Association of corneal nerve fiber measures with cognitive function in dementia

Georgios Ponirakis; Hanadi Al Hamad; Anoop Sankaranarayanan; Adnan Khan; Mani Chandran; Marwan Ramadan; Rhia Tosino; Priya Vitthal Gawhale; Maryam Alobaidi; Essa AlSulaiti; Ahmed Elsotouhy; Marwa Elorrabi; Shafi Khan; Navas Nadukkandiyil; Susan Osman; Noushad Thodi; Hamad Almuhannadi; Hoda Gad; Ziyad R. Mahfoud; Fatima Al-Shibani; Ioannis N. Petropoulos; Ahmed Own; Maryam Al Kuwari; Ashfaq Shuaib; Rayaz A. Malik

doi:10.1002/acn3.746

Association of corneal nerve fiber measures with cognitive function in dementia

Georgios Ponirakis, Hanadi Al Hamad, Anoop Sankaranarayanan, Adnan Khan, Mani Chandran, Marwan Ramadan, Rhia Tosino, Priya Vitthal Gawhale, Maryam Alobaidi, Essa AlSulaiti, Ahmed Elsotouhy, Marwa Elorrabi, Shafi Khan, Navas Nadukkandiyil, Susan Osman, Noushad Thodi, Hamad Almuhannadi, Hoda Gad, Ziyad R. Mahfoud, Fatima Al-ShibaniIoannis N. Petropoulos, Ahmed Own, Maryam Al Kuwari, Ashfaq Shuaib, Rayaz A. Malik

Western Sydney University

Research output: Contribution to journal › Article › peer-review

58 Citations (Scopus)

Abstract

Objectives: Corneal confocal microscopy (CCM) is a noninvasive ophthalmic technique that identifies corneal nerve degeneration in a range of peripheral neuropathies and in patients with multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. We sought to determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia. Methods: In this study, 76 nondiabetic participants with MCI (n = 30), dementia (n = 26), and healthy age-matched controls (n = 20) underwent assessment of cognitive and physical function and CCM. Results: There was a progressive reduction in corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P < 0.0001) in patients with MCI and dementia compared to healthy controls. Adjusted for confounders, all three corneal nerve fiber measures were significantly associated with cognitive function (P < 0.05) and functional independence (P < 0.01) in MCI and dementia. The area under the ROC curve to distinguish MCI with CNFD, CNBD, and CNFL was 69.1%, 73.2%, and 73.0% and for dementia it was 84.8%, 84.2%, and 86.2%, respectively. Interpretation: CCM demonstrates corneal nerve fiber loss, which is associated with a decline in cognitive function and functional independence in patients with MCI and dementia.

Original language	English
Pages (from-to)	689-697
Number of pages	9
Journal	Annals of Clinical and Translational Neurology
Volume	6
Issue number	4
DOIs	https://doi.org/10.1002/acn3.746
Publication status	Published - 2019

Open Access - Access Right Statement

© 2019 The Authors. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

Keywords

cornea
dementia
microscopy
nerves

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10.1002/acn3.746

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Ponirakis, G., Al Hamad, H., Sankaranarayanan, A., Khan, A., Chandran, M., Ramadan, M., Tosino, R., Gawhale, P. V., Alobaidi, M., AlSulaiti, E., Elsotouhy, A., Elorrabi, M., Khan, S., Nadukkandiyil, N., Osman, S., Thodi, N., Almuhannadi, H., Gad, H., Mahfoud, Z. R., ... Malik, R. A. (2019). Association of corneal nerve fiber measures with cognitive function in dementia. Annals of Clinical and Translational Neurology, 6(4), 689-697. https://doi.org/10.1002/acn3.746

@article{58e694e3eb55456b9ec64d22db46d88b,

title = "Association of corneal nerve fiber measures with cognitive function in dementia",

abstract = "Objectives: Corneal confocal microscopy (CCM) is a noninvasive ophthalmic technique that identifies corneal nerve degeneration in a range of peripheral neuropathies and in patients with multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. We sought to determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia. Methods: In this study, 76 nondiabetic participants with MCI (n = 30), dementia (n = 26), and healthy age-matched controls (n = 20) underwent assessment of cognitive and physical function and CCM. Results: There was a progressive reduction in corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P < 0.0001) in patients with MCI and dementia compared to healthy controls. Adjusted for confounders, all three corneal nerve fiber measures were significantly associated with cognitive function (P < 0.05) and functional independence (P < 0.01) in MCI and dementia. The area under the ROC curve to distinguish MCI with CNFD, CNBD, and CNFL was 69.1%, 73.2%, and 73.0% and for dementia it was 84.8%, 84.2%, and 86.2%, respectively. Interpretation: CCM demonstrates corneal nerve fiber loss, which is associated with a decline in cognitive function and functional independence in patients with MCI and dementia.",

keywords = "cornea, dementia, microscopy, nerves",

author = "Georgios Ponirakis and {Al Hamad}, Hanadi and Anoop Sankaranarayanan and Adnan Khan and Mani Chandran and Marwan Ramadan and Rhia Tosino and Gawhale, {Priya Vitthal} and Maryam Alobaidi and Essa AlSulaiti and Ahmed Elsotouhy and Marwa Elorrabi and Shafi Khan and Navas Nadukkandiyil and Susan Osman and Noushad Thodi and Hamad Almuhannadi and Hoda Gad and Mahfoud, {Ziyad R.} and Fatima Al-Shibani and Petropoulos, {Ioannis N.} and Ahmed Own and {Al Kuwari}, Maryam and Ashfaq Shuaib and Malik, {Rayaz A.}",

