Contributions
Abstract: P334
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: In neuromyelitis optica spectrum disorders (NMOSD) relapse-dependent accumulation of central nervous system damage is key to our current understanding of fixed neurological deficits. However, little is known about possible chronic subclinical disease processes occurring independently of acute attacks such as optic neuritis (ON) or transverse myelitis. Visual evoked potentials (VEPs) provide objective functional measures of the visual pathway.
Objective: To investigate if subclinical disease progression occurs within the visual system of NMOSD patients independently of acute ON.
Design: Retrospective longitudinal multi-center study at 16 centers of the German Neuromyelitis optica study group (NEMOS) between May 1994 and May 2017.
Methods: Five hundred sixty-four full-field VEPs of 172 NMOSD patients were longitudinally assessed. For analyses, 209 eyes of 105 predominantly Caucasian (93.3%) and female (83.3%) NMOSD patients were eligible. Rates of change over time for P100 peak-latencies (RCL) and P100-N140 peak-to-peak-amplitudes (RCA) were analyzed for each individual eye using linear regression and compared using generalized estimating equation models.
Results: A median of three VEPs per patient were performed over a median interval of 32 months. The rates of change in the absence of ON during the interval were +1.951ms/year (N=101 eyes; SD=6.274; p=0.012) for the P100-latencies and -2.149µV/year (N=64 eyes; SD=5.013; p=0.005) for the P100-N140-amplitudes. The history of a previous ON, that had occurred >6 months before baseline VEP, had no influence on RCL and RCA. ONs during the observational period led to mean RCL and RCA of +11.689ms/year (N=16 eyes; SD=17.593; p=0.003) and -1.238µV/year (N=11 eyes; SD=3.708; p=0.308), respectively.
Conclusions: This first longitudinal VEP study provides evidence of subclinical disease progression within the visual pathway of NMOSD patients, occurring independently of acute ON attacks. These findings could have an impact on the disease prognosis and management of NMOSD patients and add novel insights into the pathophysiology of the disease.
Disclosure: MR received speaker honoraria from Novartis, Bayer Vital GmbH and Ipsen and travel reimbursement from Bayer Schering, Biogen Idec, Merz, Genzyme, Teva and Merck, none related to this study.
JHar has nothing to disclose.
HZ received speaking honoraria from Teva and Bayer and a research grant from Novartis.
AUB received consulting fees unrelated to this study for research from Novartis, Biogen, Motognosis, Teva, and Bayer.
FP reports grants and personal compensations from Alexion, Bayer, Biogen, Shire, Novartis, Medimmune, Merck and Genzyme.
AH has nothing to disclose.
MB has nothing to disclose.
MWH has received travel grants for attending meetings from Novartis and Bayer HealthCare, none related to this study.
CT has received honoraria for consultation and expert testimony from Biogen GmbH, Genzyme GmbH, and Novartis Pharma GmbH.
CS has nothing to disclose.
IA received honoraria for consultancy travel reimbursement from Biogen Idec and Roche and grant support from Chugai.
IK received honoraria for consultancy or lectures and travel reimbursement from Bayer Health Care, Biogen Idec, Chugai, Merck, Novartis, Shire, and Roche and grant support from Chugai and Diamed.
KH reports grants and personal fees from Bayer healthcare, grants and personal fees from Biogen, grants and personal fees from Teva, grants and personal fees from Merck Serono, grants and personal fees from Novartis, grants and personal fees from Almirall.
JHav received speaker honoraria, travel expenses, and personal compensations from Merck, Santhera, Biogen, Bayer Healthcare, Roche, Sanofi Genzyme and Novartis Pharma.
TK has received travel expenses and speaker honoraria from Bayer Healthcare, Teva Pharma, Merck, Novartis Pharma, Sanofi-Aventis/Genzyme, CLB Behring, Roche Pharma and Biogen as well as grant support from Bayer-Schering AG, Novartis and Chugai Pharma.
SJ has received a Research Grant from the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).
BW has received grants from the German Ministry of Education and Research, Dietmar Hopp Foundation, Biogen, Biotest, Merck, Novartis Pharmaceuticals, Teva Pharma; personal fees, Biogen, Merck, Novartis Pharmaceuticals, Teva Pharma, Bayer Healthcare, Genzyme.
PR received honoraria for consultancy or lectures and travel reimbursement from Biogen, Merck, Roche, Sanofi-Genzyme. Research grants from Merck, Roche.
MSW receives research support from the National Multiple Sclerosis Society (NMSS; PP 1660), the Deutsche Forschungsgemeinschaft (DFG; WE 3547/5-1), from Novartis, TEVA, Biogen-Idec, Roche, Merck and the ProFutura Programm of the Universitätsmedizin Göttingen. MSW is serving as an editor for PLoS One. He received travel funding and/or speaker honoraria from Biogen-Idec, Merck Serono, Novartis, Roche, TEVA, Bayer and Genzyme.
