Department of Brain Repair and Rehabilitation, University College London (UCL) Institute of Neurology, University College London, London, UK.
Ann Neurol. 2010 Jan;67(1):99-113. doi: 10.1002/ana.21823.
To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage.
Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function.
Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome.
Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP).
确定功能磁共振成像（fMRI）中外侧枕叶复合体（LOC）的激活是否可以预测临床孤立性视神经炎（ON）后的视觉预后。探索尽管视神经存在脱髓鞘和神经轴突损伤，但 ON 后仍能良好恢复的原因。
对急性 ON 患者和健康志愿者进行了为期 12 个月的纵向研究。使用结构磁共振成像（MRI）、视觉诱发电位（VEPs）和光学相干断层扫描（OCT）来定量评估急性炎症、脱髓鞘、传导阻滞，以及随后对整个视觉通路中的髓鞘再形成和神经轴突损失进行评估。使用 fMRI 研究神经可塑性的作用。使用多变量线性回归分析来研究视力、结构和功能之间的关联。
基线时 LOC 中的 fMRI 反应越强，12 个月时的视觉预后越好。无论是刺激哪只眼睛（受影响眼：p = 0.007；对侧眼：p = 0.020），都存在这种相关性，且与脱髓鞘和神经轴突损失的测量无关。基线时 LOC 中的负 fMRI 反应与相对较差的视觉预后相关。在前或后视觉通路上的急性电生理或结构测量均与视觉预后无关。
高级视觉区域的早期神经可塑性似乎是 ON 恢复的重要决定因素，与前或后视觉通路上的组织损伤无关，包括神经轴突损失（MRI、VEP 和 OCT 测量）和脱髓鞘（VEP 测量）。
