AUTHOR=Dolcetti Ettore , Buttari Fabio , Bruno Antonio , Azzolini Federica , Gilio Luana , Di Caprio Veronica , Lauritano Gianluca , Borrelli Angela , Galifi Giovanni , Furlan Roberto , Finardi Annamaria , Musella Alessandra , Guadalupi Livia , Mandolesi Georgia , Rovella Valentina , Centonze Diego , Stampanoni Bassi Mario 

TITLE=Low-contrast visual acuity test is associated with central inflammation and predicts disability development in newly diagnosed multiple sclerosis patients

JOURNAL=Frontiers in Neurology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1326506

DOI=10.3389/fneur.2024.1326506

ISSN=1664-2295

ABSTRACT=<sec><title>Introduction</title><p>The visual system is a prominent site of damage in MS since the earliest phases of the disease. Altered low-contrast visual acuity (LCVA) test has been associated with visual impairment and retinal degeneration, predicting medium- and long-term disability. However, it is unclear whether LCVA may also represent a reliable measure of neuroinflammation and a predictor of disease evolution in the very early stages of MS.</p></sec><sec><title>Methods</title><p>We explored in a group of 76 consecutive newly diagnosed relapsing–remitting MS (RR-MS) patients without visual impairment or altered visual evoked potentials, the association between LCVA scores at 2.5% and 1.25% and clinical characteristics, including prospective disability evaluated after 1- and 2 years of follow-up. Associations between LCVA and the CSF levels of IL-10 at diagnosis were also analyzed.</p></sec><sec><title>Results</title><p>A negative correlation was found between LCVA at 2.5% and Expanded Disability Status Scale (EDSS) evaluated at first (Spearman’s Rho = −0.349, <italic>p</italic> = 0.005, <italic>n</italic> = 62) and second year (Spearman’s Rho = −0.418, <italic>p</italic> &lt; 0.001, <italic>n</italic> = 62) of follow-up, and negative correlations were found with Multiple Sclerosis Severity Score (MSSS) at first (Spearman’s Rho = −0.359, <italic>p</italic> = 0.004, <italic>n</italic> = 62) and second year (Spearman’s Rho = −0.472, <italic>p</italic> &lt; 0.001, n = 62). All the data were confirmed by a mixed effect model, considering other clinical variables. A positive correlation was found between the CSF concentrations of IL-10 and LCVA at 2.5% (Spearman’s Rho = 0.272, <italic>p</italic> = 0.020, <italic>n</italic> = 76), and 1.25% (Spearman’s Rho, = 0.276, <italic>p</italic> = 0.018, n = 76), also evidenced in a linear regression.</p></sec><sec><title>Discussion</title><p>In MS patients at diagnosis, altered LCVA may be associated with CSF inflammation and represent a useful parameter to identify patients with worse disease course.</p></sec>