Thalamic damage predicts the evolution of primary-progressive multiple sclerosis at 5 years

Area of Science:

• Neuroimaging
• Neurology
• Multiple Sclerosis Research

Background:

• Primary progressive multiple sclerosis (PPMS) lacks reliable monitoring markers.
• Thalamic damage and white matter integrity are potential indicators of disease progression.

Purpose of the Study:

• To investigate if conventional and diffusion tensor imaging (DTI) measures of thalamic damage predict long-term disability accumulation in PPMS.
• To identify reliable imaging biomarkers for monitoring PPMS progression.

Main Methods:

• Conventional and DTI brain scans were acquired at baseline and follow-up (15 months) in 54 PPMS patients and 8 controls.
• Clinical reassessment occurred after 5 years.
• Measures included lesion load, brain atrophy, NTV, and MD/FA histograms of normal-appearing white matter (NAWM) and gray matter (GM), including thalami.

Main Results:

• PPMS patients showed lower NTV and thalamic FA, and higher thalamic and GM MD at baseline compared to controls.
• Changes in thalamic FA during follow-up were greater in PPMS patients.
• Multivariate analysis identified average NAWM MD and thalamic FA change as independent predictors of EDSS score deterioration.

Conclusions:

• Short-term thalamic damage accrual and NAWM involvement severity predict long-term disability accumulation in PPMS.
• DTI measures of thalamic and NAWM damage are promising biomarkers for predicting long-term outcomes in PPMS.