Abstract
Several studies suggest that grey matter involvement may play a role in multiple sclerosis (MS) pathology. Diffusion tensor imaging (DTI) at 3T was used to investigate the presence of damage to the normal-appearing thalamus in MS and its relationship with disability. Twenty-four patients with relapsing-remitting (RR, n = 13, age = 41.7 +/- 6.1, Expanded Disability Status Scale [EDSS] score = 2.2 +/- 1.2) and secondary-progressive (n = 11, age = 46.9 +/- 9.6, EDSS = 5.9 +/- 1.0) MS and 24 age- and sex-matched healthy volunteers were studied. Fractional anisotropy (FA) and mean diffusivity (MD) were measured in regions of interest of normal-appearing thalamus. We examined group differences in MD and FA and correlations between DTI-derived metrics and clinical or imaging measures of disease. Patients with MS had higher thalamic FA (P < .0001) and MD (P = .035) than volunteers. MD values correlated with the Paced Auditory Serial Addition Task (r = -0.43, P = .034) and motor EDSS (r = 0.47, P = .021) scores. In patients with RRMS, MD values correlated with global EDSS (r = 0.75, P = .003) and motor EDSS (r = 0.68, P = .010). Correlations were found between MD values and T1 and T2 lesion load (r = 0.58, P < .05) and brain parenchymal fraction (r = -0.46, P < .05). DTI was able to detect abnormalities in normal-appearing thalamus of patients with MS. The strength of association between thalamic DTI measures and functional impairment was in the same range as those seen with standard MR imaging disease measures. The assessment of the integrity of the thalamus with DTI is a promising metric as a marker of disease for future studies.
Highlights
AND PURPOSE: Several studies suggest that grey matter involvement may play a role in multiple sclerosis (MS) pathology
mean diffusivity (MD) values correlated with the Paced Auditory Serial Addition Task (r ϭ Ϫ0.43, P ϭ .034) and motor Expanded Disability Status Scale (EDSS) (r ϭ 0.47, P ϭ .021) scores
Correlations were found between MD values and T1 and T2 lesion load (r ϭ 0.58, P Ͻ .05) and brain parenchymal fraction (r ϭ Ϫ0.46, P Ͻ .05)
Summary
Twenty-four patients with relapsing-remitting (RR, n ϭ 13, age ϭ 41.7 Ϯ 6.1, Expanded Disability Status Scale [EDSS] score ϭ 2.2 Ϯ 1.2) and secondary-progressive (n ϭ 11, age ϭ 46.9 Ϯ 9.6, EDSS ϭ 5.9 Ϯ 1.0) MS and 24 age- and sex-matched healthy volunteers were studied. We examined group differences in MD and FA and correlations between DTI-derived metrics and clinical or imaging measures of disease. The exclusion criteria for the study were the following: 1) inability to provide a written consent form, 2) contraindication to undergo a 3T MR imaging, and 3) the presence of clinical relapse or steroid treatment within 1 month of the study. Twenty-four healthy volunteers, age- and sex-matched to the patient group, were recruited and scanned by using the same protocol. 4 volunteers were rescanned using the same DTI protocol 2 weeks apart, and an interscan coefficient of variation (COV) was obtained
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