Temporal visual resolution and disease severity in MS

Noah Ayadi; Jan Dörr; Seyedamirhosein Motamedi; Kay Gawlik; Judith Bellmann-Strobl; Janine Mikolajczak; Alexander U Brandt; Hanna Zimmermann; Friedemann Paul

doi:10.1212/NXI.0000000000000492

Temporal visual resolution and disease severity in MS

Neurol Neuroimmunol Neuroinflamm. 2018 Aug 14;5(5):e492. doi: 10.1212/NXI.0000000000000492. eCollection 2018 Sep.

Authors

Noah Ayadi¹, Jan Dörr¹, Seyedamirhosein Motamedi¹, Kay Gawlik¹, Judith Bellmann-Strobl¹, Janine Mikolajczak¹, Alexander U Brandt¹, Hanna Zimmermann¹, Friedemann Paul¹

Affiliation

¹ Charité-Universitätsmedizin Berlin (N.A., J.D., S.M., K.G., J.B.-S., J.M., A.U.B., H.Z., F.P.), Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, NeuroCure Clinical Research Center; Neurology Department (J.D.), Multiple Sclerosis Center, Oberhavel Clinic, Henningsdorf; Experimental and Clinical Research Center (J.B.-S., F.P.), Max Delbrueck Center for Molecular Medicine and Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; and Department of Neurology (F.P.), Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.

Abstract

Objective: To 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.

Methods: Thirty-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.

Results: CFF 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).

Conclusion: CFF 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.