Objectives

The purpose of this research is to predict the cognitive impairment and to determine its correlation with retinal thickness, mainly (RFNL and GCIPL) in cases of multiple sclerosis.

Methods

60 multiple sclerosis patients and 30 age and sex-matched healthy controls were included in this study. Cognitive functions were evaluated in all study participants by the Montreal Cognitive Assessment (MoCA). OCT imaging was done to determine the thickness. The correlation between the cognitive domains of MoCA and the thickness of the retinal nerve fiber layers was analyzed by Spearman correlation. ROC curve was constructed to determine the cut-off points for retinal thickness, and a binary logistic regression was performed to determine the independent predictive capacity of established cut-off points.

Results

Impaired cognition was found in 26 MS patients (43.3%). Cognitively impaired patients were significantly older (P < 0.05), had significantly longer disease duration (P < 0.05), had higher average EDSS scores (4.3 ± 1.22 vs 3.1 ± 1.45, P < 0.001), and occurred more in progressive types of MS (P < 0.001). A significant positive correlation was found between cognitive function and RNFL thickness and GCIPL (P < 0.001). The retinal thickness (RNFL and GCIPL) cut-off points established for the prediction of cognitive impairment in MS patients were 79 μm and 76 μm, respectively.

Conclusion

The clear correlation between cognitive impairment and atrophy of inner retinal layers (RNFL and GCIPL) proposes that OCT is valuable in evaluating the neurodegeneration and prediction of early cognitive impairment in MS.

ABBREVIATIONS

EDSS: Expanded Disability Status Scale; HCs: Healthy controls; GCIPL: Ganglion cell–inner plexiform layer; ILM: Internal limiting membrane; INL: Inner nuclear layer; MoCA: Montreal Cognitive Assessment; MS: Multiple sclerosis; PPMS: Primary progressive multiple sclerosis; RNFL: Retinal nerve fiber layer; RRMS: Relapsing-remitting multiple sclerosis; SD: Standard deviations; SPMS: Secondary progressive multiple sclerosis; SPSS: Statistical Package for the Social Sciences.

中文翻译：

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视网膜厚度可作为多发性硬化症患者神经退行性变的潜在生物标志物和早期认知障碍的预测指标。

目标

这项研究的目的是预测认知障碍并确定其与视网膜厚度的相关性，主要是在多发性硬化症的情况下（RFNL和GCIPL）。

方法

本研究包括60例多发性硬化症患者以及30例年龄和性别相匹配的健康对照组。通过蒙特利尔认知评估（MoCA）对所有研究参与者的认知功能进行了评估。进行OCT成像以确定厚度。通过Spearman相关分析了MoCA认知域与视网膜神经纤维层厚度之间的相关性。构造ROC曲线来确定视网膜厚度的临界点，并进行二元logistic回归以确定已建立的临界点的独立预测能力。

结果

在26名MS患者中发现认知受损（43.3％）。认知障碍患者年龄较大（P <0.05），病程明显更长（P <0.05），平均EDSS评分较高（4.3±1.22 vs 3.1±1.45，P <0.001），并且在进行性MS发生率更高（P <0.001）。发现认知功能与RNFL厚度和GCIPL之间存在显着的正相关（P <0.001）。建立用于预测MS患者认知障碍的视网膜厚度（RNFL和GCIPL）分界点分别为79μm和76μm。

结论

认知障碍与视网膜内层萎缩（RNFL和GCIPL）之间的明确相关性表明，OCT对于评估MS的神经变性和早期认知障碍的预测是有价值的。

缩写词

EDSS：扩展的残疾状况量表；HC：健康对照；GCIPL：神经节细胞-内部丛状层；ILM：内部限制膜；INL：内核层；MoCA：蒙特利尔认知评估；MS：多发性硬化；PPMS：原发性进行性多发性硬化症；RNFL：视网膜神经纤维层；RRMS：复发缓解型多发性硬化症；SD：标准偏差；SPMS：继发性进行性多发性硬化；SPSS：社会科学统计软件包。