HP received honoraria for lectures from Bayer Health Care, Biogen Idec, and Teva Pharma and travel reimbursement from Novartis.
LR has nothing to disclose.
CG received honoraria for lectures, travel reimbursement and grant support from Merck Serono, Teva, Novartis, and CSL Behring.
NR has nothing to disclose.
UZ has patents, whether planned, pending or issued, broadly relevant to the work.
MD has nothing to disclose.
LK has received honoraria for lecturing and serving on advisory boards as well as travel expenses for attending meetings and financial research support from Novartis, Biogen, Roche, Merck, Sanofi Genzyme and the DFG and the Bundesministerium für Bildung und Forschung (BMBF).
KY has nothing to disclose.
JPS received honoraria for consultancy or lectures, travel reimbursement and grant support from Biogen, Merck Serono, Novartis, Genzyme and Medimmune.
MK has nothing to disclose.
PK received honoraria, travel reimbursement or research support from Bayer, Biogen, Genzyme, Merck, Novartis and TEVA.
WM has nothing to disclose.
FL has nothing to disclose.
HT received funding for research projects, lectures and travel from Bayer, Biogen, Genzyme-Sanofi, Fresenius, Merck, Novartis, Roche, Siemens Health Diagnostics, Teva, and received research support from Hertie-Stiftung, DMSG, BMBF, University of Ulm and Landesstiftung BW.
JG has nothing to disclose.
HPH received, with approval of the Rector of Heinrich-Heine-University and the CEO of University of Düsseldorf Hospital honoraria for consulting, serving on steering committees and speaking from Bayer, Biogen, Geneuro, Genzyme, Medimmune, Merck, Novartis, Receptos Celgene, Roche, Sanofi and Teva.
OA has received honoraria for speaking/consultation and travel grants from Bayer Healthcare, Biogen Idec, Chugai, Novartis, Merck Serono, and Teva and research grants from Bayer Healthcare, Biogen Idec, Novartis, and Teva.
PA reports grants, personal fees and non-financial support from Allergan, Biogen, Ipsen, Merz Pharmaceuticals, Novartis, and Roche, personal fees and non-financial support from Bayer Healthcare, and Merck, and non-financial support from Sanofi-Aventis/Genzyme, outside the submitted work.
Abstract: P334
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: In neuromyelitis optica spectrum disorders (NMOSD) relapse-dependent accumulation of central nervous system damage is key to our current understanding of fixed neurological deficits. However, little is known about possible chronic subclinical disease processes occurring independently of acute attacks such as optic neuritis (ON) or transverse myelitis. Visual evoked potentials (VEPs) provide objective functional measures of the visual pathway.
Objective: To investigate if subclinical disease progression occurs within the visual system of NMOSD patients independently of acute ON.
Design: Retrospective longitudinal multi-center study at 16 centers of the German Neuromyelitis optica study group (NEMOS) between May 1994 and May 2017.
Methods: Five hundred sixty-four full-field VEPs of 172 NMOSD patients were longitudinally assessed. For analyses, 209 eyes of 105 predominantly Caucasian (93.3%) and female (83.3%) NMOSD patients were eligible. Rates of change over time for P100 peak-latencies (RCL) and P100-N140 peak-to-peak-amplitudes (RCA) were analyzed for each individual eye using linear regression and compared using generalized estimating equation models.
Results: A median of three VEPs per patient were performed over a median interval of 32 months. The rates of change in the absence of ON during the interval were +1.951ms/year (N=101 eyes; SD=6.274; p=0.012) for the P100-latencies and -2.149µV/year (N=64 eyes; SD=5.013; p=0.005) for the P100-N140-amplitudes. The history of a previous ON, that had occurred >6 months before baseline VEP, had no influence on RCL and RCA. ONs during the observational period led to mean RCL and RCA of +11.689ms/year (N=16 eyes; SD=17.593; p=0.003) and -1.238µV/year (N=11 eyes; SD=3.708; p=0.308), respectively.
Conclusions: This first longitudinal VEP study provides evidence of subclinical disease progression within the visual pathway of NMOSD patients, occurring independently of acute ON attacks. These findings could have an impact on the disease prognosis and management of NMOSD patients and add novel insights into the pathophysiology of the disease.
Disclosure: MR received speaker honoraria from Novartis, Bayer Vital GmbH and Ipsen and travel reimbursement from Bayer Schering, Biogen Idec, Merz, Genzyme, Teva and Merck, none related to this study.
JHar has nothing to disclose.
HZ received speaking honoraria from Teva and Bayer and a research grant from Novartis.
AUB received consulting fees unrelated to this study for research from Novartis, Biogen, Motognosis, Teva, and Bayer.
