DX37
Moderate-to-Vigorous Physical Activity Is Positively Associated with the Retinal Nerve Fibre Layer Thickness in Pediatric Multiple Sclerosis

Thursday, May 31, 2018
Exhibit Hall A (Nashville Music City Center)
Alexander L Pearson, BA , Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
Stephanie A Grover, MSc, CCRP , Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
Danusha Nandamalavan, BSc, CCRA , Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, ON, Canada
Tara Berenbaum, BSc , Neurology, The Hospital for Sick Children, Toronto, ON, Canada
Robert W Motl, PhD , Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, AL
Marcia Finlayson, PhD, OT Reg (Ont), OTR , School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
Brenda Banwell, MD , Children's Hospital of Philadelphia, Philadelphia, PA
E. Ann Yeh, MD, MA, FRCPC, Dip ABPN , Neurology, The Hospital for Sick Children, Toronto, ON, Canada
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Background: Over 1/3 of pediatric MS patients experience optic neuritis (ON) and most experience visual pathway abnormalities, including reductions in their retinal nerve fiber layer (RNFL) and ganglion cell inner-plexiform layer (GCIPL). Previous adult MS studies have shown a positive association between moderate-to-vigorous physical activity (MVPA) and RNFL. However, this association has not been evaluated in pediatric MS patients. Evidence for an association would support an intervention targeting MVPA to improve anterior visual pathway integrity in children with MS.

Objectives: To investigate the associations between MVPA, RNFL and GCIPL in pediatric MS patients.

Methods: For this cross-sectional study, participants were recruited from the Pediatric MS and Demyelinating Disorders Center at SickKids, Toronto, Canada. Inclusion criteria: diagnosis of MS (according to IPMSSG consensus definitions), age<18 years. Exclusion criteria: neuroinflammatory abnormalities associated with underlying systemic or neurologic disorders, recurrent neuroinflammatory disorders other than MS, coexisting ocular pathologies, visual acuity +/- 6 diopters or worse.

Participants received standardized visual evaluations, including ocular coherence tomography (OCT). Evaluations were performed >90 days after an ON episode using a spectral-domain OCT Cirrus scanner (Carl Zeiss Meditec). Participants also completed the Godin Leisure-Time Exercise Questionnaire (GLTEQ) >30 days after a relapse. Health contribution score was calculated from the GLTEQ.

Generalized linear models were used to assess the associations between MVPA, RNFL and GCIPL, when controlling for sex, number of ON episodes, disease duration at time of OCT, and the within-subject correlation between eyes. Bonferroni correction was used to adjust for multiple comparisons.

Results: There were 30 participants (23 female). OCT was performed at mean age of 15.7 years (range=10.6-18.0) and median of 1.9 years from disease onset (IQR=2.6). Median RNFL was 90 µm (IQR=26.3), and median GCIPL was 73.5 µm (IQR=20.3). Median MVPA was 26.5 metabolic equivalents/week (IQR=47). MVPA was positively associated with RNFL (B=0.200, p=0.025). Although RNFL and GCIPL were moderately correlated (r=0.463; p<0.001), MVPA was not associated with GCIPL (B=0.065, p=1.0).

Conclusions: MVPA was positively associated with RNFL in pediatric MS patients. Next steps include a trial using MVPA to improve anterior visual pathway integrity in children with MS.

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