NMR Research Unit (SC, BK, LH, NC, FP, OC, and AT), Queen Square MS Centre, Department of Neuroinflammation, Queen Square Institute of Neurology, Faculty of Brain Sciences, UCL, London, United Kingdom ; Department of Medical Physics and Biomedical Engineering (BK, FP, and FB), Centre for Medical Image Computing (CMIC), University College London, London, United Kingdom ; Universitat Oberta de Catalunya (FP), Barcelona, Spain ; Department of Brain Repair and Rehabilitation (ID and FB), University College London Institute of Neurology, Faculty of Brain Sciences, UCL, London, United Kingdom ; National Institute for Health Research (FB and OC), University College London Hospitals, Biomedical Research Centre, London, United Kingdom; and Department of Radiology and Nuclear Medicine (FB), Amsterdam University Medical Centers, Vrije Universiteit, the Netherlands.
J Neuroophthalmol. 2022 Mar 1;42(1):e22-e31. doi: 10.1097/WNO.0000000000001280. Epub 2021 Sep 23.
In this study, we hypothesized that clinically isolated syndrome-optic neuritis patients may have disturbances in neuropsychological functions related to visual processes.
Forty-two patients with optic neuritis within 3 months from onset and 13 healthy controls were assessed at baseline and 6 months with MRI (brain volumes, lesion load, and optic radiation lesion volume) and optical coherence tomography (OCT) (peripapillary retinal nerve fiber layer [RNFL], ganglion cell and inner plexiform layers [GCIPLs], and inner nuclear layer). Patients underwent the brief cognitive assessment for multiple sclerosis, high-contrast and low-contrast letter acuity, and color vision.
At baseline, patients had impaired visual function, had GCIPL thinning in both eyes, and performed below the normative average in the visual-related tests: Symbol Digit Modalities Test and Brief Visuospatial Memory Test-Revised (BVMT-R). Over time, improvement in visual function in the affected eye was predicted by baseline GCIPL (P = 0.015), RNFL decreased, and the BVMT-R improved (P = 0.001). Improvement in BVMT-R was associated with improvement in the high-contrast letter acuity of the affected eye (P = 0.03), independently of OCT and MRI metrics.
Cognitive testing, assessed binocularly, of visuospatial processing is affected after unilateral optic neuritis and improves over time with visual recovery. This is not related to structural markers of the visual or central nervous system.
在这项研究中，我们假设临床孤立综合征-视神经炎患者可能存在与视觉过程相关的神经心理功能障碍。
42 例视神经炎患者在发病后 3 个月内和 13 例健康对照者在基线和 6 个月时接受 MRI（脑容积、病变负荷和视辐射病变容积）和光学相干断层扫描（OCT）（视盘周围视网膜神经纤维层 [RNFL]、节细胞和内丛状层 [GCIPLs] 和内核层）检查。患者接受了多发性硬化症的简短认知评估、高对比度和低对比度字母视力以及色觉检查。
基线时，患者的视觉功能受损，双眼 GCIPL 变薄，视觉相关测试中的表现低于正常值：符号数字模态测试和简要视觉空间记忆测试修订版（BVMT-R）。随着时间的推移，受影响眼的视觉功能的改善与基线 GCIPL（P=0.015）、RNFL 减少和 BVMT-R 改善（P=0.001）相关。BVMT-R 的改善与受影响眼的高对比度字母视力的改善相关（P=0.03），独立于 OCT 和 MRI 指标。
双侧视觉空间处理的认知测试在单侧视神经炎后受到影响，并随着视觉恢复而随时间改善。这与视觉或中枢神经系统的结构标志物无关。
