24Jul 2018

DIFFUSION TENSOR IMAGING OF OPTIC RADIATION IN MULTIPLE SCLEROSIS: CORRELATION WITH VEP.

  • Neurology Department, Faculty of Medicine, Mansoura University, Egypt.
  • Radiodiagnosis Department, Faculty of Medicine, Mansoura University, Egypt.
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Purpose: To test the significance of FA and MD of diffusion tensor imaging in differentiating MS patients with normal and delayed VEP Material and Methods: This study was conducted upon 70 patients (aged 18-46 years: mean 32years) with multiple sclerosis that underwent diffusion tensor imaging and VEP. The average fractional anisotropy (FA) and mean diffusivity (MD) value of the right and left optic radiation in patients with normal (n=39) and delayed (n=28) were calculated and correlated with VEP of both sides. The receiver operating characteristic curve was drawn to detect the cutoff point of FA and MD of optic radiation used to differentiate patients with normal and delayed VEP. Correlation between FA, MD of OR with VEP, disease duration and EDSS were tested by person correlation coefficient. Also inter-observer agreement was done by comparing the FA and MD obtained by the two observers. A P value less than 0.05 was considered statistically significant.Results: The mean FA of optic radiation in patient with delayed VEP (0.36?0.03 and 0.36?0.08 X103mm2/s first and second observer respectively) was significantly lower than the mean FA of optic radiation in patient with normal VEP (00.39?0.03 and 0.39?0.04 X10-3mm2/s first and second observer respectively). The mean MD of optic radiation in patient with delayed VEP (0.96?0.06 and 0.98?0.07 X10-3mm2/s first and second observer respectively) was significantly higher than the mean MD of optic radiation in patient with normal VEP (0.88?0.05 and 0.89?0.05 X10-3mm2/s first and second observer respectively). Selection of FA of ≤0.38 and ≤0.395 X10-3mm2/s (first and second observer respectively) to differentiate patient with delayed and normal VEP has an area under the curve of 0.804 and 0.734, , a sensitivity of 75% and 82.1% , a specificity of 82.1% and 56.4 % , and accuracy of 79.1 % and 67.16 %, respectively. Selection of MD of ≥0.885 and ≥0.90 X10-3mm2/s (first and second observer respectively) to differentiate patient with delayed and normal VEP has an area under the curve of 0.901 and 0.893, a sensitivity of 96.4 % and 92.9 %, a specificity of 76.9 % and 71.8 %, and accuracy of 85.07 % and 80.6 % respectively

  1. Balcer, L. Miller, D. Reingold, S. and Cohen, J. Vision and vision related outcome measures in multiple sclerosis. Brain. 2015;138: 11?27.
  2. Maria, R. Malte, R.Tobias, S. Zsolt, I. and Jakob, G. long term structural retinal changes in patients with optic neuritis related to multiple sclerosis.Clinical Ophthalmology. 2017; 11: 1519 ?1525.

3.?????? Azevedo, C. Overton, E.?Khadka, S.?Buckley, J.?Liu, S.?Sampat, M. Kantarci, O.?Frenay, C.Siva, A.?Okuda, D. and Palletier, D. Early CNS neurodegeneration in radiologically isolated syndrome. Neurol Neuroimmunol Neuroinflamm. 2015; 2(3): 102.

  1. Huang, D. Swanson, E. ? Lin, C. ? Schuman, J.? Stinson, W. Chang, W. Hee, M. ? Flotte, T. ?Gregory, K. ? Puliafito, C.? and? Fujimoto, J. Optical Coherence Tomography. Ann Neurol.2011; 69(2): 292 ? 302.
  2. Lauren, S. Talman, B. ??Esther, R. Bisker, M. ?David, J. Sackel, B. ?David, A. Long, B. Jr.Kristin, M. Galetta, M. ?John, N. Ratchford, M. ??Deacon, J. Lile, B. Sheena, K. Farrell, B Longitudinal study of vision and retinal nerve fiber layer thickness in multiple sclerosis. Annals of neurology. 2010; 67(6):8 ? 15.
  3. Ruchi, K., Pradeep, B., Smita, S., Ramji, S. A Comprehensive Review on Methodologies Employed for Visual Evoked Potentials. Scientifica. 2016; 4: 9.

7.?????? Casper, E. van Munster and Bernard, M. Uitdehaag, J. Outcome Measures in Clinical Trials for Multiple Sclerosis. CNC Drugs. 2017; 31(3): 217?236.

