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Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis.

Katariina Hänninen1, Matias Viitala2,3, Teemu Paavilainen4

  • 1Neurocenter, Turku University Hospital, University of Turku, Turku, Finland.

Frontiers in Neurology
|August 8, 2020
PubMed
Summary

Thalamic atrophy in multiple sclerosis (MS) patients at baseline predicts a higher risk of disability progression over 5 years. Early brain volume measurement can aid in predicting MS disability and guide treatment decisions.

Keywords:
EDSSMRIbrain atrophydisabilitymultiple sclerosisthalamus

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Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Thalamus atrophy is an early indicator in multiple sclerosis (MS).
  • Predicting disability progression is crucial for managing MS.
  • Baseline brain volume may offer prognostic value.

Purpose of the Study:

  • To investigate if thalamic atrophy at baseline predicts 5-year disability progression in Finnish MS patients.
  • To assess the relationship between baseline brain volumes and long-term disability in MS.

Main Methods:

  • Measured global and regional brain volumes in newly diagnosed relapsing MS and secondary progressive MS patients.
  • Utilized standard scores (z scores) comparing individual volumes to healthy controls, with a cutoff of -1.96 for atrophy.
  • Assessed Expanded Disability Status Scale (EDSS), MRI findings, and relapses at baseline, 2 years, and EDSS at 5 years.

Main Results:

  • Baseline thalamus volume significantly predicted 5-year disability progression (p = 0.031).
  • Patients with isolated thalamic atrophy showed a higher risk of EDSS increase (OR = 5.2) compared to those with no brain atrophy.
  • Isolated thalamic atrophy correlated with increased need for disease-modifying therapies.

Conclusions:

  • Thalamic atrophy at baseline is a significant risk factor for increased disability in MS over 5 years.
  • Baseline brain volume measurement can predict MS disability progression.
  • Brain volume assessment can complement clinical and MRI evaluations for therapeutic decision-making in MS.