Thalamic Atrophy Without Whole Brain Atrophy Is Associated With Absence of 2-Year NEDA in Multiple Sclerosis

Conclusion: Patients with isolated thalamic atrophy were at a higher risk for not reaching 2-year NEDA-3 and for EDSS increase than patients with no identified brain atrophy. The groups were clinically indistinguishable. A single measurement of thalamic and whole brain atrophy could help identify patients needing most effective therapies from early on. Introduction The quantification of brain atrophy by MRI has become an increasingly important part of evaluating neurodegeneration in MS (1, 2). Atrophy measures can reflect the damage on the central nervous system (CNS) caused by the pathological processes of the disease. However, some contributors to volumetric change, such as fluid shifts, are potentially more reversible than others, e.g., axonal and/or neuronal loss. Brain atrophy occurs in all clinical stages of untreated MS patients at a rate of 0.5–1.35%/year, in comparison with 0.1–0.3%/year in healthy individuals (1). Thalamus and other deep gray matter (GM) nuclei are among the first GM structures to be affected in MS. Several studies have shown associations between GM atrophy and measures of disease progression, such as accumulation of physical disability (3, 4) and cognitive impairment (5). Thalamic atrophy occurs from early on in the disease course (6) and it has been associated with the transition from clinically isolated syndrome (CIS) to definite MS (7). Thalamic atrophy has been shown to correlate with accumulation of disability in patients w...
Source: Frontiers in Neurology - Category: Neurology Source Type: research

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