Connecting white matter injury and thalamic atrophy in clinically isolated syndromes

Roland G. Henry, Mason Shieh, Bagrat Amirbekian, SungWon Chung, Darin T. Okuda, Daniel Pelletier

Research output: Contribution to journalArticle

90 Scopus citations

Abstract

Previous studies suggest that thalamic degeneration is prominent in multiple sclerosis (MS) and even in pre-MS patients presenting with a clinically isolated syndrome (CIS). However, the relationships between white matter lesions and deep grey matter loss are not well understood. We analyzed the association between white matter lesions and the thalami in CIS patients to determine if connectivity is an important determinant. We studied 24 CIS patients and 18 normal controls with anatomical and diffusion tensor (DTI) MRI images. DTI fiber tracking was used to create probabilistic templates of the thalamocortical white matter and to define white matter connecting lesions and thalami. DTI metrics in the lesions and normal-appearing white matter (NAWM) regions were compared between CIS and controls, and correlated with thalamic volume changes estimated by voxel-based morphometry. There was 10 times higher density of lesions in thalamocortical compared to other brain white matter. Increased diffusivities and decreased fractional anisotropies were measured in the thalamocortical NAWM of CIS patients compared to controls. A step-wise regression analysis demonstrated that thalamocortical lesion volume and the mean diffusivity in track regions connecting lesion and thalami were significantly correlated with thalamic volumes in patients (Rsq = 0.66, p < 0.001), a finding not observed in regions outside the thalamocortical white matter. These results provide compelling evidence for a direct relationship between white matter lesions and thalamic atrophy in CIS patients.

Original languageEnglish (US)
Pages (from-to)61-66
Number of pages6
JournalJournal of the Neurological Sciences
Volume282
Issue number1-2
DOIs
StatePublished - Jul 15 2009

Keywords

  • Atrophy
  • CIS
  • DTI
  • Grey matter
  • Multiple sclerosis
  • Thalamus
  • Tractography
  • VBM

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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