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Updated: Aug 6, 2026
Automated Segmentation of Cortical Grey Matter from T1-Weighted MRI Images
Published on: January 7, 2019
Regional gray matter atrophy in early primary progressive multiple sclerosis: a voxel-based morphometry study
Jorge Sepulcre1, Jaume Sastre-Garriga, Mara Cercignani
1Institute of Neurology, University College of London, 23 Queen Square, London WC1N 3BG, England.
Background:
Gray matter (GM) atrophy has been reported in multiple sclerosis (MS). However, little is known about its regional distribution.
Objective:
To investigate the regional distribution of GM atrophy in clinically early primary progressive MS (PPMS).
Design And Patients:
Thirty-one patients with PPMS within 5 years of symptom onset (mean age, 43.2 years; median Expanded Disability Status Scale score, 4.5) and 15 healthy control subjects (mean age, 43.7 years) were studied. All subjects underwent a 3-dimensional inversion-recovery fast spoiled gradient-recalled echo sequence that was repeated after 1 year in patients only. Magnetic resonance images underwent an optimized voxel-based morphometric analysis that segments magnetic resonance data volumes in a normalized space and quantifies tissue atrophy on a voxel-by-voxel basis. A lesion mask was created for each patient and used in normalization and segmentation steps to minimize bias from lesions. A multisubject design was used in the cross-sectional study to compare patients with PPMS and controls. A 1-way analysis of variance (within-subjects) design was used in the longitudinal study.
Results:
At baseline, patients with PPMS displayed bilateral thalamic atrophy compared with controls. In addition, a significant association between lesion load and decreased GM volume was found for the thalami. Loss of GM in the putamen, caudate, thalami, and cortical and infratentorial areas was observed in patients after 1 year of follow-up.
Conclusions:
Atrophy is most obvious in deep GM in clinically early PPMS. This may reflect increased sensitivity of these regions to neurodegeneration. Cortical and infratentorial atrophy developed as the disease evolved.
Insights
Gray matter atrophy in early primary progressive multiple sclerosis (PPMS) is most prominent in deep gray matter structures like the thalamus. This pattern of neurodegeneration evolves over time, affecting cortical and infratentorial regions as the disease progresses.
Area of Science:
- Neuroimaging
- Neurology
- Neurodegeneration
Background:
- Gray matter (GM) atrophy is a known feature of multiple sclerosis (MS).
- The specific regional distribution of GM atrophy in primary progressive MS (PPMS) remains poorly understood.
Purpose of the Study:
- To investigate the regional distribution of GM atrophy in clinically early primary progressive MS (PPMS).
Main Methods:
- Voxel-based morphometry was used to analyze 3D MRI scans from 31 early PPMS patients and 15 controls.
- Longitudinal analysis involved repeat scans after 1 year for patients.
- Lesion masks were utilized to minimize bias during normalization and segmentation.
Main Results:
- At baseline, PPMS patients showed bilateral thalamic atrophy compared to controls.
- Thalamic GM volume reduction was associated with lesion load.
- Over one year, GM loss was observed in the putamen, caudate, thalami, and cortical/infratentorial areas.
Conclusions:
- Deep gray matter structures are most affected by atrophy in early PPMS.
- These deep GM regions may be more susceptible to neurodegeneration.
- Cortical and infratentorial atrophy emerge as the disease progresses.
