title: Neuroplasticity predicts outcome of optic neuritis independent of tissue damage.
abstract: OBJECTIVE
  To determine whether lateral occipital complex (LOC) activation with functional magnetic resonance imaging (fMRI) predicts visual outcome after clinically isolated optic neuritis (ON). To investigate the reasons behind good recovery following ON, despite residual optic nerve demyelination and neuroaxonal damage.
  
  
  METHODS
  Patients with acute ON and healthy volunteers were studied longitudinally over 12 months. Structural MRI, visual evoked potentials (VEPs), and optical coherence tomography (OCT) were used to quantify acute inflammation, demyelination, conduction block, and later to estimate remyelination and neuroaxonal loss over the entire visual pathway. The role of neuroplasticity was investigated using fMRI. Multivariable linear regression analysis was used to study associations between vision, structure, and function.
  
  
  RESULTS
  Greater baseline fMRI responses in the LOCs were associated with better visual outcome at 12 months. This was evident on stimulation of either eye (p = 0.007 affected; p = 0.020 fellow eye), and was independent of measures of demyelination and neuroaxonal loss. A negative fMRI response in the LOCs at baseline was associated with a relatively worse visual outcome. No acute electrophysiological or structural measures, in the anterior or posterior visual pathways, were associated with visual outcome.
  
  
  CONCLUSIONS
  Early neuroplasticity in higher visual areas appears to be an important determinant of recovery from ON, independent of tissue damage in the anterior or posterior visual pathway, including neuroaxonal loss (as measured by MRI, VEP, and OCT) and demyelination (as measured by VEP).
authors.affiliation: Department of Brain Repair and Rehabilitation, University College London (UCL) Institute of Neurology, University College London, London, UK.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Jenkins
authors.forename: Ahmed T
authors.initials: AT
authors.lastname: Toosy
authors.forename: Olga
authors.initials: O
authors.lastname: Ciccarelli
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Miszkiel
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Wheeler-Kingshott
authors.forename: Andrew P
authors.initials: AP
authors.lastname: Henderson
authors.forename: Constantinos
authors.initials: C
authors.lastname: Kallis
authors.forename: Laura
authors.initials: L
authors.lastname: Mancini
authors.forename: Gordon T
authors.initials: GT
authors.lastname: Plant
authors.forename: David H
authors.initials: DH
authors.lastname: Miller
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
mesh_terms: D000328:Adult; D001369:Axons / Q000473:pathology / Q000502:physiology; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003711:Demyelinating Diseases / Q000473:pathology / Q000503:physiopathology; D005074:Evoked Potentials, Visual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009473:Neuronal Plasticity; D009900:Optic Nerve / Q000473:pathology / Q000503:physiopathology; D009902:Optic Neuritis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D011379:Prognosis; D013997:Time Factors; D041623:Tomography, Optical Coherence; D014786:Vision Disorders / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D014795:Visual Pathways / Q000473:pathology / Q000503:physiopathology; D055815:Young Adult