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Background:   Decreased motion perception has been suggested as a marker for visual pathway demyelination in optic neuritis (ON) and/or multiple sclerosis (MS).Objectives:   To examine the influence of neuro-axonal damage on motion perception in MS and neuromyelitis optica spectrum disorders (NMOSD).Methods:   We analysed motion perception with numbers-from-motion (NFM), visual acuity, (multifocal (mf)) VEP, optical coherence tomography in patients with MS ( n = 38, confirmatory cohort n = 43), NMOSD ( n = 13) and healthy controls ( n = 33).Results:   NFM was lower compared with controls in MS ( B = −12.37, p &lt; 0.001) and NMOSD ( B = −34.5, p &lt; 0.001). NFM was lower in ON than in non-ON eyes ( B = −30.95, p = 0.041) in NMOSD, but not MS. In MS and NMOSD, lower NFM was associated with worse visual acuity ( B = −139.4, p &lt; 0.001/ B = −77.2, p &lt; 0.001) and low contrast letter acuity ( B = 0.99, p = 0.002/ B = 1.6, p &lt; 0.001), thinner peripapillary retinal nerve fibre layer ( B = 1.0, p &lt; 0.001/ B = 0.92, p = 0.016) and ganglion cell/inner plexiform layer ( B = 64.8, p &lt; 0.001/ B = 79.5, p = 0.006), but not with VEP P100 latencies. In the confirmatory MS cohort, lower NFM was associated with thinner retinal nerve fibre layer ( B = 1.351, p &lt; 0.001) and increased mfVEP P100 latencies ( B = −1.159, p &lt; 0.001).Conclusions:   Structural neuro-axonal visual pathway damage is an important driver of motion perception impairment in MS and NMOSD.

multiple sclerosis journal

Impaired motion perception is associated with functional and structural visual pathway damage in multiple sclerosis and neuromyelitis optica spectrum disorders