title: Pattern of gray matter volumes related to retinal thickness and its association with cognitive function in relapsing-remitting MS.
abstract: Neurodegeneration in multiple sclerosis (MS) may be investigated in the visual system as optical coherence tomography (OCT) and magnetic resonance imaging (MRI) allows examining structural integrity in detail. The association between thickness of retinal layers and focal cortical volumes beyond the primary visual system has not been thoroughly investigated.
  
  
  
  To investigate the association between focal cortical volume and thickness of retinal layers.
  
  
  
  Fifty-four patients (relapsing-remitting MS, mean age 40.5 years, mean disease duration 7.6 years, median EDSS 2) underwent OCT and MRI. The association between focal cortical volume and OCT measurements was investigated with voxel-based morphometry (VBM). Patterns of association were determined with Yeo's functional network atlas and the Harvard-Oxford cortical atlas. We used GEE models with cortical volumes from the FreeSurfer parcellation to confirm VBM results. Post hoc, we analyzed the association between OCT, focal cortical volumes, and an extended neuropsychological assessment in a subgroup of 14 patients.
  
  
  
  Macular retinal nerve fiber layer (mRNFL) and ganglion cell /inner plexiform layer (GCIPL) showed a robust association with mainly the insular cortex and the cingulate cortex. VBM findings were confirmed with FreeSurfer volumes. The post hoc analysis detected significant correlations between both OCT outcomes and cognition.
  
  
  
  Besides the primary visual system, OCT outcomes show a correlation pattern with cortical regions that are known to be important for cognitive performance, predominantly the insula in both hemispheres. Thus, OCT should be further investigated as a marker for neurodegeneration in MS.
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Jan-Patrick
authors.initials: JP
authors.lastname: Stellmann
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Hanife
authors.initials: H
authors.lastname: Cetin
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Kim Lea
authors.initials: KL
authors.lastname: Young
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Sibylle
authors.initials: S
authors.lastname: Hodecker
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Jana
authors.initials: J
authors.lastname: Pöttgen
authors.affiliation: Klinik für Augenheilkunde Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Diana
authors.initials: D
authors.lastname: Bittersohl
authors.affiliation: Klinik für Augenheilkunde Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Hassenstein
authors.affiliation: NeuroCure Clinical Research Center and Experimental and Clinical Research Center Charité-Universitätsmedizin Berlin and Max Delbrück Center for Molecular Medicine Berlin Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Oberwahrenbrock
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neurologie Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Heesen
authors.affiliation: Institut für Neuroimmunologie und Multiple Sklerose Universitätsklinikum Hamburg-Eppendorf Germany; Klinik und Poliklinik für Neuroradiologische Diagnostik und Intervention Universitätsklinikum Hamburg-Eppendorf Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Siemonsen
mesh_terms: D000293:Adolescent; D000328:Adult; D002540:Cerebral Cortex / Q000000981:diagnostic imaging / Q000473:pathology*; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D005260:Female; D066128:Gray Matter / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008266:Macula Lutea / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D012160:Retina / Q000000981:diagnostic imaging / Q000473:pathology*; D055351:Retinal Neurons / Q000473:pathology; D041623:Tomography, Optical Coherence; D055815:Young Adult
keywords: atrophy; cognition; magnetic resonance imaging; multiple sclerosis; neuropsychology; optical coherence tomography