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Pattern of thalamic nuclei atrophy in early relapse-onset multiple sclerosis

      Highlights

      • Thalamic atrophy is present in multiple sclerosis in early stages of the disease.
      • Anterior and posterior thalamic nuclei most vulnerable in early multiple sclerosis.
      • Toxic CSF-mediated processes may be at least partially driving thalamic atrophy.

      Abstract

      Background

      Thalamic atrophy is prominent in multiple sclerosis; however, it is unclear which thalamic nuclei are most vulnerable, especially early in disease.

      Introduction

      To investigate which thalamic nuclei differ between patients in early stages of relapsing-remitting multiple sclerosis (RRMS) versus healthy controls and examine the relationship between thalamic nuclei volume and T2 lesion volume.

      Methods

      We derived 15 thalamic subfields from high-resolution 3T magnetic resonance images in 182 patients with early RRMS (diagnosed ≤5.0 years, median 2.0 years). Independent t-tests assessed differences between patients and 35 controls across thalamic subfield volumes. Pearson correlations assessed the relationships between thalamic volumes and T2 lesion volumes.

      Results

      Patients had lower anterior and posterior nuclei volume than controls, whereas medial and ventral nuclei volumes were preserved. Higher T2 lesion volumes were disproportionately related to lower posterior subfield volumes.

      Conclusions

      We found specific thalamic subfields were more vulnerable to early disease-related changes. We discuss potential mechanisms of differential thalamic subfield atrophy in early MS, including cortical demyelination, CSF toxicity, leptomeningeal inflammation, and iron deposition.

      Keywords

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