The prevalence of internuclear ophthalmoparesis in a population-based cohort of individuals with multiple sclerosis

Hof, Samuel N; Loonstra, Floor C.; Ruiter, Lodewijk R J de; Rijn, L.J. van; Petzold, Axel; Uitdehaag, Bernard M. J.; Bijvank, Jenny A. Nij

doi:10.1016/j.msard.2022.103824

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…Pioneering work by Elliot and Teresa Frohman on the internuclear ophthalmoplegia (INO) has laid the foundations for interrogating an anatomically and clinically well-defined symptom in MS 10 11. Confirming this original research our group has demonstrated in different large cohorts that an INO can be found in about 25% of people with MS (pwMS) 12 13. A concise protocol for quantification of the INO has been validated for a multicentre setting 14.…”

Section: Introductionmentioning

confidence: 83%

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Measuring and predicting the effect of remyelinating therapy in multiple sclerosis: a randomised controlled trial protocol (RESTORE)

Hof,

van Rijn,

Uitdehaag

et al. 2024

BMJ Open

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IntroductionRemyelination failure hampers symptomatic recovery in multiple sclerosis (MS), underlining the importance of developing remyelinating therapies. Optic neuritis is currently the most established method of measuring remyelination in MS trials. Complementary more generalisable methods of measuring remyelination are required to confirm treatment efficacy. Measuring internuclear ophthalmoplegia (INO) with infrared oculography provides such a method. Moreover, this method can be expanded with a test for selecting likely treatment responders by using fampridine. The aim of this trial is to investigate the (long-term) remyelinating effects of clemastine fumarate in patients with MS and INO and to evaluate if treatment response can be predicted using fampridine.Methods and analysisRESTORE is a single-centre double-blind randomised placebo-controlled trial of clemastine fumarate versus placebo. Prior to clemastine treatment improvement in oculographic features of INO after a single 10 mg dose of fampridine is measured in all participants and used to predict the treatment response to clemastine. Eighty individuals with MS and INO will be 1:1 randomised to 4 mg of clemastine fumarate two times a day for 6 months or equivalent placebo. Our primary outcome is improvement in the Versional Dysconjugacy Index-area under the curve, measured by infrared oculography after 6 months of treatment. Participants are assessed for persistent treatment effects 6, 18 and 30 months after end of treatment. Secondary outcome measures include other oculography parameters including double-step saccades, retinal imaging, visual acuities, physical disability, cognition and patient-reported outcomes.Ethics and disseminationClemastine is a registered and very well-established drug with well-known safety and side effects. The protocol was approved by the medical ethical committee of the Amsterdam UMC, location VUMC and the Dutch Central Committee on Research Involving Human Subject. Written informed consent is obtained from all participants. The results will be published in peer-reviewed medical scientific journals.Trial registration numberEudraCT: 2021-003677-66, ClinicalTrials.gov:NCT05338450.

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Section: Introductionmentioning

confidence: 83%

“…A combination of VDI-pV/Am and VDI-AUC in 15° saccades resulted in the highest accuracy with 98% specificity. A threshold of 1.174 VDI-AUC or 1.180 VDI-pV/Am resulted in a prevalence of INO in MS of 24–34% 12 13. Identical thresholds will be used to diagnose INO in the current study.…”

Section: Methods and Analysismentioning

confidence: 99%

Measuring and predicting the effect of remyelinating therapy in multiple sclerosis: a randomised controlled trial protocol (RESTORE)

Hof,

van Rijn,

Uitdehaag

et al. 2024

BMJ Open

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“…Auch die okuläre Dysmotilität, einschließlich der internukleären Ophthalmoplegie (INO) und der bilateralen INO mit dem Schielauge, ist bei MS weit verbreitet [77]. Es gibt nur wenige Artikel in der Literatur, die sich mit den ethnischen und rassischen Unterschieden bei diesen Befunden befassen, was erwähnenswert ist, zumal es Literaturstellen gibt, die darauf hindeuten, dass die Hirnstammregionen, die diese Funktionen steuern, bei Menschen mit afroamerikanischer Abstammung strukturell besonders anfällig sind [78].…”

Section: Okuläre Dysmotilitätunclassified

Eine Übersicht über neuro-ophthalmologische Erkrankungen bei Afroamerikanern und Hispanics mit multipler Sklerose

Tardo,

Salter,

Truong-Le

et al. 2023

Kompass Ophthalmol

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Multiple Sklerose (MS) ist die häufigste nichttraumatische Ursache für Behinderungen bei jungen Menschen, wobei der Verlust des Sehvermögens bei dieser Krankheit den zweitgrößten Anteil an der Behinderung ausmacht. Insbesondere afroamerikanische MS-Patienten haben ein schlechteres Sehvermögen als die Vergleichsgruppe der Kaukasier. In dieser Übersichtsarbeit untersuchen wir die Unterschiede bei Augenkrankheiten in der MS-Population unter Berücksichtigung der vorhandenen Wissenslücken und diskutieren die zugrunde liegende Natur der pathologischen Diskrepanzen.

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“…Among the younger population, cases are linked to multiple sclerosis (MS) [1]. INO has been reported to occur in 15-52% of individuals with MS [2]. Other less common causes include Lyme disease, neurosyphilis, brain tumours, head injuries, nutritional deficiencies such as Wernicke encephalopathy, and certain drugs, such as phenothiazines, opioids, and tricyclic antidepressants [1].…”

Section: Introductionmentioning

confidence: 99%

A Stroke of Vision as One-and-a-Half Syndrome: Is It Time to Update the FAST Criteria and ABCD2 Score?

Zafar

McCafferty

Sarwar

et al. 2022

Cureus

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FAST (Face, Arm, Speech, Time) is the most commonly used acronym to identify a possible acute stroke. However, it fails to include visual or vestibular changes as potential hallmarks of an acute event. In this case report, we discuss a patient presenting with visual disturbances and internuclear ophthalmoplegia, with a resulting diagnosis of acute ischaemia. We discuss the associated causes, syndromes, and acute management. Though FAST is an important tool for early recognition of a possible stroke, we want to highlight the consideration of visual changes as an increasing phenomenon in an acute cerebrovascular event.

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The prevalence of internuclear ophthalmoparesis in a population-based cohort of individuals with multiple sclerosis

Cited by 6 publications

References 28 publications

Measuring and predicting the effect of remyelinating therapy in multiple sclerosis: a randomised controlled trial protocol (RESTORE)

Measuring and predicting the effect of remyelinating therapy in multiple sclerosis: a randomised controlled trial protocol (RESTORE)

Eine Übersicht über neuro-ophthalmologische Erkrankungen bei Afroamerikanern und Hispanics mit multipler Sklerose

A Stroke of Vision as One-and-a-Half Syndrome: Is It Time to Update the FAST Criteria and ABCD2 Score?

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