Temporal aspects of visual perception in demyelinative diseases

Raz, Noa; Shear-yashuv, Gabriel; Backner, Yael; Bick, Atira; Levin, Netta

doi:10.1016/j.jns.2015.07.037

Cited by 8 publications

(10 citation statements)

References 21 publications

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“… 33 Thus, we postulated that CFF could reflect integrity of the magnocellular retinal cells' ability to detect higher frequency stimuli, 34 and damage of magnocellular retinal ganglion cells might specifically cause decreased CFF. However, our results show no significant association of CFF with any afferent visual system marker, indicating that retinal neuroaxonal retinal damage had no or only negligible influence to CFF in patients with MS. 34 , 35 These findings could be explained by effects being small and masked by other associations. However, neuroaxonal retinal damage and demyelination of our MS cohort seem to be comparable to other MS cohorts regarding OCT and VEP measurements.…”

Section: Discussionmentioning

confidence: 95%

Temporal visual resolution and disease severity in MS

Ayadi

Dörr

Motamedi

et al. 2018

Neurol Neuroimmunol Neuroinflamm

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ObjectiveTo examine temporal visual resolution assessed as critical flicker frequency (CFF) in patients with MS and to investigate associations with visual system damage and general disability and cognitive function.MethodsThirty-nine patients with MS and 31 healthy controls (HCs) were enrolled in this cross-sectional study and underwent CFF testing, high- and low-contrast visual acuity, alertness and information processing speed using the paced auditory serial addition task (PASAT), and retinal optical coherence tomography (OCT). In patients with MS, visual evoked potentials (VEPs) and Expanded Disability Status Scale (EDSS) scores were assessed.ResultsCFF in patients with MS (mean ± SD: 40.9 ± 4.4 Hz) was lower than in HCs (44.8 ± 4.4 Hz, p < 0.001). There was no significant CFF difference between eyes with and without previous optic neuritis (ON). CFF was not associated with visual acuity, VEP latency, the peripapillary retinal nerve fiber layer thickness, and the combined ganglion cell and inner plexiform layer volume. Instead, reduced CFF was associated with worse EDSS scores (r2 = 0.26, p < 0.001) and alertness (r2 = 0.42, p = 0.00042) but not with PASAT (p = 0.33).ConclusionCFF reduction in MS occurs independently of ON and structural visual system damage. Its association with the EDSS score and alertness suggests that CFF reflects global disease processes and higher cortical processing rather than focal optic nerve or retinal damage.

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Section: Discussionmentioning

confidence: 95%

Temporal visual resolution and disease severity in MS

Ayadi

Dörr

Motamedi

et al. 2018

Neurol Neuroimmunol Neuroinflamm

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“…Motion perception was assessed using object-from-motion (OFM) and number-from-motion (NFM) extraction tasks, based on the opposing movement of dot arrays outside and inside the formed object/number. The camouflaged object/number cannot be discerned when the dots are stationary [these tests have been previously described (14)]. Briefly, stimuli were presented at seven speeds, the slowest being most difficult.…”

Section: Methodsmentioning

confidence: 99%

Vision and Vision-Related Measures in Progressive Multiple Sclerosis

et al. 2019

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Background: Over the last few years there has been growing interest in use of visual measures as useful tools for multiple sclerosis (MS) prognosis and tracking. Optic neuritis (ON) being a prevalent and often-presenting symptom of the disease, as well as the high occurrence rate of posterior visual system damage independent of ON (optic radiation lesions), make the visual system a prime candidate for such endeavors. However, while the visual system makes for a convenient model in early stages of MS, processes which may be true in those stages may drastically change as the disease progresses, due to accumulated disease load. Here, we examine whether vision-related tools reflect demyelinative and axonal damage of the visual pathways and may be used for assessment in the clinical setup in progressive multiple sclerosis (MS) patients, in whom disease load may alter the early stage picture. Methods: Forty-eight progressive MS patients, with and without prior optic neuritis (ON), underwent a battery of behavioral tests, visual evoked potential (VEP) tests, optical coherence tomography (OCT), and structural MRI scans, at two time-points. Data were analyzed for stability between visits and for correlation between behavioral and electrophysiological data. Results: All measures were stable between visits. Significant differences were found in all measures between the affected and fellow eyes of ON patients and in VEP latencies between the affected and non-ON eyes. Motion perception differentially correlated with latencies of both ON eyes and with the non-ON eyes. Retinal nerve fiber layer thickness correlated with the latencies of non-ON eyes but not of either ON eye. No difference in lesion load was found between the ON and non-ON patients. Conclusions: ON still leaves its mark in the patient's visual system over time, with all visual measures of the affected eyes notably reduced compared to fellow eyes. Motion perception, reflecting myelination level along the visual pathway, shows its usefulness also in progressive MS. In the non-ON eyes, axonal loss appears to explain prolonged latencies, unlike in ON eyes, where demyelination appears to be the main mechanism. Lastly, the visual measures assessed herein are applicable as valid assessment tools in therapeutic studies.

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“…The role of psychophysical tests in ON and MS is expanding due to the temporal effect exerted by demyelination. Other tests of the dynamic visual system include the object-from-motion and number-from-motion tests presented by Raz et al [1][2][3] and the CFF test, which is of some diagnostic value in the field of ON and MS [5][6][7][8] but rather unspecific as it seemingly depends on visual acuity [22]. We did not include CFF as an end point.…”

Section: Discussion/conclusionmentioning

confidence: 99%

“…Various static visual tests are involved in the clinical evaluation of ON. The value of dynamic visual tests is becoming recognized due to the effect on the temporal aspects of the visual system exerted by demyelination [1][2][3][4][5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test

et al. 2019

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Background: The Aulhorn flicker test (AFT) previously showed promise in diagnosing acute optic neuritis (ON) albeit with suboptimal sensitivity. A new, digitalized version of the AFT (the DFT) has not previously been examined in acute ON. Objectives: To examine the sensitivity, specificity and reproducibility of the DFT in acute ON. Method: The DFT assesses the subjective brightness of a flickering field (1-60 Hz). In normal subjects, brightness enhancement occurs at intermediate frequencies, whereas in acute ON darkness enhancement (DE) is hypothesized. AFT and DFT measurements were obtained in acute ON patients (≤31 days from first symptom) with DE as a quantitative covariate. Reproducibility of the DFT end point was assessed in the form of an intraclass correlation. Results: 30 untreated first-time acute ON patients and 55 healthy controls were examined. AFT and DFT were performed 12.7 days (range: 4-30) following ON onset. The DFT showed a sensitivity of 0.93 (95% CI = 0.78-0.99) to a specificity of 0.96 (95% CI = 0.87-1.00). The AFT showed a sensitivity of 0.76 (95% CI = 0.56-0.90) to a specificity of 1.00 (95% CI = 0.93-1.00). No significant correlation was shown between DFT and visual acuity. The intraclass correlation of the DFT end point in healthy subjects was 0.84. Conclusions: We present a new DFT in acute ON displaying a high specificity of 0.96 and a sensitivity of 0.93. Our study indicates the DFT to be an accurate and easy-to-use tool in diagnosing acute ON, which may be especially helpful in atypical cases.

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Temporal aspects of visual perception in demyelinative diseases

Cited by 8 publications

References 21 publications

Temporal visual resolution and disease severity in MS

Temporal visual resolution and disease severity in MS

Vision and Vision-Related Measures in Progressive Multiple Sclerosis

Sensitive Assessment of Acute Optic Neuritis by a New, Digital Flicker Test

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