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. 2020 Nov;142(5):418-427.
doi: 10.1111/ane.13282. Epub 2020 Jun 4.

Retinal thinning and brain atrophy in early MS and CIS

Max Borgström  1 , Anders Tisell  2   3 , Hans Link  4 , Elisabeth Wilhelm  5 , Peter Lundberg  2   3 , Yumin Huang-Link  1
Affiliations

Retinal thinning and brain atrophy in early MS and CIS

Max Borgström et al. Acta Neurol Scand. 2020 Nov.

Abstract

Background: Optical coherence tomography (OCT) could be complementary to magnetic resonance imaging (MRI) of the brain in monitoring course of multiple sclerosis (MS) and clinically isolated syndrome (CIS). Thinning of neurons in ganglion cell-inner plexiform layer (GCIPL) measured by OCT is assumed to be associated with brain atrophy.

Objectives: To evaluate association of GCIPL with brain parameters detected by quantitative MRI (qMRI) and MR-spectroscopy (MRS) in early MS and CIS.

Methods: Seventeen newly diagnosed MS and 18 CIS patients were prospectively included. The patients were assessed at baseline as well as at 1 year follow-up by OCT, qMRI and MRS. Brain parenchymal and myelin volumes (BPV, MYV respectively) and the corresponding fractions (BPF, MYF) were measured with qMRI. Metabolites including myo-inositol (myo-Ins) were measured in the normal-appearing white matter (NAWM) using MRS. T-tests and ANOVA were used to analyze group differences, and linear regression models to evaluate association of GCIPL with BPV, MYV and myo-Ins after correlation analysis.

Results: Disease activity reflected by lesions on MRI and presence of CSF oligoclonal IgG bands were more prominent in MS compared to CIS. GCIPL, BPV, MYV, BPF and MYF were reduced, while concentration of myo-Ins was increased in MS compared to CIS. Follow-up showed consistency of thinner GCIPL in MS compared to CIS. GCIPL thinning correlated with reduced BPV and MYV (P < .05 for both), but with increased myo-Ins (P < .01).

Conclusions: Significant GCIPL thinning occurs in early MS and is associated with enhanced brain inflammation and atrophy.

Keywords: Multiple sclerosis (MS); clinically isolated syndrome (CIS); ganglion cell-inner plexiform layer (GCIPL); optical coherence tomography (OCT); quantitative magnetic resonance imaging (qMRI); quantitative magnetic resonance-spectroscopy (MRS).

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