Abstract

Multiple Sclerosis (MS) is an autoimmune demyelinating disease that damages the insulation of nerve cell fibers in the brain and spinal cord. In the visual system, this demyelination results in a robust delay of visually evoked potentials (VEPs), even in the absence of overt clinical symptoms such as blurred vision. VEPs, therefore, offer an avenue for early diagnosis, monitoring disease progression, and, potentially, insight into the differential impairment of specific pathways. A primary hypothesis has been that visual stimuli driving the magno-, parvo-, and konio-cellular pathways should lead to differential effects because these pathways differ considerably in terms of myelination. Experimental tests of this hypothesis, however, have led to conflicting results. Some groups reported larger latency effects for chromatic stimuli, while others found equivalent effects across stimulus types. We reasoned that this lack of pathway specificity could, at least in part, be attributed to the relatively coarse measure of pathway impairment afforded by the latency of a VEP. We hypothesized that network synchrony could offer a more sensitive test of pathway impairments. To test this hypothesis, we analyzed the synchrony of occipital electroencephalography (EEG) signals during the presentation of visual stimuli designed to bias activity to one of the three pathways. Specifically, we quantified synchrony in the occipital EEG using two graph-theoretic measures of functional connectivity: the characteristic path length (L; a measure of long-range connectivity) and the clustering coefficient (CC; a measure of short-range connectivity). Our main finding was that L and CC were both smaller in the MS group than in controls. Notably, this change in functional connectivity was limited to the magnocellular pathway. The effect sizes (Hedge’s g) were 0.89 (L) and 1.26 (CC) measured with magno stimuli. Together, L and CC define the small-world nature of a network, and our finding can be summarized as a reduction in the small-worldness of the magnocellular network. We speculate that the reduced efficiency of information transfer associated with a reduction in small-worldness could underlie visual deficits in MS. Relating these measures to differential diagnoses and disease progression is an important avenue for future work.

Highlights

  • Multiple Sclerosis (MS) is an autoimmune disease that results in both demyelination and axonal injury

  • After preprocessing (Methods), our data set consisted of ~30 trials per condition for each of 16 people living with MS and 16 controls

  • We focused our latency analysis on the P100 of the visually evoked potentials (VEPs) (Methods)

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Summary

Introduction

Multiple Sclerosis (MS) is an autoimmune disease that results in both demyelination and axonal injury. Many studies have examined the effect of MS on vision, starting with acuity tests such as the high-contrast Snellen letter test and the Landolt C test. These tests, are not reliable diagnostic instruments for MS. Some patients achieve 20/20 scores for visual acuity on the Snellen test, yet they report that their vision is imperfect in one eye or both. This may be explained by the fact that tests such as the Snellen eye chart focus on fine, high-contrast detail, while MS affects visual sensitivity more at lower spatial frequencies [11]. The visual properties of stimuli that are most affected match the preferences of the magnocellular visual pathway, which is most sensitive at low contrast and low spatial frequencies

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