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August 06, 2013; 81 (6) Article

Optic nerve head component responses of the multifocal electroretinogram in MS

Teresa C. Frohman, Shin Chien Beh, Shiv Saidha, Zane Schnurman, Darrel Conger, Amy Conger, John N. Ratchford, Carmen Lopez, Steven L. Galetta, Peter A. Calabresi, Laura J. Balcer, Ari J. Green, Elliot M. Frohman
First published July 3, 2013, DOI: https://doi.org/10.1212/WNL.0b013e31829e6faa
Teresa C. Frohman
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Shin Chien Beh
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Shiv Saidha
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Zane Schnurman
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Darrel Conger
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Amy Conger
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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John N. Ratchford
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Carmen Lopez
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Steven L. Galetta
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Peter A. Calabresi
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Laura J. Balcer
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Ari J. Green
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Elliot M. Frohman
From the Departments of Neurology (T.C.F., S.C.B., Z.S., D.C., A.C., C.L., E.M.F.) and Ophthalmology (E.M.F.), University of Texas Southwestern Medical Center at Dallas; Department of Neurology (S.S., J.N.R., P.A.C.), Johns Hopkins Hospital, Baltimore, MD; Departments of Neurology and Ophthalmology (S.L.G., L.J.B.), New York University School of Medicine, New York; and the Departments of Neurology and Ophthalmology (A.J.G.), University of California at San Francisco.
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Full PDF
Citation
Optic nerve head component responses of the multifocal electroretinogram in MS
Teresa C. Frohman, Shin Chien Beh, Shiv Saidha, Zane Schnurman, Darrel Conger, Amy Conger, John N. Ratchford, Carmen Lopez, Steven L. Galetta, Peter A. Calabresi, Laura J. Balcer, Ari J. Green, Elliot M. Frohman
Neurology Aug 2013, 81 (6) 545-551; DOI: 10.1212/WNL.0b013e31829e6faa

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Abstract

Objective: To employ a novel stimulation paradigm in order to elicit multifocal electroretinography (mfERG)–induced optic nerve head component (ONHC) responses, believed to be contingent upon the transformation in electrical transmission properties of retinal ganglion cell axons from membrane to saltatory conduction mechanisms, as they traverse the lamina cribrosa and obtain oligodendrocyte myelin. We further sought to characterize abnormalities in ONHC responses in eyes from patients with multiple sclerosis (MS).

Methods: In 10 normal subjects and 7 patients with MS (including eyes with and without a history of acute optic neuritis), we utilized a novel mfERG stimulation paradigm that included interleaved global flashes in order to elicit the ONHC responses from 103 retinal patches of pattern-reversal stimulation.

Results: The number of abnormal or absent ONHC responses was significantly increased in MS patient eyes compared to normal subject eyes (p < 0.001, by general estimating equation modeling, and accounting for age and within-subject, intereye correlations).

Conclusion: Studying the relationship between ONHC abnormalities and alterations in validated structural and functional measures of the visual system may facilitate the ability to dissect and characterize the pathobiological mechanisms that contribute to tissue damage in MS, and may have utility to detect and monitor neuroprotective or restorative effects of novel therapies.

GLOSSARY

AON=
acute optic neuritis;
ERG=
electroretinography;
GEE=
generalized estimating equation;
mfERG=
multifocal electroretinography;
mfVEP=
multifocal visual evoked potential;
MS=
multiple sclerosis;
ONHC=
optic nerve head component;
RGC=
retinal ganglion cell

Footnotes

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Editorial, page 518

  • Received January 6, 2013.
  • Accepted in final form April 4, 2013.
  • © 2013 American Academy of Neurology
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