PMID- 33590339 OWN - NLM STAT- MEDLINE DCOM- 20210623 LR - 20210623 IS - 1432-1459 (Electronic) IS - 0340-5354 (Linking) VI - 268 IP - 7 DP - 2021 Jul TI - Visual deficits and cognitive assessment of multiple sclerosis: confounder, correlate, or both? PG - 2578-2588 LID - 10.1007/s00415-021-10437-5 [doi] AB - BACKGROUND: The relationship between visual impairment and cognitive performance in multiple sclerosis (MS) remains poorly understood. OBJECTIVE: To determine associations between visual acuity and optical coherence tomography (OCT) measures with cognitive performance of MS patients and healthy controls (HCs). METHODS: 141 MS patients (with and without MS optic neuritis; MSON) and 50 HCs underwent neuropsychological, visual, and OCT testing. California Verbal Learning Test (CVLT-II), Brief Visuospatial Memory Test (BVMT-R), and Symbol Digit Modalities Test (SDMT) were used. Patients with test performance below - 1.5 standard deviations of the mean HCs scores were labeled as cognitive impairment. Visual ability was assessed with 100%, 2.5%, and 1.25% low-contrast letter acuity (LCLA) charts. OCT-derived peripapillary retinal nerve fiber layer (pRNFL) thickness, macular volume (MV), macular ganglion cell inner plexiform (mGCIP) thickness (as a sum of GC and IP layers), and macular inner nuclear layer (mINL) were computed. RESULTS: 100% and 2.5% LCLA associated with SDMT in MS and HCs (p < 0.001; and p < 0.012, respectively). In MSON patients, visually demanding tests were explained by pRNFL and macular volume for SDMT (beta = 0.172, p = 0.039 and beta = 0.27, p = 0.001) and MV for BVMT-R (beta = 0.21, p = 0.012). In non-MSON, only mINL was predictor of CVLT-II. pRNFL and MV predicted cognitive impairment with an accuracy of 72.2% (Negelkerke R(2) = 0.234). These findings were driven by associations within the progressive MS subgroup. HC's SDMT performance was explained by mGCIP (beta = 0.316, p = 0.001). CONCLUSIONS: Both LCLA and OCT-based measures (pRNFL and macular volume) were associated with MS cognitive performance. OCT-based measures were also significant predictors of cognitive status in MS patients. mGCIP associated with cognitive performance in HCs. FAU - Jakimovski, Dejan AU - Jakimovski D AUID- ORCID: 0000-0001-7114-4958 AD - Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. djakimovski@bnac.net. AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. djakimovski@bnac.net. FAU - Benedict, Ralph H B AU - Benedict RHB AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Weinstock-Guttman, Bianca AU - Weinstock-Guttman B AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Ozel, Osman AU - Ozel O AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Fuchs, Tom A AU - Fuchs TA AD - Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Lincoff, Norah AU - Lincoff N AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Bergsland, Niels AU - Bergsland N AD - Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. AD - IRCCS, Fondazione Don Carlo Gnocchi ONLUS, Milan, Italy. FAU - Dwyer, Michael G AU - Dwyer MG AD - Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. FAU - Zivadinov, Robert AU - Zivadinov R AD - Department of Neurology, Buffalo Neuroimaging Analysis Center (BNAC), Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, 100 High Street, Buffalo, NY, 14203, USA. AD - Department of Neurology, Jacobs Comprehensive MS Treatment and Research Center, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, USA. AD - Center for Biomedical Imaging at Clinical Translational Science Institute, University at Buffalo, State University of New York, Buffalo, NY, USA. LA - eng PT - Journal Article DEP - 20210215 PL - Germany TA - J Neurol JT - Journal of neurology JID - 0423161 SB - IM MH - Cognition MH - Humans MH - *Multiple Sclerosis/complications/diagnostic imaging MH - *Optic Neuritis MH - Retina MH - Tomography, Optical Coherence OTO - NOTNLM OT - Cognitive performance OT - GCIP OT - Low-contrast letter acuity OT - Macular volume OT - Multiple sclerosis OT - Optical coherence tomography OT - RNFL EDAT- 2021/02/17 06:00 MHDA- 2021/06/24 06:00 CRDT- 2021/02/16 06:15 PHST- 2020/11/02 00:00 [received] PHST- 2021/01/30 00:00 [accepted] PHST- 2021/01/29 00:00 [revised] PHST- 2021/02/17 06:00 [pubmed] PHST- 2021/06/24 06:00 [medline] PHST- 2021/02/16 06:15 [entrez] AID - 10.1007/s00415-021-10437-5 [pii] AID - 10.1007/s00415-021-10437-5 [doi] PST - ppublish SO - J Neurol. 2021 Jul;268(7):2578-2588. doi: 10.1007/s00415-021-10437-5. Epub 2021 Feb 15.