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    Neurology(R) neuroimmunology & neuroinflammation. 2021 Oct 19. pii: 9/1/e1099. doi: 10.1212/NXI.0000000000001099
    CNS Involvement in Chronic Inflammatory Demyelinating Polyneuropathy: Subtle Retinal Changes in Optical Coherence Tomography.
    Ingwersen J1,  Graf J2,  Kluge J3,  Weise M4,  Dietrich M5,  Lee JI6,  Harmel J7,  Hartung HP8,  Ruck T9,  Meuth SG10,  Albrecht P11,  Aktas O12,  Ringelstein M13
    Author information
    1From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    2From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    3From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    4From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    5From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    6From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    7From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    8From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    9From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    10From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    11From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    12From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic.
    13From the Department of Neurology (J.A., J.G., J.K., M.W., M.D., J.-I.L., J.H., H.-P.H., T.R., S.G.M., P.A., O.A., M.R.), Medical Faculty, Heinrich-Heine-University Düsseldorf, Germany; Brain and Mind Centre (H.-P.H.), University of Sydney; Department of Neurology (H.-P.H.), Medical University of Vienna, Austria; Department of Neurology (H.-P.H., M.R.), Center for Neurology and Neuropsychiatry, LVR-Klinikum Düsseldorf, Germany; and Department of Neurology (H.-P.H.), Palacky University in Olomouc, Olomouc, Czech Republic. marius.ringelstein@med.uni-duesseldorf.de.
    Abstract

    BACKGROUND AND OBJECTIVES: Chronic inflammatory demyelinating polyneuropathy (CIDP) is an autoimmune disease primarily affecting the peripheral nervous system. However, several noncontrolled studies have suggested concomitant inflammatory CNS demyelination similar to multiple sclerosis. The aim of this study was to investigate an involvement of the visual pathway in patients with CIDP.

    METHODS: In this prospective cross-sectional study, we used high-resolution spectral-domain optical coherence tomography to compare the thickness of the peripapillary retinal nerve fiber layer and the deeper macular retinal layers as well as the total macular volume (TMV) in 22 patients with CIDP and 22 age-matched and sex-matched healthy control (HC) individuals. Retinal layers were semiautomatically segmented by the provided software and were correlated with clinical measures and nerve conduction studies.

    RESULTS: In patients with CIDP compared with healthy age-matched and sex-matched controls, we found slight but significant volume reductions of the ganglion cell/inner plexiform layer complex (CIDP 1.86 vs HC 1.95 mm, = 0.015), the retinal pigment epithelium (CIDP 0.38 vs HC 0.40 mm, = 0.02), and the TMV (CIDP 8.48 vs HC 8.75 mm, = 0.018). The ganglion cell layer volume and motor nerve conduction velocity were positively associated (B = 0.002, = 0.02).

    DISCUSSION: Our data reveal subtle retinal neurodegeneration in patients with CIDP, providing evidence for visual pathway involvement, detectable by OCT. The results need corroboration in independent, larger cohorts.


    Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

    Publikations ID: 34667130
    Quelle: öffnen
     
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