Nij Bijvank, JA;
Sánchez Aliaga, E;
Balk, LJ;
Coric, D;
Davagnanam, I;
Tan, HS;
Uitdehaag, BMJ;
... Petzold, A; + view all
(2021)
A model for interrogating the clinico-radiological paradox in multiple sclerosis: internuclear ophthalmoplegia.
European Journal of Neurology
, 28
(5)
pp. 1617-1626.
10.1111/ene.14723.
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Abstract
BACKGROUND: The clinico-radiological paradox in MS is well recognised, relevant and yet poorly understood. We tested the suitability of an in vivo model for the clinico-radiological paradox, using internuclear ophthalmoplegia (INO) and the medial longitudinal fasciculus (MLF). METHOD: In this cross-sectional study lesions of the MLF were rated by an experienced MS neuroradiologist blinded to all other information. Presence of an INO was objectively determined by a validated infrared oculography protocol (DEMoNS). Clinical information, amongst which the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25), was obtained. RESULTS: This study included 202 patients with MS. The clinico-radiological paradox occurred in 50 patients (25%). This consisted of 45 patients having an INO without a MLF lesion, and 5 patients with a MLF lesion but without an INO. The visual function overall score was related to presence of an INO (p=0.016), but not to MLF lesions seen on MRI (p=0.207). A consensus list of potential causes for the clinico-radiological paradox was compiled and the MRI images were deposited in an open access repository. CONCLUSION: This study provides an objective and quantitative model to investigate the clinico-radiological paradox. Our data suggest that pathology of the MLF is more frequently detected and more clinically relevant by infrared oculography than by MLF lesion rating on MRI.
| Type: | Article |
|---|---|
| Title: | A model for interrogating the clinico-radiological paradox in multiple sclerosis: internuclear ophthalmoplegia |
| Location: | England |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1111/ene.14723 |
| Publisher version: | https://doi.org/10.1111/ene.14723 |
| Language: | English |
| Additional information: | This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Eye Movements, Magnetic Resonance Imaging, Multiple Sclerosis, Ophthalmoplegia, Saccades |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Department of Neuromuscular Diseases |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10119289 |
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