title: An Eye on Brain Integrity: Acute Optic Neuritis Affects Resting State Functional Connectivity.
abstract: OBJECTIVE
  Currently, the ability for imaging to capture brain adaptations to injury that occurs in multiple sclerosis (MS) is limited. In particular, how the brain initially contends with the earliest clinical manifestations of white matter injury has yet to be defined. The purpose of this study was to determine the impact of acute optic neuritis (ON) on resting state functional connectivity magnetic resonance imaging (rs-fcMRI).
  
  
  METHODS
  Fifteen patients with a clinically isolated syndrome of acute ON were evaluated at an academic center in a prospective study. Subjects were assessed with structural and functional vision measures, including optical coherence tomography (OCT), high- and low-contrast letter acuity testing, and visual fields and quality-of-life measures (VFQ-25). The rs-fcMRI was compared with age- and sex-matched healthy controls.
  
  
  RESULTS
  We observed reduced functional connectivity within the visual system and a loss of anticorrelations between the visual system and nonvisual networks. Stronger functional connectivity between visual regions correlated with better quality of life, as measured by the VFQ-25, and better acuity scores for both high- and low-contrast testing in the affected eye.
  
  
  CONCLUSIONS
  The rs-fcMRI functional connectivity changes within (intranetwork) and between (internetwork) resting state networks occur after acute ON, indicating immediate cortical responses to focal inflammatory demyelination. Thus, focal white matter injury in the central nervous system acutely results in widespread network alterations that may lead to functional neurologic changes seen in MS.
authors: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States 2Department of Pathology and Immunology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
authors: Gregory F
authors: GF
authors: Wu
authors: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
authors: Matthew R
authors: MR
authors: Brier
authors: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
authors: Cassie A-L
authors: CA
authors: Parks
authors: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States 3Department of Radiology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
authors: Beau M
authors: BM
authors: Ances
authors: Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States 4Department of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, St. Louis, Missouri, United States.
authors: Gregory P
authors: GP
authors: Van Stavern
mesh_terms: D000208:Acute Disease; D000328:Adult; D001921:Brain / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009902:Optic Neuritis / Q000175:diagnosis / Q000503:physiopathology*; D011446:Prospective Studies; D012146:Rest / Q000502:physiology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity; D014795:Visual Pathways / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult