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Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Thalamic atrophy is associated with development of clinically definite multiple sclerosis
Robert Zivadinov1, Eva Havrdová, Niels Bergsland
1Department of Neurology, SUNY, Buffalo Neuroimaging Analysis Center, University at Buffalo, 100 High St, Buffalo, NY 14203, USA. rzivadinov@bnac.net
Radiology
|April 25, 2013
Summary
Thalamic atrophy and enlarged ventricles in clinically isolated syndrome (CIS) predict conversion to clinically definite multiple sclerosis (CDMS). These MRI markers, alongside new T2 and contrast-enhancing lesions, improve CDMS risk assessment.
Area of Science:
- Neurology
- Radiology
- Neuroimmunology
Background:
- Clinically isolated syndrome (CIS) is an early stage of multiple sclerosis (MS).
- Predicting conversion from CIS to clinically definite multiple sclerosis (CDMS) is crucial for timely treatment.
- Magnetic resonance (MR) imaging plays a key role in monitoring disease progression.
Purpose of the Study:
- To examine the association between thalamic and cortical atrophy and conversion to CDMS in CIS patients.
- To identify specific MR imaging markers predictive of CDMS development.
Main Methods:
- Prospective study of 216 CIS patients treated with interferon β1a.
- Serial MR imaging at baseline, 6 months, 1 year, and 2 years.
- Analysis of lesion load (T2, contrast-enhancing) and brain volume changes (whole-brain, regional gray matter, thalamus, lateral ventricles).
Main Results:
- 42.6% of CIS patients converted to CDMS within 2 years.
- Increased lateral ventricle volume, accumulation of contrast-enhancing lesions, and new/enlarging T2 lesions were associated with CDMS development.
- Decreased thalamic and whole-brain volumes also correlated with CDMS conversion.
Conclusions:
- Thalamic atrophy and increased ventricular size are significant predictors of CDMS development in CIS patients.
- These volumetric changes, in addition to lesion assessment, enhance the prediction of MS conversion.
- Incorporating these MR imaging biomarkers can aid in early risk stratification and management of CIS.
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