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Affection of thalamic subnuclei in NMOSD: evidence of anterograde transsynaptic degeneration in the visual pathway
Author(s): ,
A. Papadopoulou
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, University and University Hospital of Basel
,
F.C. Oertel
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
L. Gaetano
Affiliations:
Department of Neurology, University and University Hospital of Basel; Medical Image Analysis Center (MIAC AG), Basel, Switzerland
,
J. Kuchling
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
,
H. Zimmermann
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
N. Borisow
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
J. Bellmann-Strobl
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Experimental and Clinical Research Center, Max Delbrück Center for Molecular Medicine and Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu B
,
K. Ruprecht
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
,
M. Scheel
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neuroradiology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
,
S. Magon
Affiliations:
Department of Neurology, University and University Hospital of Basel; Medical Image Analysis Center (MIAC AG), Basel, Switzerland
,
J. Wuerfel
Affiliations:
Medical Image Analysis Center (MIAC AG), Basel, Switzerland
,
F. Paul
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health
A.U. Brandt
Affiliations:
NeuroCure Clinical Research Center, Charité – Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany; Department of Neurology, University of California Irvine, Irvine, CA, United States
ECTRIMS Online Library. Papadopoulou A. Oct 12, 2018; 228936
Dr. Athina Papadopoulou
Dr. Athina Papadopoulou
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Abstract: P1096

Type: Poster Sessions

Abstract Category: Pathology and pathogenesis of MS - Neurodegeneration

Introduction: In multiple sclerosis (MS), neurodegenerative damage in the thalamus is detected early in the course of the disease. In neuromyelitis optica spectrum disorders (NMOSD), thalamic damage remains controversial, with most studies showing negative results.
Objectives: To assess neurodegenerative damage in thalamic subnuclei in NMOSD. Our hypothesis is that only specific subnuclei are affected in NMOSD: the lateral geniculate nucleus (LGN) and the ventral posterior nucleus (VPN), due to anterograde degeneration following optic neuritis (ON) and longitudinally extensive transverse myelitis (LETM) respectively.
Methods: We included 39 patients with aquaporin 4-IgG seropositive NMOSD (mean age: 50.2±14.1years, 92.3% women, 64% with positive ON history (NMO-ON) vs. 36% with negative ON history (NMO-NON), 92.3% with positive LETM history) and 37 matched healthy controls (HC; mean age: 47.8±12.5 years, 86.5% women). All underwent clinical assessment, magnetic resonance imaging (MRI) at 3T and retinal optical coherence tomography (OCT). Thalamic subnuclei were segmented automatically using the “MAGeT” Brain algorithm. Linear mixed effects models were used in the analysis, with correction for age, sex and brain side.
Results: The entire thalamic volume was not significantly different between NMOSD and HC (B=-68.5, p=0.57), nor between NMO-ON patients and HC (B=-37.4, p=0.79).
The LGN was significantly smaller in NMO-ON (181.6±44.2mm3) vs. HC (198.3±49.4; B=-17, p=0.004), while there was no difference between NMO-NON patients (206.1±50) and HC (B=5.3, p=0.48). In line with this, NMO-ON patients had significantly smaller LGN volumes than NMO-NON (beta=-23.74, p=0.001).
The LGN-volume of NMOSD patients was significantly related to the number of ON episodes (B=-23.6, p=0.0006) and the mean peripapillary retinal nerve fiber layer thickness (pRNFL; beta=0.7, p< 0.0001). Although it was also weakly associated with visual acuity ([logMAR]; B=-0.007, p=0.0006), this did not remain significant after inclusion of pRNFL in the model.
In contrast to the LGN, the VPN-volume did not differ significantly between NMOSD patients and HC (p=0.73), nor between LETM-NMOSD and HC (p=0.59).
Conclusions: Although the entire thalamus is not significantly smaller in NMOSD patients vs. HC, we found evidence of LGN-affection, due to previous ON. These results support transsynaptic degeneration as a neurodegenerative mechanism in the visual pathway of patients with NMOSD.
Disclosure: A. Papadopoulou consulted for Teva, received speaker-fee from Sanofi-Genzyme, travel support from Bayer AG, Teva, UCB-Pharma AG, Roche and research support from the Swiss National Science Foundation to work on the current project (P300PB_174480).
F.C. Oertel is employee of Nocturne UG, unrelated to this project.
L. Gaetano was a temporary employee of Novartis.
J. Kuchling received conference registration fees from Biogen and financial research support from Krankheitsbezogenes Kompetenznetzwerk Multiple Sklerose (KKNMS).
H. Zimmermann received a research grant from Novartis and speaking fees from Teva.
N. Borisow has nothing to disclose.
J. Bellman-Strobl has received travel grants and speaking fees from Bayer Healthcare, Biogen Idec, Merck Serono, sanofi-aventis/Genzyme, Teva Pharmaceuticals, and Novartis.
K. Ruprecht served on the scientific advisory board for Sanofi-Aventis/Genzyme, Novartis, and Roche; received travel funding and/or speaker honoraria from Bayer Healthcare, Biogen Idec, Merck Serono, Sanofi-Aventis/Genzyme, Teva Pharmaceuticals, Novartis, and Guthy Jackson Charitable Foundation; is an academic editor for PLoS ONE; receives publishing royalties from Elsevier; and received research support from Novartis and German Ministry of Education and Research.
M. Scheel reports not disclosures.
S. Magon has received research support from Swiss Multiple Sclerosis Society, Swiss National Science Foundation, University of Basel and Stiftung zur Förderung der gastroenterologischen und allgemeinen klinischen Forschung sowie
der medizinischen BildauswertungUniversity Hospital Basel. He also received travel support from Biogen and Genzyme.
J. Wuerfel is CEO of MIAC AG Basel, Switzerland. He served on scientific advisory boards of Actelion, Biogen, Genzyme-Sanofi, Novartis, and Roche. He is or was supported by grants of the EU (Horizon2020), German Federal Ministeries of Education and Research (BMBF) and of Economic Affairs and Energy (BMWI).
F. Paul serves on the scientific advisory board for Novartis; received speaker honoraria and travel funding from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Merck Serono, Alexion, Chugai, MedImmune, and Shire; is an academic editor for PLoS ONE; is an associate editor for Neurology® Neuroimmunology & Neuroinflammation; consulted for SanofiGenzyme, Biogen Idec, MedI- mmune, Shire, and Alexion; and received research support from Bayer, Novartis, Biogen Idec, Teva, Sanofi-Aventis/Genzyme, Alexion, Merck Serono, German Research Council, Werth Stiftung of the City of Cologne, German Ministry of Education and Research, Arthur Arnstein Stiftung Berlin, EU FP7 Framework Program, Arthur Arnstein Founda- tion Berlin, Guthy Jackson Charitable Foundation, and National Multiple Sclerosis of the USA.
A.U. Brandt is cofounder and shareholder of Motognosis and Nocturne. He is named as inventor on several patent applications regarding MS serum biomarkers, OCT image analysis and perceptive visual computing.

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