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Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis

BACKGROUND: PIRA (progression independent of relapse) has emerged as a term to quantify the proportion of disability worsening due to non-inflammatory neurodegenerative processes in multiple sclerosis (MS). OBJECTIVE: To determine the impact of PIRA on retinal thinning, a biomarker of neuroaxonal de...

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Autores principales: Bsteh, Gabriel, Hegen, Harald, Altmann, Patrick, Auer, Michael, Berek, Klaus, Pauli, Franziska Di, Wurth, Sebastian, Zinganell, Anne, Rommer, Paulus, Deisenhammer, Florian, Leutmezer, Fritz, Berger, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2020
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604994/
https://www.ncbi.nlm.nih.gov/pubmed/33194221
http://dx.doi.org/10.1177/2055217320966344
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author Bsteh, Gabriel
Hegen, Harald
Altmann, Patrick
Auer, Michael
Berek, Klaus
Pauli, Franziska Di
Wurth, Sebastian
Zinganell, Anne
Rommer, Paulus
Deisenhammer, Florian
Leutmezer, Fritz
Berger, Thomas
author_facet Bsteh, Gabriel
Hegen, Harald
Altmann, Patrick
Auer, Michael
Berek, Klaus
Pauli, Franziska Di
Wurth, Sebastian
Zinganell, Anne
Rommer, Paulus
Deisenhammer, Florian
Leutmezer, Fritz
Berger, Thomas
author_sort Bsteh, Gabriel
collection PubMed
description BACKGROUND: PIRA (progression independent of relapse) has emerged as a term to quantify the proportion of disability worsening due to non-inflammatory neurodegenerative processes in multiple sclerosis (MS). OBJECTIVE: To determine the impact of PIRA on retinal thinning, a biomarker of neuroaxonal degeneration in MS, in comparison to traditional disability worsening and relapse. METHODS: In a 4-year, prospective observational study including 171 relapsing MS (RMS) patients, retinal thinning was determined by annual spectral-domain optical coherence tomography measuring macular ganglion-cell-and-inner-plexiform-layer (GCIPL) and peripapillary-retinal-nerve-fibre-layer (pRNFL). PIRA was defined as an expanded disability status scale (EDSS) or symbol digit modalities test (SDMT) worsening confirmed after 24 weeks with no relapse in the 30 days before or after the disability worsening. RESULTS: Each PIRA event was associated with a mean additional loss of GCIPL (1.8 µm) and pRNFL (1.9 µm), similar to the impact of EDSS and SDMT worsening. Overall relapse and relapse without subsequent EDSS worsening did not influence retinal thinning, while a relapse with EDSS worsening was associated with an additional loss of GCIPL (1.3 µm) and pRNFL (1.4 µm). CONCLUSIONS: PIRA is associated with retinal thinning, likely reflecting neurodegenerative processes, not directly associated with focal inflammation. It might be a clinical measure to identify MS patients with ongoing MS-associated neurodegeneration.
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spelling pubmed-76049942020-11-12 Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis Bsteh, Gabriel Hegen, Harald Altmann, Patrick Auer, Michael Berek, Klaus Pauli, Franziska Di Wurth, Sebastian Zinganell, Anne Rommer, Paulus Deisenhammer, Florian Leutmezer, Fritz Berger, Thomas Mult Scler J Exp Transl Clin Original Research Paper BACKGROUND: PIRA (progression independent of relapse) has emerged as a term to quantify the proportion of disability worsening due to non-inflammatory neurodegenerative processes in multiple sclerosis (MS). OBJECTIVE: To determine the impact of PIRA on retinal thinning, a biomarker of neuroaxonal degeneration in MS, in comparison to traditional disability worsening and relapse. METHODS: In a 4-year, prospective observational study including 171 relapsing MS (RMS) patients, retinal thinning was determined by annual spectral-domain optical coherence tomography measuring macular ganglion-cell-and-inner-plexiform-layer (GCIPL) and peripapillary-retinal-nerve-fibre-layer (pRNFL). PIRA was defined as an expanded disability status scale (EDSS) or symbol digit modalities test (SDMT) worsening confirmed after 24 weeks with no relapse in the 30 days before or after the disability worsening. RESULTS: Each PIRA event was associated with a mean additional loss of GCIPL (1.8 µm) and pRNFL (1.9 µm), similar to the impact of EDSS and SDMT worsening. Overall relapse and relapse without subsequent EDSS worsening did not influence retinal thinning, while a relapse with EDSS worsening was associated with an additional loss of GCIPL (1.3 µm) and pRNFL (1.4 µm). CONCLUSIONS: PIRA is associated with retinal thinning, likely reflecting neurodegenerative processes, not directly associated with focal inflammation. It might be a clinical measure to identify MS patients with ongoing MS-associated neurodegeneration. SAGE Publications 2020-10-29 /pmc/articles/PMC7604994/ /pubmed/33194221 http://dx.doi.org/10.1177/2055217320966344 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Research Paper
Bsteh, Gabriel
Hegen, Harald
Altmann, Patrick
Auer, Michael
Berek, Klaus
Pauli, Franziska Di
Wurth, Sebastian
Zinganell, Anne
Rommer, Paulus
Deisenhammer, Florian
Leutmezer, Fritz
Berger, Thomas
Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title_full Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title_fullStr Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title_full_unstemmed Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title_short Retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
title_sort retinal layer thinning is reflecting disability progression independent of relapse activity in multiple sclerosis
topic Original Research Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7604994/
https://www.ncbi.nlm.nih.gov/pubmed/33194221
http://dx.doi.org/10.1177/2055217320966344
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