year = "2019",

doi = "10.1002/acn3.746",

language = "English",

volume = "6",

pages = "689--697",

journal = "Annals of Clinical and Translational Neurology",

issn = "2328-9503",

publisher = "John Wiley & Sons",

number = "4",

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Ponirakis, G, Al Hamad, H, Sankaranarayanan, A, Khan, A, Chandran, M, Ramadan, M, Tosino, R, Gawhale, PV, Alobaidi, M, AlSulaiti, E, Elsotouhy, A, Elorrabi, M, Khan, S, Nadukkandiyil, N, Osman, S, Thodi, N, Almuhannadi, H, Gad, H, Mahfoud, ZR, Al-Shibani, F, Petropoulos, IN, Own, A, Al Kuwari, M, Shuaib, A & Malik, RA 2019, 'Association of corneal nerve fiber measures with cognitive function in dementia', Annals of Clinical and Translational Neurology, vol. 6, no. 4, pp. 689-697. https://doi.org/10.1002/acn3.746

TY - JOUR

T1 - Association of corneal nerve fiber measures with cognitive function in dementia

AU - Ponirakis, Georgios

AU - Al Hamad, Hanadi

AU - Sankaranarayanan, Anoop

AU - Khan, Adnan

AU - Chandran, Mani

AU - Ramadan, Marwan

AU - Tosino, Rhia

AU - Gawhale, Priya Vitthal

AU - Alobaidi, Maryam

AU - AlSulaiti, Essa

AU - Elsotouhy, Ahmed

AU - Elorrabi, Marwa

AU - Khan, Shafi

AU - Nadukkandiyil, Navas

AU - Osman, Susan

AU - Thodi, Noushad

AU - Almuhannadi, Hamad

AU - Gad, Hoda

AU - Mahfoud, Ziyad R.

AU - Al-Shibani, Fatima

AU - Petropoulos, Ioannis N.

AU - Own, Ahmed

AU - Al Kuwari, Maryam

AU - Shuaib, Ashfaq

AU - Malik, Rayaz A.

PY - 2019

Y1 - 2019

N2 - Objectives: Corneal confocal microscopy (CCM) is a noninvasive ophthalmic technique that identifies corneal nerve degeneration in a range of peripheral neuropathies and in patients with multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. We sought to determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia. Methods: In this study, 76 nondiabetic participants with MCI (n = 30), dementia (n = 26), and healthy age-matched controls (n = 20) underwent assessment of cognitive and physical function and CCM. Results: There was a progressive reduction in corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P < 0.0001) in patients with MCI and dementia compared to healthy controls. Adjusted for confounders, all three corneal nerve fiber measures were significantly associated with cognitive function (P < 0.05) and functional independence (P < 0.01) in MCI and dementia. The area under the ROC curve to distinguish MCI with CNFD, CNBD, and CNFL was 69.1%, 73.2%, and 73.0% and for dementia it was 84.8%, 84.2%, and 86.2%, respectively. Interpretation: CCM demonstrates corneal nerve fiber loss, which is associated with a decline in cognitive function and functional independence in patients with MCI and dementia.

AB - Objectives: Corneal confocal microscopy (CCM) is a noninvasive ophthalmic technique that identifies corneal nerve degeneration in a range of peripheral neuropathies and in patients with multiple sclerosis, Parkinson's disease, and amyotrophic lateral sclerosis. We sought to determine whether there is any association of corneal nerve fiber measures with cognitive function and functional independence in patients with MCI and dementia. Methods: In this study, 76 nondiabetic participants with MCI (n = 30), dementia (n = 26), and healthy age-matched controls (n = 20) underwent assessment of cognitive and physical function and CCM. Results: There was a progressive reduction in corneal nerve fiber density (CNFD), branch density (CNBD), and fiber length (CNFL) (P < 0.0001) in patients with MCI and dementia compared to healthy controls. Adjusted for confounders, all three corneal nerve fiber measures were significantly associated with cognitive function (P < 0.05) and functional independence (P < 0.01) in MCI and dementia. The area under the ROC curve to distinguish MCI with CNFD, CNBD, and CNFL was 69.1%, 73.2%, and 73.0% and for dementia it was 84.8%, 84.2%, and 86.2%, respectively. Interpretation: CCM demonstrates corneal nerve fiber loss, which is associated with a decline in cognitive function and functional independence in patients with MCI and dementia.

KW - cornea

KW - dementia

KW - microscopy

KW - nerves

UR - http://handle.westernsydney.edu.au:8081/1959.7/uws:51691

U2 - 10.1002/acn3.746

DO - 10.1002/acn3.746

M3 - Article

SN - 2328-9503

VL - 6

SP - 689

EP - 697

JO - Annals of Clinical and Translational Neurology

JF - Annals of Clinical and Translational Neurology

IS - 4

ER -

Association of corneal nerve fiber measures with cognitive function in dementia

Abstract

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