Visual Pathway Measures are Associated with Neuropsychological Function in Multiple Sclerosis

ABSTRACT

Purpose: To determine the relationships between visual function and ganglion cell and inner plexiform layer thickness and neuropsychological measures in multiple sclerosis (MS).

Methods: Ninety-five relapsing–remitting MS (RRMS) and 36 progressive MS patients underwent 100%-contrast visual acuity (VA), 2.5%- and 1.25%-contrast letter acuity (LA) testing, Cirrus-HD-optical coherence tomography, and neuropsychological assessments. Mixed-effects regression models were used to assess relationships.

Results: Across the cohort, 1.25%-contrast LA was associated with Symbol Digit Modalities Test (SDMT; β = 2.17, p = 0.005) and Brief Visuospatial Memory Test-Revised (BVMT-R) total recall (TR) and delayed recall (DR) scores (β = 0.31, p < 0.001; β = 0.15, p = 0.039, respectively). 2.5%-contrast LA was associated with BVMT-R TR scores (β = 0.27, p = 0.006). In the RRMS cohort, 1.25%-contrast LA was generally more significantly associated with cognitive measures: SDMT (β = 2.97, p = 0.001) and BVMT-R TR (β = 0.32, p < 0.001) and DR (β = 0.22, p = 0.012).

Conclusion: This study suggests that visual pathway measures, particularly visual function measures, reflect aspects of cognitive function in MS, further supporting their roles as complementary outcomes in MS neuroprotection trials.

KEYWORDS:

• Visual pathway
• visual function
• neuropsychological assessment
• multiple sclerosis
• optical coherence tomography

Acknowledgments

J. Nguyen: data collection, data analysis, interpretation of data, drafting, and revision of manuscript. A. Rothman: data collection and revision of manuscript for important intellectual content. Dr. Fitzgerald: data analysis and revision of manuscript for important intellectual content. Dr. Balcer: revision of manuscript for important intellectual content. Dr. Frohman: revision of manuscript for important intellectual content. T. Frohman: revision of manuscript for important intellectual content. Dr. Crainiceanu: data analysis, interpretation of data, drafting, and revision of manuscript for important intellectual content. Dr. Meghan Beier: data analysis, interpretation of data, drafting, and revision of manuscript for important intellectual content. Dr. Newsome: drafting, and revision of manuscript for important intellectual content. Dr. Calabresi: data collection, interpretation of data, drafting, and revision of manuscript for important intellectual content. Dr. Saidha: data collection, data analysis, interpretation of data, drafting, and revision of manuscript for important intellectual content.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the contents and writing of the paper.

Additional information

Funding

This study was funded by Race to Erase MS (to S.S.); National Institutes of Health (5R01NS082347-02 [to P.A.C.]); National Multiple Sclerosis Society (RG-1606-08768 [to SS]; TR 3760-A-3 [to P.A.C.] & RG 4212-A-4 [to L.J.B. subcontracted to P.A.C.]); National Eye Institute (R01 EY 014933 & R01 EY 019473 [to L.J.B. subcontracted to P.A.C.]); and Braxton Debbie Angela Dillon & Skip (DADS) Donor Advisor Fund (to P.A.C., E.M.F., and L.J.B);