A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis

Area of Science:

• Neuroimaging
• Radiology
• Cognitive Neuroscience

Background:

• Multiple sclerosis (MS) is a demyelinating disease affecting the central nervous system.
• Cognitive impairment is a common and disabling symptom in people with MS (PwMS).
• Conventional volumetric analysis may not capture subtle changes in brain structures like thalamic nuclei relevant to cognition.

Purpose of the Study:

• To apply radiomics to thalamic nuclei in PwMS to identify imaging features associated with cognitive performance.
• To compare the utility of radiomic features (RF) against volumetric measures for cognitive assessment in MS.
• To explore the association of radiomic features from the putamen with cognitive function.

Main Methods:

• Radiomic features and volumes were extracted from the thalamus and putamen in 601 individuals (342 PwMS, 259 healthy controls).
• Cognitive performance was assessed using standardized tests (SDMT, PASAT, DSST).
• Multivariate linear regression and LASSO models were used to identify associations and predictive values of RF and volumes.

Main Results:

• Twenty-eight radiomic feature-region of interest (RF-ROI) pairs from the thalamus were significantly associated with cognitive performance in PwMS.
• These thalamic RF showed strong associations with multiple cognitive tests, outperforming volumetric measures.
• Only four putamen-derived RF pairs were associated with cognitive performance, and volumetric measures showed limited replicated associations.

Conclusions:

• Thalamic radiomic features are sensitive imaging biomarkers for cognitive performance in people with MS.
• Radiomics offers a promising approach to detect subtle neuroimaging changes related to cognitive deficits in MS.
• These findings support the potential of radiomics for enhanced monitoring and understanding of cognitive aspects in MS.