Abstract
We have previously demonstrated that assessment of antisaccades (AS) provides not only measures of motor function in multiple sclerosis (MS), but measures of cognitive control processes in particular, attention and working memory. This study sought to demonstrate the potential for AS measures to sensitively reflect change in functional status in MS. Twenty-four patients with relapsing-remitting MS and 12 age-matched controls were evaluated longitudinally using an AS saccade task. Compared to control subjects, a number of saccade parameters changed significantly over a two year period for MS patients. These included saccade error rates, latencies, and accuracy measures. Further, for MS patients, correlations were retained between OM measures and scores on the PASAT, which is considered the reference task for the cognitive evaluation of MS patients. Notably, EDSS scores for these patients did not change significantly over this period. These results demonstrate that OM measures may reflect disease evolution in MS, in the absence of clinically evident changes as measured using conventional techniques. With replication, these markers could ultimately be developed into a cost-effective, non-invasive, and well tolerated assessment tool to assist in confirming progression early in the disease process, and in measuring and predicting response to therapy.
Highlights
Multiple sclerosis is a multifocal inflammatory demyelinating disease, with a pathophysiological process that involves the interplay of damage and repair mechanisms
We have previously demonstrated that assessment of ocular motor (OM) function provides a measure of lower level motor control processes, but of impaired cognitive control processes in multiple sclerosis (MS) [6,7,8]
Compared to control subjects, changes in AS saccade parameters were significantly greater for MS patients: these included AS error rate, U = 66.5, z = 22.33, p,0.05, and AS latency, U = 69, z = 22.12, p,0.05, with a near significant difference in AS position error, t(34) = 1.89, p = 0.06
Summary
Multiple sclerosis is a multifocal inflammatory demyelinating disease, with a pathophysiological process that involves the interplay of damage and repair mechanisms. While more modern quantitative MRI techniques have the potential to overcome some of the limitations of conventional measures, their cost, availability, complexity and lack of validation limit their use in routine clinical practice [5] It is crucial from a clinical perspective, that we concurrently develop userfriendly, cost-effective surrogate markers of disease activity that provide sensitive assessment of functional change. A group of patients with relapsing-remitting MS (RRMS) and age-matched control were retested on the AS task approximately two years following initial testing (M = 23.83 mths, range 23–29 mths) We propose that these measures may provide para-clinical or surrogate markers of (dys)function which can be used to assess relapse, progression, recovery, and the consequences of therapeutic intervention in MS
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