Corneal axonal loss as an imaging biomarker of neurodegeneration in multiple sclerosis: a longitudinal study

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dc.contributor.authorPetropoulos, Ioannis N.
dc.contributor.authorAl-Shibani, Fatima
dc.contributor.authorBitirgen, Gulfidan
dc.contributor.authorPonirakis, Georgios
dc.contributor.authorKhan, Adnan
dc.contributor.authorGad, Hoda
dc.contributor.authorMahfoud, Ziyad R.
dc.date.accessioned2024-02-23T14:27:11Z
dc.date.available2024-02-23T14:27:11Z
dc.date.issued2023
dc.departmentNEÜen_US
dc.description.abstractBackground:Resourceful endpoints of axonal loss are needed to predict the course of multiple sclerosis (MS). Corneal confocal microscopy (CCM) can detect axonal loss in patients with clinically isolated syndrome and established MS, which relates to neurological disability. Objective:To assess corneal axonal loss over time in relation to retinal atrophy, and neurological and radiological abnormalities in MS. Methods:Patients with relapsing-remitting (RRMS) (n = 68) or secondary progressive MS (SPMS) (n = 15) underwent CCM and optical coherence tomography. Corneal nerve fibre density (CNFD-fibres/mm(2)), corneal nerve branch density (CNBD-branches/mm(2)), corneal nerve fibre length (CNFL-mm/mm(2)) and retinal nerve fibre layer (RNFL-mu m) thickness were quantified along with neurological and radiological assessments at baseline and after 2 years of follow-up. Age-matched, healthy controls (n = 20) were also assessed. Results:In patients with RRMS compared with controls at baseline, CNFD (p = 0.004) and RNFL thickness (p < 0.001) were lower, and CNBD (p = 0.003) was higher. In patients with SPMS compared with controls, CNFD (p < 0.001), CNFL (p = 0.04) and RNFL thickness (p < 0.001) were lower. For identifying RRMS, CNBD had the highest area under the receiver operating characteristic (AUROC) curve (0.99); and for SPMS, CNFD had the highest AUROC (0.95). At follow-up, there was a further significant decrease in CNFD (p = 0.04), CNBD (p = 0.001), CNFL (p = 0.008) and RNFL (p = 0.002) in RRMS; in CNFD (p = 0.04) and CNBD (p = 0.002) in SPMS; and in CNBD (p = 0.01) in SPMS compared with RRMS. Follow-up corneal nerve loss was greater in patients with new enhancing lesions and optic neuritis history. Conclusion:Progressive corneal and retinal axonal loss was identified in patients with MS, especially those with more active disease. CCM may serve as an imaging biomarker of axonal loss in MS.en_US
dc.description.sponsorshipQatar National Research Fund [UREP26-094-3-037, BMRP20038654]; Merck Grant for Multiple Sclerosis Innovation [201701.10249.POT]en_US
dc.description.sponsorshipThe authors disclosed receipt of the following financial support for the research, authorship and/or publication of this article: This work was sup-ported by the Qatar National Research Fund (grant numbers UREP26-094-3-037, BMRP20038654) and a Merck Grant for Multiple Sclerosis Innovation (grant number 201701.10249.POT). The sponsors had no role in the study design, data analysis or manuscript preparation.en_US
dc.identifier.doi10.1177/17562864221118731
dc.identifier.issn1756-2856
dc.identifier.issn1756-2864
dc.identifier.pmid36776530en_US
dc.identifier.scopus2-s2.0-85147586582en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.urihttps://doi.org/10.1177/17562864221118731
dc.identifier.urihttps://hdl.handle.net/20.500.12452/14467
dc.identifier.volume16en_US
dc.identifier.wosWOS:000940574500001en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherSage Publications Ltden_US
dc.relation.ispartofTherapeutic Advances In Neurological Disordersen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectAxonal Lossen_US
dc.subjectBiomarkeren_US
dc.subjectCorneal Confocal Microscopyen_US
dc.subjectMultiple Sclerosisen_US
dc.subjectNeurodegenerationen_US
dc.titleCorneal axonal loss as an imaging biomarker of neurodegeneration in multiple sclerosis: a longitudinal studyen_US
dc.typeArticleen_US

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