Highlights
- •Patients with NMOSD exhibit cognitive deficits but not impairment.
- •Impaired sensory-cognitive parallel processing neural networks may contribute to cognitive performance deficits in patients with NMOSD.
- •A physiological association of the primary visual network functional connectivity and cognitive performance appears absent in patients with NMOSD.
- •Visual network functional connectivity was able to explain 19% of the variance in cognitive performance in healthy controls, but none in patients.
Abstract
Background Neuromyelitis Optica Spectrum Disorders (NMOSD) is an autoimmune disease leading
to disability from optic neuritis, myelitis and more rarely brain stem attacks and
encephalitis. Patients with NMOSD also exhibit cognitive deficits, the cause of which
remains unclear. Recent evidence highlights sensory-cognitive parallel processing
converging on the primary visual cortex. The objective of this study was to investigate
the effect of the primary visual network disruption from damage caused by optic neuritis
on cognition in NMOSD.
Methods Twenty-nine aquaporin-4 antibody seropositive patients with NMOSD and 22 healthy
controls (HC) completed the brief repeatable battery of neuropsychological tests (BRB-N)
and underwent 3 Tesla MRI. Primary visual network functional connectivity (FC) at
resting state was analyzed and correlated with performance on BRB-N. These correlations
were compared between the groups.
Results Patients performed significantly worse than HC on the BRB-N Index score (t = 2.366, p = 0.02). Among HC, visual network FC decreased significantly as cognitive performance
on the BRB-N Index score increased (rho(17)=-0.507, p = 0.02). Among patients, this association was absent (rho(23)=0.197, p = 0.18), and the difference in correlation direction and strength to HC was significant
(z=-2.175, p = 0.01). Visual network FC was able to explain 19% of the variance in cognitive performance
in HC, but none in patients.
Conclusions A physiological association of the primary visual network FC and cognitive performance
appears absent in patients with NMOSD, suggesting a partial explanation for cognitive
deficits. Our findings extend neuroscientific concepts on sensory-cognitive parallel
processing neural networks to a clearly defined pathological state, and may be relevant
for other diseases with visual system damage.
Keywords
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Article info
Publication history
Published online: July 16, 2020
Accepted:
July 15,
2020
Received in revised form:
July 7,
2020
Received:
May 16,
2020
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
