Multifocal visual evoked potentials in optic neuritis and multiple sclerosis: A review

Pihl-Jensen, Gorm; Schmidt, Mathias Falck; Frederiksen, Jette Lautrup

doi:10.1016/j.clinph.2017.03.047

Cited by 38 publications

(27 citation statements)

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“…MfVEP response amplitude and latency informs about axonal and myelin integrity respectively (Graham et al, 2017). MfVEP has high sensitivity in detecting visual deficits (Ruseckaite et al, 2005, Grover et al, 2008, Laron et al, 2010), can detect more abnormalities than traditional pattern-reversal VEP in MS/ON eyes (Klistorner et al, 2008b, Pihl-Jensen et al, 2017), and can be reliably used to track visual function changes over time in MS eyes (Yang et al, 2007, Narayanan et al, 2015b). …”

Section: Introductionmentioning

confidence: 99%

“…To our knowledge, currently the only publication that investigated the relationship between mfVEP responses and GCIPLT was limited to MS non-ON eyes (Sriram et al, 2014, Pihl-Jensen et al, 2017). In the current study, we evaluated the relationship between structural measurements (GCIPLT and RNFLT) and functional tests including mfVEP amplitude and latency, Pelli-Robson contrast sensitivity (CS), and Humphrey visual field (HVF) in eyes with or without a history of ON from relapsing-remitting MS (RRMS) patients.…”

Section: Introductionmentioning

confidence: 99%

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Multifocal visual evoked potentials and contrast sensitivity correlate with ganglion cell-inner plexiform layer thickness in multiple sclerosis

Narayanan

Cheng

Tang

et al. 2019

Clinical Neurophysiology

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Objective: To examine the relationship between optical coherence tomography (OCT) macular ganglion cell-inner plexiform layer thickness (GCIPLT), peripapillary retinal nerve fiber layer thickness (RNFLT) and visual function in relapsing remitting multiple sclerosis (RRMS). Methods: Cirrus OCT, VERIS 60-sector multifocal visual evoked potential (mfVEP) and Pelli-Robson contrast sensitivity (CS) were obtained for 53 eyes with last optic neuritis (ON)>6 months and 105 non-ON eyes in 90 patients. One eye (43 ON, 73 non-ON) was used for correlations when both had the same history. Global (G, 60 sectors) and central 5.6° (C, 24 sectors) mfVEP amplitude and latency were calculated as mean logSNR and median latency. Results: Eyes showing abnormal mfVEP (amplitude or latency) vs OCT (GCIPLT or RNFLT) was 77% vs 69% (p=0.33) in ON, 45% vs 22% (p<0.0005) in non-ON. In ON and non-ON, mfVEP measures and CS correlated with GCIPLT and RNFLT (r=−0.24 to 0.78, p=0.03 to 0.0001). In ON, mfVEP amplitude (C,G) correlated better with GCIPLT (r=0.78, 0.76) than RNFLT (r=0.43, 0.58; p< 0.001, 0.01). Conclusions: MfVEP measures and CS correlated well with GCIPLT and RNFLT in ON and non-ON. MfVEP amplitudes were more highly correlated with GCIPLT than RNFLT in ON. MfVEP detected significantly more defects than OCT in non-ON. Significance: GCIPLT, mfVEP and CS provide useful measures of optic nerve integrity in RRMS.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Multifocal visual evoked potentials and contrast sensitivity correlate with ganglion cell-inner plexiform layer thickness in multiple sclerosis

Narayanan

Cheng

Tang

et al. 2019

Clinical Neurophysiology

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“…The optic pathway can be accurately evaluated in detail due to the availability of highly sensitive electrophysiological tests, such as visual evoked potential (VEP) recording. VEPs are helpful in clinics to assess the ON functionality and the involvement of cortical structures in MS patients . In particular, VEP latency delays can be considered a marker of myelin loss along the visual pathways both in humans and in animal models of demyelination , while permanent ON demyelination makes axons more vulnerable to damage and may potentially cause axonal degeneration, leading to VEP amplitude loss .…”

Section: Introductionmentioning

confidence: 99%

Non‐invasive visual evoked potentials to assess optic nerve involvement in the dark agouti rat model of experimental autoimmune encephalomyelitis induced by myelin oligodendrocyte glycoprotein