  1. Wingerchuk, D. Banwell, B. Bennett, J. Cabre, P. Carroll, W. Chitnis, T., et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology. 2016; 86:491? 492.
  2. Kim, H. Paul, F. Lana-Peixoto, M. Tenembaum, S. Asgari, N. Palace, J., et al. MRI characteristics of neuromyelitis optica spectrum disorder: an international update. Neurology. 2015; 84: 1165 ? 1173. Kuchling, J. Brandt, A. Paul, F. and Scheel, M. Diffusion tensor imaging for multilevel assessment of the visual pathway: possibilities for personalized outcome prediction in autoimmune disorders of the central nervous system. EPMA J. 2017; 8:279 ?294.
  3. Oreja-Guevara, C. Rovaris, M. Iannucci, G., et al. Progressive gray matter damage in patients with elapsing-remitting multiple sclerosis: a longitudinal diffusion tensor magnetic resonance imaging study.Archives of Neurology. 2005; 62 (4):578 ?584.
  4. Parker, G. Stephan, K. Barker, J. Rowe, J. MacManus, D. Wheeler-Kingshott, C. et al. Initial Demonstration of In Vivo Tracing of Axonal Projections in the Macaque Brain and Comparison with the Human Brain using Diffusion Tensor Imaging and Fast Marching Tractography. 2002; 15(15): 797? 809.
  5. Scholz, J. and?Johansen-Berg, H. Individual Differences in White Matter Microstructure in the Healthy Brain.?Diffusion MRI From Quantitative Measurement to In vivo Neuroanatomy (Second Edition).?2014; chapter 14: 301?
  6. Scheel, M. Finke, C. Oberwahrenbrock, T. Freing, A. Pech, L. Schlichting, J., et al. Retinal nerve fibre layer thickness correlates with brain white matter damage in multiple sclerosis: a combined optical coherence tomography and diffusion tensor imaging study. Multiple Sclerosis. 2014; 19:1904 ?1907.
  7. Lobsien, D. Ettrich, B. Sotiriou, K. Classen, J. Then Bergh, F. and Hoffmann, K. Whole-brain diffusion tensor imaging in correlation to visual-evoked potentials in multiple sclerosis: a tract-based spatial statistics analysis. Am J Neuroradiol. 2014; 35: 2076 ?2081.
  8. Kolbe, S. Bajraszewski, C. Chapman, C. Nguyen, T. Mitchell, P. Paine, M., et al. Diffusion tensor imaging of the optic radiations after optic neuritis. Hum Brain Mapp. 2012; 33:2047? 2061.
  9. Rocca, M. Mesaros, S. Preziosa, P. Pagani, E. Stosic-Opincal, T. Dujmovic-Basuroski, I., et al. Wallerian and trans-synaptic degeneration contribute to optic radiation damage in multiple sclerosis: a diffusion tensor MRI study. Multiple Sclerosis. 2013; 19:1610 ?1617.
  10. Reich, D. Smith, S. Gordon-Lipkin, E. Ozturk, A. Caffo, B. Balcer, L., et al. Damage to the optic radiation in multiple sclerosis is associated with retinal injury and visual disability. Arch Neurol. 2009; 66: 998 ?1006.
  11. Raz, N. Chokron, S., Ben-Hur, T. and Levin, N. Temporal reorganization to overcome monocular demyelination. Neurology. 2013; 81: 702 ? 709.
  12. Alshowaeir, D. Yiannikas, C. Garrick, R. Parratt, J. Barnett, M. Graham, S., et al. Latency of multifocal visual evoked potentials in nonoptic neuritis eyes of multiple sclerosis patients associated with optic radiation lesions. Invest. Opthalmol. Vis. Sci. 2014; 55: 3758 ? 3764.

[Azza El Mongui El Mongui1, Maha Hazem Khalil2, Ahmed Abdel Khalek Abdel Razek, Mohammad Abu-Hegazy, Ahmed Abdulatif Mosa and Mahitab Ghoneim. (2018); DIFFUSION TENSOR IMAGING OF OPTIC RADIATION IN MULTIPLE SCLEROSIS: CORRELATION WITH VEP. Int. J. of Adv. Res. 6 (Jul). 865-871] (ISSN 2320-5407). www.journalijar.com

Ahmed Abdulatif Mosa
Neurologist

DOI:

Article DOI: 10.21474/IJAR01/7435      
DOI URL: https://dx.doi.org/10.21474/IJAR01/7435

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