Christensen Ronja, Jolly Amy, Yam Charmaine, Yiannakas Marios C, Toosy Ahmed T, Pitteri Marco, He Anna, Nistri Riccardo, Mohamud Suraya, Samdanidou Eirini, Thompson Alan J, Ciccarelli Olga
Queen Square MS Centre, Department of Neuroinflammation, UCL Queen Square Institute of Neurology, Faculty of Brain Sciences, University College London, London, UK.
Neurosciences Institute, Cleveland Clinic London, London, UK.
Mult Scler. 2025 Feb;31(2):218-230. doi: 10.1177/13524585241304356. Epub 2024 Dec 20.
Cognitive decline in multiple sclerosis (MS) is associated with neuro-axonal loss, quantifiable by optical coherence tomography (OCT). Associations between OCT measures and cognition in relapsing-remitting MS (RRMS) remain incompletely investigated, particularly the added value of OCT when combined with magnetic resonance imaging (MRI). We investigated the contributions of OCT and MRI while applying stringent criteria to control for subclinical optic neuropathy.
In this cross-sectional study, 137 RRMS patients underwent OCT, Brief International Cognitive Assessment for MS (BICAMS), Expanded Disability Status Scale (EDSS) and brain MRI (lesion load, grey and white matter volume); associations were explored using linear regression models.
RRMS patients (aged 40.88 ± 10.6 years; disease duration 7.95 ± 7.39 years; EDSS 2; 0-6.5) were studied. Of BICAMS, 50.36% showed impaired Symbol Digit Modalities Test (SDMT), 37.23% impaired Brief Visuospatial Memory Test and 5.11% impaired California Verbal Learning and Memory Test; better SDMT performance was associated with thicker ganglion cell-inner plexiform (GCIPL) layers for eyes unaffected by optic neuritis ( = 0.23, 95% CI = (0.01-0.44), = 0.03), but not when MRI measures were included ( = 0.18, CI = (-0.03 to 0.38), = 0.09).
GCIPL thinning correlates with SDMT, supporting OCT as a biomarker of cognitive dysfunction. However, GCIPL did not uniquely predict SDMT performance when including MRI measures, suggesting limited utility of OCT in predicting cognitive performance over MRI in RRMS.
多发性硬化症（MS）中的认知功能下降与神经轴突损失有关，可通过光学相干断层扫描（OCT）进行量化。复发缓解型多发性硬化症（RRMS）中OCT测量值与认知之间的关联尚未得到充分研究，尤其是OCT与磁共振成像（MRI）联合使用时的附加价值。我们在应用严格标准控制亚临床视神经病变的同时，研究了OCT和MRI的作用。
在这项横断面研究中，137例RRMS患者接受了OCT、简易国际MS认知评估（BICAMS）、扩展残疾状态量表（EDSS）和脑部MRI（病变负荷、灰质和白质体积）检查；使用线性回归模型探索关联。
对RRMS患者（年龄40.88±10.6岁；病程7.95±7.39年；EDSS为2；范围0 - 6.5）进行了研究。在BICAMS测试中，50.36%的患者符号数字模态测试（SDMT）受损，37.23%的患者简易视觉空间记忆测试受损，5.11%的患者加利福尼亚语言学习和记忆测试受损；对于未受视神经炎影响的眼睛，较好的SDMT表现与较厚的神经节细胞 - 内丛状层（GCIPL）相关（r = 0.23，95%CI =（0.01 - 0.44），P = 0.03），但纳入MRI测量值后则无此关联（r = 0.18，CI =（ - 0.03至0.38），P = 0.09）。
GCIPL变薄与SDMT相关，支持OCT作为认知功能障碍的生物标志物。然而，纳入MRI测量值后，GCIPL并不能独特地预测SDMT表现，这表明在RRMS中，与MRI相比，OCT在预测认知表现方面的效用有限。
