Visual activation patterns in patients with optic neuritis

Rombouts, Serge A.R.B.; Lazeron, R.H.C.; Scheltens, Philip; Uitdehaag, B. M.J.; Sprenger, M.; Valk, J.; Barkhof, Frederik

doi:10.1212/wnl.50.6.1896

Cited by 76 publications

(43 citation statements)

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“…Relatively few fMRI studies have assessed the visual system in patients with MS [68,101,125]. A preliminary report demonstrated that recovery from optic neuritis is associated with a change in the cerebral response to photic stimulation [125].…”

Section: ■ Structural Mr Findingsmentioning

confidence: 99%

Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis

Miller

Thompson

Filippi

2003

Journal of Neurology

204

161

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Magnetic resonance (MR) techniques are of value in following the pathological process of multiple sclerosis in vivo. They are widely applied to monitor the disease natural history and its modification by treatment. However, serial studies of lesion measures have yielded generally disappointing correlations with the development of clinical disability. A potential explanation for this is the presence of abnormalities, beyond the visible lesions, in the normal appearing white matter (NAWM) and grey matter (NAGM). Quantitative structural MR techniques, including measures of magnetisation transfer, diffusion, relaxation times and spectroscopic metabolite concentrations, reveal that there are abnormalities in NAWM and NAGM. These are present from clinical onset and become more pronounced with clinical progression, increasing disability and increasing lesion load. Furthermore, functional MRI (fMRI) studies of motor and visual paradigms has identified a range of responses suggesting that cortical plasticity exists; such modified responses are seen in the earliest stages of disease and in the absence of visible lesions, but are more pronounced with disease progression and increasing lesion load and abnormality in the NAWM. Limited reproducibility and sensitivity to change can pose methodological limitations for MR studies of NAWM and NAGM, especially when follow up intervals are relatively short. Whilst existing quantitative MR measures from normal appearing tissues provide valuable information to understand the natural history and monitor treatment effects in MS, none of them fully or even predominantly accounts for the patient's functional state nor can be relied on as a definitive surrogate measure of treatment effect. Better resolution of the abnormalities is needed especially in grey matter where pathological foci are known to be abundant. Studies correlating structural MR and fMRI parameters with measures of function in well defined anatomical pathways should further elucidate the pathogenic role of abnormality in the normal appearing tissues. In future, new imaging modalities are needed that provide a more specific measure of histopathological and cellular aspects of the disease process in vivo.

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Section: ■ Structural Mr Findingsmentioning

confidence: 99%

Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis

Miller

Thompson

Filippi

2003

Journal of Neurology

204

161

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“…Most studies have used paradigms for the visual and motor systems and have addressed clinically isolated syndromes, [2][3][4][5][6][7][8][9] relapsing-remitting multiple sclerosis (MS), 10 -15 secondary progressive MS, 16 and primary progressive MS. 17,18 The most persuasive evidence for adaptive cortical plasticity comes from those studies above in which stable patients with preserved clinical function demonstrate altered fMRI activation that also correlates with structural central nervous system damage. This suggests that cortical reorganization after MS injury may have a role in limiting clinical disability.…”

mentioning

confidence: 99%

“…19 -21 We focused on two visual function markers (logarithm of the minimum angle of resolution [logMAR] visual acuity and 30-2 Humphrey visual field mean deviation [HMD] scores) and two optic nerve structural MRI markers (the crosssectional area measured by fat-saturated short echo fast fluid-attenuated inversion recovery sequence and the baseline gadolinium-enhanced lesion length). Our aims were: (1) to investigate the direct relationships between optic nerve structure, visual function, and functional activation and their variation over time; (2) to apply a novel technique that related fMRI to clinical function after accounting for any confounding structural influences, thereby effectively searching for true adaptive cortical reorganization; and (3) to investigate whether the rate of early clinical recovery was related to the corresponding fMRI response.…”

mentioning

confidence: 99%

Adaptive cortical plasticity in higher visual areas after acute optic neuritis

Toosy

Hickman

Miszkiel

et al. 2005

Annals of Neurology

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The ability to distinguish adaptive cortical reorganization may help to target future therapeutic strategies after neurological insult. We investigated cortical plasticity by prospectively applying visual functional magnetic resonance imaging (fMRI) and optic nerve MRI to 20 patients with acute optic neuritis at baseline, 1, 3, 6, and 12 months. We performed three types of correlation analyses to investigate the relationships between fMRI activity, clinical function, and optic nerve structure. The first analysis directly correlated the fMRI response to clinical function or optic nerve structure and found dynamic relations especially within the first 3 months. The second analysis used a novel technique that modeled the fMRI response and optic nerve structure together with clinical function, to determine the contribution fMRI made to clinical function after accounting for structural factors. Significant effects were found at baseline only, within the right peristriate cortex, and bilaterally in the lateral occipital complexes, which are normally involved in higher order visual processing. The third analysis investigated the relation between the modeled visual recovery rate and fMRI response but found no significant effects. The key findings of this study are from the second analysis and suggest a genuine adaptive role for cortical reorganization within extrastriate visual areas early after optic neuritis.

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“…Less activation of visual cortex is seen in patients with both acute and previous ON than in controls, which probably represents reduced neuronal input due to acute pathological changes in the nerve such as oedema, inflammation, and later demyelination and axonal loss [21,27,60,83,85,98,109]. Increases in BOLD signal correlate significantly with both Snellen's visual acuity and contrast sensitivity measurements [60].…”

Section: ■ Functional Mrimentioning

confidence: 99%

Assessing structure and function of the afferent visual pathway in multiple sclerosis and associated optic neuritis

et al. 2009

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The afferent visual pathway is commonly affected in MS. Assessment of the afferent visual pathway using clinical, imaging and electrophysiological methods not only provides insights into the pathophysiology of MS, but also provides a method of investigating potential therapeutic measures in MS. This review summarises the various assessment methods, in particular imaging techniques of the visual pathway. Retinal nerve fibre layer (RNFL) thickness is usually reduced following an episode of optic neuritis. Techniques such as optical coherence tomography, scanning laser polarimetry, and confocal scanning laser ophthalmoscopy are used to quantify RNFL thickness. MRI of the optic nerve is not routinely used in the diagnosis of MS or optic neuritis, but is valuable in atypical cases and in research. T2- weighted images of the optic nerve usually show the hyperintense lesion in optic neuritis and gadolinium enhancement is seen in the acute attack. Quantifying atrophy of the optic nerve using MRI gives an indication of the degree of axonal loss. Magnetization transfer ratio (MTR) of the optic nerve provides an indication of myelination. Diffusion tensor imaging (DTI) of the optic nerve and optic radiation provide information about the integrity of the visual white matter tracts. Functional MRI following visual stimulation is used to assess the contribution of cortical reorganisation to functional recovery following optic neuritis. Investigations including logMAR visual acuity, Sloan contrast acuity, Farnsworth- Munsell 100-hue colour vision tests and Humphrey perimetry provide detailed quantitative information on different aspects of visual function. Visual evoked potentials identify conduction block or delay reflecting demyelination. These collective investigative methods have advanced knowledge of pathophysiological mechanisms in MS and optic neuritis. Relevant ongoing studies and future directions are discussed.

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Visual activation patterns in patients with optic neuritis

Cited by 76 publications

References 0 publications

Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis

Magnetic resonance studies of abnormalities in the normal appearing white matter and grey matter in multiple sclerosis

Adaptive cortical plasticity in higher visual areas after acute optic neuritis

Assessing structure and function of the afferent visual pathway in multiple sclerosis and associated optic neuritis

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