVM) subtest, and the Symbol Digit Modalities Test (SDMT written version). Total letters read using HCVA and LCVA charts by each eye and using binocular testing were recorded and mean counts compared between groups. Mean values of the standardized scores for the bVMI, WJVM and SDMT were compared between MS patients and controls using student t-tests. Pearson correlations were performed to determine the strength of associations between cognitive tests, as well as between each test and the magnitude of binocular summation.
Results: Of 42 pediatric MS eyes, monocular HCVA (mean 53 letters, 1.6 SD) and LCVA (mean 11 letters, 1.8 SD) differed from that of the 30 control eyes (mean 57 letters, 1.4 SD HCVA, mean 22 letters, 1.4 SD, LCVA). There was no difference in binocular summation between controls and MS patients (p=0.536). The mean standardized scores did not differ for the bVMI between pediatric MS subjects and healthy controls (p=0.8381). For the WJVM, paediatric MS patients scored 9-points lower than the control group, (p=0.057), and SDMT z-scores were significantly lower in MS patients (p= 0.006). The bVMI, WJVM and SDMT did not correlate with the magnitude of binocular summation. Within the MS group, the WJVM correlated with the SDMT (correlation coefficient 0.6093, p=0.001).
Conclusion: Children with MS have preserved magnitude of binocular summation and in general, perform well on tests of higher order visual processing. The correlation between the WJVM and SDMT favors a relationship with processing speed, rather than visual perception, which may reflect a more general disruption of white matter rather than a specific impairment in visual networks.
Disclosure: Krystle Karoscik: nothing to disclose
Amy Lavery: nothing to disclose
Ritobrato Datta: nothing to disclose
Allison Thomas: nothing to disclose
Brenda Banwell: Dr. Banwell serves as a consultant for Novartis, and as an unpaid advisor on clinical trial design for Sanofi, Teva Neuroscience, and Biogen IDEC.
Amy Waldman: Dr. Waldman is currently funded by the National Institutes of Health (USA) and receives research support from Biogen Idec. She is also the site-PI for a clinical trial sponsored by Novartis, who has also provided travel reimbursement for study meetings. Prior research funding was provided by the National Multiple Sclerosis Society and the American Brain Foundation.