Hsiao Maria N, Krupinsk Juliana S, Froio Nayara L, Yamaki Vitor N, Paiva Wellingson S, Silva Vinicius T
Department of Neurology, Division of Neurosurgery, University of Sao Paulo Medical School, Sao Paulo, Brazil; Comprehensive Brain Research Network, Brazil.
Nove de Julho University, Sao Paulo, Brazil; Comprehensive Brain Research Network, Brazil.
J Clin Neurosci. 2025 Jul 16;140:111492. doi: 10.1016/j.jocn.2025.111492.
Trans-synaptic degeneration (TSD) has been considered as a plausible mechanism in the visual pathway. However, the consequences of optic neuritis in the optic pathways and primary visual cortex (V1) are not well established. To address this gap, we conducted a systematic review of the literature, registered in PROSPERO (no. 42023479709), aiming to evaluate primary visual cortex impairment due to TSD following optic neuritis. On July 25th, 2023, the electronic databases EMBASE, PubMed, and Scopus were searched to identify eligible publications. Quality assessment was performed using the ROBINS-I tool. Out of 130 studies identified, 10 met the inclusion criteria. Using neuroimaging techniques such as diffusion tensor imaging (DTI) and structural magnetic resonance imaging (MRI), nine observational studies in multiple sclerosis (MS) (n = 863 participants) and one observational study on neuromyelitis optica spectrum disorder (NMOSD) (n = 60 participants) showed a significant reduction of the primary visual cortex volume and thickness and an important damage to the integrity of optic radiation, with decreased fractional anisotropy (FA) {Cohen's d (95 % CI): -1.17 [-1.48, -0.86]} and increased mean diffusivity (MD) {Cohens'd (95 % CI): 1.147 [0.807, 1.488]} in patients with optic neuritis, compared to healthy controls. The findings suggest that TSD affects the optic pathways after optic neuritis in these demyelinating diseases, in which damage to the optic nerve led to degeneration in the primary visual cortex, with consistent neuroimaging evidence of white matter integrity loss and cortical atrophy. No analyses of other optic neuropathies were found in the reviewed studies. We encourage future research to standardize imaging protocols and explore various etiologies of optic neuritis.
跨突触变性（TSD）被认为是视觉通路中一种可能的机制。然而，视神经炎对视神经通路和初级视觉皮层（V1）的影响尚未完全明确。为了填补这一空白，我们对在PROSPERO（编号42023479709）注册的文献进行了系统综述，旨在评估视神经炎后TSD导致的初级视觉皮层损伤。2023年7月25日，我们检索了电子数据库EMBASE、PubMed和Scopus以识别符合条件的出版物。使用ROBINS-I工具进行质量评估。在识别出的130项研究中，10项符合纳入标准。使用诸如扩散张量成像（DTI）和结构磁共振成像（MRI）等神经成像技术，对多发性硬化症（MS）患者（n = 863名参与者）进行的9项观察性研究和对视神经脊髓炎谱系障碍（NMOSD）患者（n = 60名参与者）进行的1项观察性研究显示，与健康对照相比，视神经炎患者的初级视觉皮层体积和厚度显著减小，视神经辐射完整性受到重要损害，分数各向异性（FA）降低{Cohen's d（95%CI）：-1.17[-1.48，-0.86]}，平均扩散率（MD）增加{Cohens'd（95%CI）：1.147[0.807，1.488]}。研究结果表明，在这些脱髓鞘疾病中，视神经炎后TSD会影响视神经通路，其中视神经损伤导致初级视觉皮层发生变性，有一致的神经成像证据表明白质完整性丧失和皮质萎缩。在综述的研究中未发现对其他视神经病变的分析。我们鼓励未来的研究规范成像方案，并探索视神经炎的各种病因。