Castoldi¹,

Marenna²,

d’Isa³

et al. 2019

Brain Pathology

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Experimental autoimmune encephalomyelitis (EAE) is the primary disease model of multiple sclerosis (MS), one of the most diffused neurological diseases characterized by fatigue, muscle weakness, vision loss, anxiety and depression. EAE can be induced through injection of myelin peptides to susceptible mouse or rat strains. In particular, EAE elicited by the autoimmune reaction against myelin oligodendrocyte glycoprotein (MOG) presents the common features of human MS: inflammation, demyelination and axonal loss. Optic neuritis affects visual pathways in both MS and in several EAE models. Neurophysiological evaluation through visual evoked potential (VEP) recording is useful to check visual pathway dysfunctions and to test the efficacy of innovative treatments against optic neuritis. For this purpose, we investigate the extent of VEP abnormalities in the dark agouti (DA) rat immunized with MOG, which develops a relapsing-remitting disease course. Together with the detection of motor signs, we acquired VEPs during both early and late stages of EAE, taking advantage of a non-invasive recording procedure that allows long follow-up studies. The validation of VEP outcomes was determined by comparison with ON histopathology, aimed at revealing inflammation, demyelination and nerve fiber loss. Our results indicate that the first VEP latency delay in MOG-EAE DA rats appeared before motor deficits and were mainly related to an inflammatory state. Subsequent VEP delays, detected during relapsing EAE phases, were associated with a combination of inflammation, demyelination and axonal loss. Moreover, DA rats with atypical EAE clinical course tested at extremely late time points, manifested abnormal VEPs although motor signs were mild. Overall, our data demonstrated that non-invasive VEPs are a powerful tool to detect visual involvement at different stages of EAE, prompting their validation as biomarkers to test novel treatments against MS optic neuritis.Castoldi et al VEPs in preclinical models of multiple sclerosis Brain Pathology 30 (2020) 137-150

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“…Unlike ffVEP, which largely represents macular vision, mfVEP examines nerve conduction from the entire visual field including peripheral lesions. Previous studies have pointed out a superior sensitivity and specificity of mfVEP compared to ffVEP in ON [75]. Interestingly, the differential effect of the two treatments in MOVING appeared to be in parallel with changes of the self-reported visual quality of life.…”

Section: Discussionmentioning

confidence: 73%

Fingolimod after a first unilateral episode of acute optic neuritis (MOVING) – preliminary results from a randomized, rater-blind, active-controlled, phase 2 trial

et al. 2020

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Background: Neuroprotection and promotion of remyelination represent important therapeutic gaps in multiple sclerosis (MS). Acute optic neuritis (ON) is a frequent MS manifestation. Based on the presence and properties of sphingosine-1-phosphate receptors (S1PR) on astrocytes and oligodendrocytes, we hypothesized that remyelination can be enhanced by treatment with fingolimod, a S1PR modulator currently licensed for relapsing-remitting MS. Methods: MOVING was an investigator-driven, rater-blind, randomized clinical trial. Patients with acute unilateral ON, occurring as a clinically isolated syndrome or MS relapse, were randomized to 6 months of treatment with 0.5 mg oral fingolimod or subcutaneous IFN-β 1b 250 μg every other day. The change in multifocal visual evoked potential (mfVEP) latency of the qualifying eye was examined as the primary (month 6 vs. baseline) and secondary (months 3, 6 and 12 vs. baseline) outcome. In addition, full field visual evoked potentials, visual acuity, optical coherence tomography as well as clinical relapses and measures of disability, cerebral MRI, and self-reported visual quality of life were obtained for follow-up. The study was halted due to insufficient recruitment (n = 15), and available results are reported.Results: Per protocol analysis of the primary endpoint revealed a significantly larger reduction of mfVEP latency at 6 months compared to baseline with fingolimod treatment (n = 5; median decrease, 15.7 ms) than with IFN-β 1b treatment (n = 4; median increase, 8.15 ms) (p < 0.001 for interaction). Statistical significance was maintained in the secondary endpoint analysis. Descriptive results are reported for other endpoints. Conclusion: Preliminary results of the MOVING trial argue in support of a beneficial effect of fingolimod on optic nerve remyelination when compared to IFN-β treatment. Interpretation is limited by the small number of complete observations, an unexpected deterioration of the control group and a difference in baseline mfVEP latencies. The findings need to be confirmed in larger studies.Trial registration: The trial was registered as EUDRA-

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Multifocal visual evoked potentials in optic neuritis and multiple sclerosis: A review

Cited by 38 publications

References 50 publications

Multifocal visual evoked potentials and contrast sensitivity correlate with ganglion cell-inner plexiform layer thickness in multiple sclerosis

Multifocal visual evoked potentials and contrast sensitivity correlate with ganglion cell-inner plexiform layer thickness in multiple sclerosis

Non‐invasive visual evoked potentials to assess optic nerve involvement in the dark agouti rat model of experimental autoimmune encephalomyelitis induced by myelin oligodendrocyte glycoprotein

Fingolimod after a first unilateral episode of acute optic neuritis (MOVING) – preliminary results from a randomized, rater-blind, active-controlled, phase 2 trial

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