Division of Cognitive and Behavioral Neurosciences, Department of Neurology, Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Sherman Hall Annex 114, Buffalo, NY, USA.
Multiple Sclerosis and Neuroimmunology Center, Clalit Health Services, Nazareth, Israel.
J Neurol. 2024 Feb;271(2):658-673. doi: 10.1007/s00415-023-12075-5. Epub 2023 Dec 13.
Spectral Optical Coherence Tomography (OCT) and Visual Evoked Potentials (VEPs) have both emerged as potentially useful biomarkers of cognitive decline in people with multiple sclerosis (PwMS). Their combined use may provide additional predictive value for identifying disease impact, progression, and remyelination capacity above-and-beyond what is captured using either approach alone.
We examined the relationship between OCT/VEP measures and cognitive functioning in 205 PwMS. OCT measures included Retinal Nerve Fiber Layer Volume (RNFLV), Papillo-Macular Bundle Volume (PBMV), and Macular Volume (MV). VEP measures included latency of the P100, and inter-ocular latency. Cognitive performance was evaluated across seven separate domains of performance, and for overall cognition, using the NeuroTrax computerized testing battery.
Both OCT and VEP measures were significantly correlated with cognitive performance across several domains. Linear regression models that controlled for the influence of visual acuity revealed (1) that reduced MV was significantly predictive of poorer visual-spatial functioning, and (2) that delayed VEP latency was significantly predictive of performance in global cognitive functioning and visual-spatial functioning, after controlling for multiple comparisons. Among PwMS with normal visual acuity, PwMS with a combination of both relatively low MV and delayed VEP latency tended to have poorer performance in the domains of global, executive, and visual-spatial functioning compared to PwMS with both high MV and normal VEP latency.
Approaches that combine the use of OCT and VEP measures can enhance insight into underlying factors that contribute to variance in cognitive functioning in PwMS.
光谱光学相干断层扫描（OCT）和视觉诱发电位（VEPs）都已成为多发性硬化症（PwMS）患者认知能力下降的潜在有用生物标志物。将它们结合使用可能会提供比单独使用任何一种方法更多的预测价值，以识别疾病的影响、进展和髓鞘再生能力。
我们研究了 205 名 PwMS 中 OCT/VEP 测量值与认知功能之间的关系。OCT 测量包括视网膜神经纤维层体积（RNFLV）、乳头黄斑束体积（PBMV）和黄斑体积（MV）。VEP 测量包括 P100 潜伏期和眼间潜伏期。使用 NeuroTrax 计算机测试电池评估了七个单独的认知功能领域的认知表现和整体认知表现。
OCT 和 VEP 测量值与多个领域的认知表现均显著相关。在控制视力影响的线性回归模型中，（1）MV 减少与视觉空间功能较差显著相关，（2）VEP 潜伏期延迟与整体认知功能和视觉空间功能的表现显著相关，在控制了多次比较后。在视力正常的 PwMS 中，MV 相对较低且 VEP 潜伏期延迟的 PwMS 与 MV 较高且 VEP 潜伏期正常的 PwMS 相比，在整体、执行和视觉空间功能领域的表现往往较差。
结合使用 OCT 和 VEP 测量方法可以深入了解导致 PwMS 认知功能差异的潜在因素。
