The public defence will be held as a video conference over Zoom.
The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.
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Digital Trial Lecture – time and place
Adjudication committee
- First opponent: Associate Professor Fiona Costello, Cumming School of Medicine, University of Calgary, Canada
- Second opponent: Senior Consultant Jana Midelfart Hoff, Haukeland Universitetssykehus
- Third member and chair of the evaluation committee: Professor Torgeir Bruun Wyller, University of Oslo
Chair of the Defence
Professor Mona Kristiansen Beyer, Faculty of Medicine, University of Oslo
Principal Supervisor
Professor Elisabeth Gulowsen Celius, Faculty of Medicine, University of Oslo
Summary
Multiple sclerosis (MS) cause inflammation and function loss at an early disease stage. Detection and prevention of neuronal loss may prevent end-stage atrophy. Cognitive and autonomic changes are associated with neurodegeneration in MS, and are as well as fatigue part of the initial symptoms in MS.
This Thesis explores the symptom complex of cognitive impairment, fatigue and autonomic dysfunction in a well-defined cohort (n=49) of newly diagnosed MS patients. We performed neuro-ophthalmic and neuropsychologic structure and function studies of the eye, in order to identify markers of neurodegeneration.
Eye-tracking revealed longer saccadic initiation time (SI time) in MS patients than in healthy controls. There was no cognitive impairment on group level. Pupillometry in a subgroup of participants with low cognitive score (LCS) revealed a smaller pupillary response in MS patients than controls during arithmetic tasks of increasing difficulty. Fatigued patients had signs of changed pupillary curve profile. Optical coherence tomography (OCT) showed asymptomatic neuro retinal thinning. In the same MS cohort there was a 10% occurrence of postural orthostatic tachycardia syndrome (POTS). MS patients reported a high symptom burden linked to autonomic nervous system (ANS) function without signs of changes in the pupillary light reflex (PLR) or any findings of bedside orthostatism.
Our results underline the importance of saccadic evaluation, if the test paradigm require the use of rapid eye movements, antecedent to cognitive test conclusion. The eyes pupil’s dilations reveal changes in LCS MS patients and a probable link between cognition and fatigue. MS patients present preclinical neuro retinal loss and a high level of ANS symptoms linked to POTS without PLR changes. The heavy symptom burden and neurodegenerative signs in early MS may be due to neuro inflammatory stress and changes in central neuropeptides as these interdisciplinary eye studies points to.
Additional information
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