Impaired motion perception is associated with functional and structural visual pathway damage in multiple sclerosis and neuromyelitis optica spectrum disorders

Abstract

Background: Decreased motion perception has been suggested as a marker for visual pathway demyelination in optic neuritis (ON) and/or multiple sclerosis (MS). Objectives: To examine the influence of neuro-axonal damage on motion perception in MS and neuromyelitis optica spectrum disorders (NMOSD). Methods: We analysed motion perception with numbers-from-motion (NFM), visual acuity, (multifocal (mf)) VEP, optical coherence tomography in patients with MS ( n = 38, confirmatory cohort n = 43), NMOSD ( n = 13) and healthy controls ( n = 33). Results: NFM was lower compared with controls in MS ( B = −12.37, p < 0.001) and NMOSD ( B = −34.5, p < 0.001). NFM was lower in ON than in non-ON eyes ( B = −30.95, p = 0.041) in NMOSD, but not MS. In MS and NMOSD, lower NFM was associated with worse visual acuity ( B = −139.4, p < 0.001/ B = −77.2, p < 0.001) and low contrast letter acuity ( B = 0.99, p = 0.002/ B = 1.6, p < 0.001), thinner peripapillary retinal nerve fibre layer ( B = 1.0, p < 0.001/ B = 0.92, p = 0.016) and ganglion cell/inner plexiform layer ( B = 64.8, p < 0.001/ B = 79.5, p = 0.006), but not with VEP P100 latencies. In the confirmatory MS cohort, lower NFM was associated with thinner retinal nerve fibre layer ( B = 1.351, p < 0.001) and increased mfVEP P100 latencies ( B = −1.159, p < 0.001). Conclusions: Structural neuro-axonal visual pathway damage is an important driver of motion perception impairment in MS and NMOSD.

GAP-43 Induces the Differentiation of Bone Marrow-Derived Mesenchymal Stem Cells into Retinal Ganglial-Like Cells

“…The deficiency of NFL is related with the progression of ON. Several studies have indicated that NFL and NFM are significantly downregulated in the eyes of the patients with ON, and the expression of NFL has always been selected as a biomarker for the diagnosis of optical system [ 22 , 23 ]. These proofs suggest that GAP-43 could induce the differentiation of BMSCs into RGC-like cells.…”

Utility of the visual system to monitor neurodegeneration in multiple sclerosis

“…Measuring motion perception, another type of visual assessment, may predict both axonal loss and demyelination, though without regional specificity. A study by Ayadi et al (2021) investigated two cohorts of people with MS in Berlin and Sydney and found that motion perception deficits correlated with RNFL and GCIPL thicknesses and visual acuity. This suggests that motion perception may be correlated with axonal loss.…”

“…This suggests that motion perception may be correlated with axonal loss. However, in the cohort from Sydney, where patients had more pronounced optic neuritis, motion perception also correlated with mfVEP latencies ( Ayadi et al, 2021 ). This is consistent with a study showing that, especially in patients with a history of optic neuritis, full-field VEP latencies were inversely associated with motion perception ability ( Backner et al, 2019 ).…”

“…Another measure of visual function is high- and low-contrast visual acuity, which is associated with retinal degeneration and clinical disability in MS (reviewed in Balcer et al, 2017 ). Finally, motion perception deficits have been studied as a potential marker of axonal degeneration and demyelination in MS ( Ayadi et al, 2021 ). Decreases in motion perception have been associated with retinal thinning, visual acuity, and VEP latency ( Backner et al, 2019 ; Ayadi et al, 2021 ).…”

“…Finally, motion perception deficits have been studied as a potential marker of axonal degeneration and demyelination in MS ( Ayadi et al, 2021 ). Decreases in motion perception have been associated with retinal thinning, visual acuity, and VEP latency ( Backner et al, 2019 ; Ayadi et al, 2021 ). Here, we discuss current literature on visual assessments relevant for monitoring MS, focusing on the potential for earlier detection of neurodegeneration.…”