期刊
ARCHIVES OF NEUROLOGY
卷 69, 期 1, 页码 65-71出版社
AMER MEDICAL ASSOC
DOI: 10.1001/archneurol.2011.243
关键词
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资金
- Acorda Therapeutics
- National Institutes of Health (NIH) [K23NS052430-01A1, K12RR02324902, K24 RR017100, CO6 RR020092, RR024992]
- sanofi-aventis
- Genentech Inc.
- Biogen Idec
- National Institute of Neurological Disorders and Stroke [PO1 NS059560-01, UO1 NS45719-01A1, RO1 NS047592, RO1 NS 051591]
- Washington University Institute of Clinical and Translational Sciences
- National Multiple Sclerosis Society [FG1782A1, CA1012, RG 3670]
- Consortium of Multiple Sclerosis Centers
- Barnes-Jewish Hospital Foundation
- National Center for Research Resources, a component of the NIH [UL1 RR024992]
- NIH Roadmap for Medical Research
Objective: To evaluate directional diffusivities within the optic nerve in a first event of acute optic neuritis to determine whether decreased axial diffusivity (AD) would predict 6-month visual outcome and optic nerve integrity measures. Design: Cohort study. Setting: Academic multiple sclerosis center. Patients: Referred sample of 25 individuals who presented within 31 days after acute visual symptoms consistent with optic neuritis. Visits were scheduled at baseline, 2 weeks, and 1, 3, 6, and 12 months. Main Outcome Measures: Visual acuity, contrast sensitivity, visual evoked potentials (VEPs), and thickness of the retinal nerve fiber layer (RNFL). Results: An incomplete 6-month visual recovery was associated with a lower baseline AD (1.50 mu m(2)/ms [95% confidence interval {CI}, 1.36-1.64 mu m(2)/ms for incomplete recovery vs 1.75 mu m(2)/ms [95% CI, 1.67-1.83 mu m(2)/ms] for complete recovery). Odds of complete recovery decreased by 53% (95% CI, 27%-70%) for every 0.1-unit decrease in baseline AD. A lower baseline AD correlated with worse 6-month visual outcomes in visual acuity (r=0.40, P=.03), contrast sensitivity (r=0.41, P=.02), VEP amplitude (r=0.55, P <.01), VEP latency (r=-0.38, P=.04), and RNFL thickness (r=0.53, P=.02). Radial diffusivity increased between months 1 and 3 to become higher in those with incomplete recovery at 12 months than in those with complete recovery (1.45 mu m(2)/ms [95% CI, 1.31-1.59 mu m(2)/ms] vs 1.19 mu m(2)/ms [95% CI, 1.10-1.28 mu m(2)/ms]). Conclusions: Decreased AD in acute optic neuritis was associated with a worse 6-month visual outcome and correlated with VEP and RNFL measures of axon and myelin injury. Axial diffusivity may serve as a marker of axon injury in acute white matter injury.
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