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Retinal clues for selective neuronal loss in multiple sclerosis

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Abstract

Objective

The relationship between the cell body layer and the dendritic network layer of the retina and cognitive performance (CP) in MS patients has not been examined separately. The objective of this study is to predict cognitive impairment (CI) in RRMS patients and to examine the relationship between CP and ganglion cell layer (GCL), inner plexiform layer (IPL), and GCL divided by IPL (GCL/IPL).

Methods

Ophthalmological evaluation, retinal segmentation, and Symbol Digit Modalities Test (SDMT) were performed on 102 RRMS patients and 54 healthy subjects. The relationships of GCL, IPL, and GCL/IPL with CP in eyes without a history of optic neuritis were investigated using Spearman’s correlation. Models were created by accepting 1 standard deviation less of the SDMT mean of the control group as the limit for CI. The cutoff value of the GCL/IPL variable that could predict CI was calculated by ROC analysis, and the ability to accurately predict CI was tested with binary logistic regression.

Results

No correlation was found between OCT parameters and CP in healthy subjects. Correlation was found between GCL thickness and GCL/IPL variable and CP in RRMS patients (r=0.235, r=0.667 respectively). A GCL/IPL value of 1.255 was able to identify CI with 81.8% sensitivity and 75.9% specificity (AUC=0.844, LR=3.38) and predicted CI with 74.5% accuracy (Nagelkerke R2=0.439).

Conclusion

In RRMS patients, the IPL thickness is unrelated to CP. Therewithal, the GCL/IPL-CP relationship is stronger than the GCL-CP relationship and GCL/IPL can predict CI.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

AUC:

Area under curve

CI:

Cognitive impairment

CP:

Cognitive performance

CNS:

Central nervous system

EDSS:

Expanded Disability Status Scale

ETDRS:

Early Treatment Diabetic Retinopathy Study

GCL:

Ganglion cell layer

IPL:

Inner plexiform layer

GCL/IPL:

GCL divided by IPL

INL:

Inner nuclear layer

LR:

Likelihood ratio

MCI:

Mild cognitive impairment

OCT:

Optical coherence tomography

ON:

Optic neuritis

RNFL:

Retinal nerve fiber layer

ROC:

Receiver operating characteristics

RRMS:

Relapsing remitting multiple sclerosis

SD:

Standard deviation

SDMT:

Symbol Digit Modalities Test

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Authors and Affiliations

  1. Department of Neurology, Van Yuzuncu Yil University, Bardakcı, Tusba, 65300, Van, Turkey

    Vedat Cilingir

  2. Department of Neuroscience Research, Van Yuzuncu Yil University, Tusba, Van, Turkey

    Vedat Cilingir

  3. Department of Ophthalmology, Van Yuzuncu Yil University, Tusba, Van, Turkey

    Erbil Seven

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  1. Vedat Cilingir
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  2. Erbil Seven
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Correspondence to Vedat Cilingir.

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This study has been approved by the clinical research ethical committee of faculty of medicine-Van Yuzuncu Yil university.

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Cilingir, ., Seven, E. Retinal clues for selective neuronal loss in multiple sclerosis. Neurol Sci 45, 1163–1171 (2024). https://doi.org/10.1007/s10072-023-07110-2

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