Neuroplasticity predicts outcome of optic neuritis independent of tissue damage
Version of Record online: 11 AUG 2009
Copyright © 2010 American Neurological Association
Annals of Neurology
Volume 67, Issue 1, pages 99–113, January 2010
How to Cite
Jenkins, T. M., Toosy, A. T., Ciccarelli, O., Miszkiel, K. A., Wheeler-Kingshott, C. A., Henderson, A. P., Kallis, C., Mancini, L., Plant, G. T., Miller, D. H. and Thompson, A. J. (2010), Neuroplasticity predicts outcome of optic neuritis independent of tissue damage. Ann Neurol., 67: 99–113. doi: 10.1002/ana.21823
- Issue online: 23 FEB 2010
- Version of Record online: 11 AUG 2009
- Accepted manuscript online: 11 AUG 2009 12:00AM EST
- Manuscript Accepted: 31 JUL 2009
- Manuscript Revised: 17 JUN 2009
- Manuscript Received: 18 DEC 2008
To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage.
Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function.
Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome.
Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP). ANN NEUROL 2010;67:99–113