Abstract Details

Title Anterior and Posterior Visual Pathway Injury in Pediatric-Onset Multiple Sclerosis as Measured by Visual Evoked Potentials and Magnetoencephalography

Topic Multiple Sclerosis

Presentation(s) P11 - Poster Session 11 (8:00 AM-9:00 AM)

Poster/Presentation
Number 9-012

Objective To determine whether delays in visual evoked potential (VEP) latency relate to white matter (WM) diffusion integrity in the posterior visual pathway of pediatric-onset multiple sclerosis (POMS) patients.

Background Prolonged VEP latency is indicative of demyelination in MS. We have explored visual-stimuli-evoked cortical activity using magnetoencephalography (MEG), demonstrating that visual gamma power in the cuneus is predicted by mean fractional anisotropy (FA) of the optic radiations (ORs). We hypothesized that prolonged VEP latencies relate to FA of the ORs.

Design/Methods Participants with POMS were recruited from an ongoing comprehensive vision study at the Children’s Hospital of Philadelphia. Participants who had undergone pattern-reversal VEP, MEG (conducted during a visuomotor task), MRI (including DTI analyzed using FSL toolbox), and optical coherence tomography were included. P100 latencies and amplitudes (VEP), visual gamma power (MEG), FA of the ORs corrected for the effects of age and sex (DTI), and retinal nerve fiber layer thickness (RNFL) were averaged across hemispheres, and general linear regression was used to assess inter-relationships.

Results

A pilot cohort of 10 POMS subjects were enrolled (mean age 17.6 years, SD 3.0; 5 with remote optic neuritis). RNFL thinning predicted delayed VEP latency (p=0.029). VEP latency and amplitude were not significantly related to visual gamma power (pseudo-t). Mean FA of the ORs significantly predicted visual gamma power (pseudo-t) in the cuneus (p=0.040). However, VEP latency and amplitude were not related to mean FA of the ORs (p=0.186 and p=0.632, respectively).

Conclusions In POMS, anterior visual pathway pathology with axonal loss contributes to delayed VEP latencies. Posteriorly, we were unable to detect a relationship in this small sample between VEP and WM integrity in the ORs. Reduced neuronal activity in the visual cortex (assessed by MEG) does not correspond to VEP metrics, although further analyses with a larger sample size are needed to fully explore the relationship.

Authors/Disclosures
John R. Sollee (Sidney Kimmel Medical College At Thomas Jefferson University) PRESENTER	Mr. Sollee has nothing to disclose.
	No disclosure on file
Amy Lavery	No disclosure on file
	No disclosure on file
Brenda L. Banwell, MD, F�鶹��ýӳ�� (Johns Hopkins University)	Dr. Banwell has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Novartis. Dr. Banwell has received personal compensation in the range of $0-$499 for serving as a Consultant for UCB. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Roche. Dr. Banwell has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Janssen. Dr. Banwell has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Genentech. Dr. Banwell has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. The institution of Dr. Banwell has received research support from National MS Society. The institution of Dr. Banwell has received research support from NIH.
	No disclosure on file
Amy T. Waldman, MD (Children's Hospital of Philadelphia)	Dr. Waldman has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for SwanBio. An immediate family member of Dr. Waldman has or had stock in Pfizer. The institution of Dr. Waldman has received research support from Ionis Pharmaceuticals. The institution of Dr. Waldman has received research support from Roche/Genentech. The institution of Dr. Waldman has received research support from Ionis Pharmaceuticals. The institution of Dr. Waldman has received research support from Calico. Dr. Waldman has received publishing royalties from a publication relating to health care. Dr. Waldman has received publishing royalties from a publication relating to health care.

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