FP reports grants and personal compensations from Alexion, Bayer, Biogen, Shire, Novartis, Medimmune, Merck and Genzyme.
AH has nothing to disclose.
MB has nothing to disclose.
MWH has received travel grants for attending meetings from Novartis and Bayer HealthCare, none related to this study.
CT has received honoraria for consultation and expert testimony from Biogen GmbH, Genzyme GmbH, and Novartis Pharma GmbH.
CS has nothing to disclose.
IA received honoraria for consultancy travel reimbursement from Biogen Idec and Roche and grant support from Chugai.
IK received honoraria for consultancy or lectures and travel reimbursement from Bayer Health Care, Biogen Idec, Chugai, Merck, Novartis, Shire, and Roche and grant support from Chugai and Diamed.
KH reports grants and personal fees from Bayer healthcare, grants and personal fees from Biogen, grants and personal fees from Teva, grants and personal fees from Merck Serono, grants and personal fees from Novartis, grants and personal fees from Almirall.
JHav received speaker honoraria, travel expenses, and personal compensations from Merck, Santhera, Biogen, Bayer Healthcare, Roche, Sanofi Genzyme and Novartis Pharma.
TK has received travel expenses and speaker honoraria from Bayer Healthcare, Teva Pharma, Merck, Novartis Pharma, Sanofi-Aventis/Genzyme, CLB Behring, Roche Pharma and Biogen as well as grant support from Bayer-Schering AG, Novartis and Chugai Pharma.
SJ has received a Research Grant from the European Committee for Treatment and Research in Multiple Sclerosis (ECTRIMS).
BW has received grants from the German Ministry of Education and Research, Dietmar Hopp Foundation, Biogen, Biotest, Merck, Novartis Pharmaceuticals, Teva Pharma; personal fees, Biogen, Merck, Novartis Pharmaceuticals, Teva Pharma, Bayer Healthcare, Genzyme.
PR received honoraria for consultancy or lectures and travel reimbursement from Biogen, Merck, Roche, Sanofi-Genzyme. Research grants from Merck, Roche.
MSW receives research support from the National Multiple Sclerosis Society (NMSS; PP 1660), the Deutsche Forschungsgemeinschaft (DFG; WE 3547/5-1), from Novartis, TEVA, Biogen-Idec, Roche, Merck and the ProFutura Programm of the Universitätsmedizin Göttingen. MSW is serving as an editor for PLoS One. He received travel funding and/or speaker honoraria from Biogen-Idec, Merck Serono, Novartis, Roche, TEVA, Bayer and Genzyme.
HP received honoraria for lectures from Bayer Health Care, Biogen Idec, and Teva Pharma and travel reimbursement from Novartis.
LR has nothing to disclose.
CG received honoraria for lectures, travel reimbursement and grant support from Merck Serono, Teva, Novartis, and CSL Behring.
NR has nothing to disclose.
UZ has patents, whether planned, pending or issued, broadly relevant to the work.
MD has nothing to disclose.
LK has received honoraria for lecturing and serving on advisory boards as well as travel expenses for attending meetings and financial research support from Novartis, Biogen, Roche, Merck, Sanofi Genzyme and the DFG and the Bundesministerium für Bildung und Forschung (BMBF).
KY has nothing to disclose.
JPS received honoraria for consultancy or lectures, travel reimbursement and grant support from Biogen, Merck Serono, Novartis, Genzyme and Medimmune.
MK has nothing to disclose.
PK received honoraria, travel reimbursement or research support from Bayer, Biogen, Genzyme, Merck, Novartis and TEVA.
WM has nothing to disclose.
FL has nothing to disclose.
HT received funding for research projects, lectures and travel from Bayer, Biogen, Genzyme-Sanofi, Fresenius, Merck, Novartis, Roche, Siemens Health Diagnostics, Teva, and received research support from Hertie-Stiftung, DMSG, BMBF, University of Ulm and Landesstiftung BW.
JG has nothing to disclose.
HPH received, with approval of the Rector of Heinrich-Heine-University and the CEO of University of Düsseldorf Hospital honoraria for consulting, serving on steering committees and speaking from Bayer, Biogen, Geneuro, Genzyme, Medimmune, Merck, Novartis, Receptos Celgene, Roche, Sanofi and Teva.
OA has received honoraria for speaking/consultation and travel grants from Bayer Healthcare, Biogen Idec, Chugai, Novartis, Merck Serono, and Teva and research grants from Bayer Healthcare, Biogen Idec, Novartis, and Teva.
PA reports grants, personal fees and non-financial support from Allergan, Biogen, Ipsen, Merz Pharmaceuticals, Novartis, and Roche, personal fees and non-financial support from Bayer Healthcare, and Merck, and non-financial support from Sanofi-Aventis/Genzyme, outside the submitted work.