Contributions
Abstract: 164
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Vision is often impaired in multiple sclerosis (MS). Low contrast letter acuity (LCLA) has been proposed as a disability outcome measure in MS research. A technology-enabled adaptation of the LCLA, the Contrast Sensitivity Test (CST) administered via an iPad®application, has been implemented in routine clinical care at our center.
Objectives: To determine the relationship of the CST to other performance measures, patient reported outcomes (PROs), and quantitative MRI metrics in a large clinical cohort.
Methods: Demographics, disease history, performance tests, PROs, and quantitative MRI data were collected from the MS population at a single site. Brain MRIs were obtained within 3 months of clinical encounters during which 2.5% and 100% contrast vision testing was administered. MRIs were quantitatively analyzed via semi-automated method to calculate T2 lesion volume (T2LV), brain parenchymal fraction (BPF), gray matter fraction (GMF), thalamic volume (TV), and spinal cord area (CA). Spearman correlation coefficients (ρ) were used to correlate 2.5% and 100% CST scores with performance measures, PROs, and MRI metrics; significance was set at p≤0.001 to account for multiple comparisons.
Results: 475 patients (mean age 44.8±10.6, disease duration 11.1±9.3, mean 2.5% CST score 31.0±12.9) who completed CST were included. 2.5% CST was moderately correlated with iPad®versions of the 9-Hole Peg Test (ρ=-0.40) and Symbol Digit Modalities Test (SDMT) (ρ=-0.55). There were weak correlations with a self-administered Timed 25-Foot Walk (ρ=-0.31), hand function (ρ=0.33) and mobility (ρ=0.36) domains of the Quality of Life in Neurological Disorders, and the Patient Determined Disease Steps (ρ=-0.32). 2.5% CST was also weakly correlated with T2LV (ρ=-0.33), GMF(ρ=0.34), TV(ρ=0.31), BPF(ρ=0.35), and CA (ρ=0.19). p≤0.001 for all. Correlations with 100% CST were weaker but statistically significant. MRI metrics were included in a linear model predicting 2.5% CST scores using a Box-Cox transformation. CA was still statistically significant after accounting for age and sex.
Conclusions: CST correlates with other disability measures including SDMT, disease-related PROs, and semi-quantitative MRI metrics. Correlations are stronger with 2.5% than 100% contrast letters. CA was still a significant predictor after accounting for age and sex.
Disclosure: Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Kunio Nakamura has received personal fees for consulting from NeuroRx Research, speaking from Sanofi Genzyme, and license from Biogen. He has received research support from NIH NINDS, NMSS, DOD, Biogen, Sanofi Genzyme, and Novartis.
Marisa McGinley has served on scientific advisory boards for Genzyme and Genentech, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1506-04742)
Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL.
Laura Baldassari has received personal fees for serving on a scientific advisory board for Teva, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1606-24540).
Hong Li: Nothing to disclose
Malory Weber: Nothing to disclose
Jeffrey Cohen has received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.
Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.
Abstract: 164
Type: Scientific Session
Abstract Category: Clinical aspects of MS - Clinical assessment tools
Background: Vision is often impaired in multiple sclerosis (MS). Low contrast letter acuity (LCLA) has been proposed as a disability outcome measure in MS research. A technology-enabled adaptation of the LCLA, the Contrast Sensitivity Test (CST) administered via an iPad®application, has been implemented in routine clinical care at our center.
Objectives: To determine the relationship of the CST to other performance measures, patient reported outcomes (PROs), and quantitative MRI metrics in a large clinical cohort.
Methods: Demographics, disease history, performance tests, PROs, and quantitative MRI data were collected from the MS population at a single site. Brain MRIs were obtained within 3 months of clinical encounters during which 2.5% and 100% contrast vision testing was administered. MRIs were quantitatively analyzed via semi-automated method to calculate T2 lesion volume (T2LV), brain parenchymal fraction (BPF), gray matter fraction (GMF), thalamic volume (TV), and spinal cord area (CA). Spearman correlation coefficients (ρ) were used to correlate 2.5% and 100% CST scores with performance measures, PROs, and MRI metrics; significance was set at p≤0.001 to account for multiple comparisons.
Results: 475 patients (mean age 44.8±10.6, disease duration 11.1±9.3, mean 2.5% CST score 31.0±12.9) who completed CST were included. 2.5% CST was moderately correlated with iPad®versions of the 9-Hole Peg Test (ρ=-0.40) and Symbol Digit Modalities Test (SDMT) (ρ=-0.55). There were weak correlations with a self-administered Timed 25-Foot Walk (ρ=-0.31), hand function (ρ=0.33) and mobility (ρ=0.36) domains of the Quality of Life in Neurological Disorders, and the Patient Determined Disease Steps (ρ=-0.32). 2.5% CST was also weakly correlated with T2LV (ρ=-0.33), GMF(ρ=0.34), TV(ρ=0.31), BPF(ρ=0.35), and CA (ρ=0.19). p≤0.001 for all. Correlations with 100% CST were weaker but statistically significant. MRI metrics were included in a linear model predicting 2.5% CST scores using a Box-Cox transformation. CA was still statistically significant after accounting for age and sex.
Conclusions: CST correlates with other disability measures including SDMT, disease-related PROs, and semi-quantitative MRI metrics. Correlations are stronger with 2.5% than 100% contrast letters. CA was still a significant predictor after accounting for age and sex.
Disclosure: Brandon Moss is supported by National Multiple Sclerosis Society Institutional Clinician Training Award ICT 0002.
Kunio Nakamura has received personal fees for consulting from NeuroRx Research, speaking from Sanofi Genzyme, and license from Biogen. He has received research support from NIH NINDS, NMSS, DOD, Biogen, Sanofi Genzyme, and Novartis.
Marisa McGinley has served on scientific advisory boards for Genzyme and Genentech, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1506-04742)
Gabrielle Macaron is supported by Biogen Fellowship Grant # 6873-P-FEL.
Laura Baldassari has received personal fees for serving on a scientific advisory board for Teva, and receives funding via a Sylvia Lawry Physician Fellowship Grant through the National Multiple Sclerosis Society (#FP-1606-24540).
Hong Li: Nothing to disclose
Malory Weber: Nothing to disclose
Jeffrey Cohen has received personal fees for consulting from Adamas, Celgene, Convelo, EMD Serono, Novartis, and PendoPharm; speaking for Mylan; and serving as Co-Editor of Multiple Sclerosis Journal - Experimental, Translational and Clinical.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.
Daniel Ontaneda has received research support from National Multiple Sclerosis Society, National Institutes of Health, Patient Centered Research Institute, Race to Erase MS Foundation, Genentech, and Genzyme. He has also received consulting fees from Biogen Idec, Genentech/Roche, Genzyme, and Merck.
Robert Bermel has served as a consultant for Biogen, Genzyme, Genentech, and Novartis. He receives research support from Biogen and Genentech.