Aims and objectives
Deep Gray Matter (DGM) involvement is a consistent feature in Multiple Sclerosis (MS),
generating great interest due to its clinical relevance [1].
In particular,
the occurrence of DGM atrophy in these patients has been described by several volumetric MRI studies as an early phenomenon,
with a significant correlation with clinical disability,
cognition and disease progression [2-5].
Along with volume loss,
a wide range of pathological changes affecting the DGM of MS patients has been also demonstrated using different advanced MRI techniques including Diffusion Tensor Imaging...
Methods and materials
Subjects
In this single-center observational study,
77 MS patients (52 RRMS and 25 PMS according to the 2013 revised definition of MS phenotypes [12]) and 44 Healthy Controls (HC) of comparable age and sex were enrolled.
All MS patients fulfilled the 2010 revised McDonald criteria [13],
while none of the HC presented any condition that could affect the CNS.
MRI data acquisition and processing
All MR images were acquired using the same 3T scanner (Trio,
Siemens Medical Systems,
Erlangen,
Germany).
The acquisition protocol included a...
Results
Between-group MRI analysis
MS patients showed a multifaceted involvement of thalamus and basal ganglia,
with significant atrophy of all DGM structures (p<0.0001),
increased MD values in patients at the level of caudate nucleus and thalamus (p<0.0001) and a reduction of susceptibility values in the thalamus compared to HC (p=0.001).
Relationship between advanced MRI metrics and DGM volumes
The regression analysis conducted on the entire MS group showed that LL (all with p≤0.02) and microstructural GM changes (all with p≤0.0001) were independent predictors of volume loss...
Conclusion
In this study we used a multimodal MRI approach to investigate different features of DGM involvement in MS,
confirming the presence of a diffuse and multifaceted involvement of subcortical GM structures in this condition.
We demonstrated that WM lesion burden represents the main determinant of DGM atrophy in RRMS,
with a concomitant although relative role of local microstructural damage,
which in turn proved to be the main contributor to the development of subcortical GM volume loss in PMS,
along with thalamic susceptibility changes.
This results...
Personal information
Giuseppe Pontillo,
MD
Department of Advanced Biomedical Sciences
University of Naples “Federico II”,
Naples,
Italy
e-mail:
[email protected]
References
Pirko I,
Lucchinetti CF,
Sriram S,
et al.
Gray matter involvement in multiple sclerosis.
Neurology 2007;68:634-642
Eshaghi A,
Marinescu RV,
Young AL,
et al.
Progression of regional grey matter atrophy in multiple sclerosis.
Brain : a journal of neurology 2018;141:1665-1677
Zivadinov R,
Havrdova E,
Bergsland N,
et al.
Thalamic atrophy is associated with development of clinically definite multiple sclerosis.
Radiology 2013;268:831-841
Eshaghi A,
Prados F,
Brownlee WJ,
et al.
Deep gray matter volume loss drives disability worsening in multiple sclerosis.
Annals of neurology 2018;83:210-222
Schoonheim...