RT Journal Article
SR Electronic
T1 Subcortical and Cortical Gray Matter Atrophy in a Large Sample of Patients with Clinically Isolated Syndrome and Early Relapsing-Remitting Multiple Sclerosis
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1573
OP 1578
DO 10.3174/ajnr.A3086
VO 33
IS 8
A1 N. Bergsland
A1 D. Horakova
A1 M.G. Dwyer
A1 O. Dolezal
A1 Z.K. Seidl
A1 M. Vaneckova
A1 J. Krasensky
A1 E. Havrdova
A1 R. Zivadinov
YR 2012
UL http://www.ajnr.org/content/33/8/1573.abstract
AB BACKGROUND AND PURPOSE: Recent studies have shown that selective regional, but not global, GM atrophy occurs from clinical onset to conversion to clinically definite MS. Our aim was to investigate the difference in the extent of SDGM and cortical atrophy in a large sample of patients with CIS and early RRMS and to explore the relationship between SDGM and cortical atrophy and other MR imaging and clinical outcomes. MATERIALS AND METHODS: Two hundred twelve patients with CIS recruited at the first clinical event (mean age, 29.3 years; median EDSS, 1.5; median disease duration, 3 months) and 177 patients with early RRMS (mean age, 30.7 years; median EDSS, 2.0; median disease duration, 47 months) were imaged on a 1.5T scanner by using a high-resolution 3D T1 spoiled gradient-recalled sequence. Volumetric data for SDGM structures were obtained by using FSL FIRST, while whole-brain, GM, white matter, cortical, and lateral ventricle volumes were estimated by using SIENAX software. Comparisons between the groups were adjusted for age and sex. RESULTS: Patients with early RRMS showed significantly lower SDGM but not cortical volumes compared with patients with CIS. The most apparent SDGM differences were evident in the caudate and thalamus (P < .0001), total SDGM (P = .0001), and globus pallidus (P = .01). Patients with CIS with a median T2 lesion volume >4.49 mL showed lower total SDGM, caudate, thalamus (P < .001), globus pallidus (P = .007), hippocampus (P = .004), and putamen (P = .01) volumes and higher lateral ventricle volume (P = .001) than those with a median T2 lesion volume <4.49 mL. Decreased thalamic volume showed the most consistent relationship with MR imaging outcomes (P < .0001) in patients with CIS. CONCLUSIONS: Significant SDGM, but not cortical, atrophy develops during the first 4 years of the RRMS. GM atrophy is relevant for disease progression from the earliest clinical stages. ASAAvonex-Steroid-AzathioprineCISclinically isolated syndromeEDSSExpanded Disease Status ScaleFSLFMRIB Software LibraryGMgray matterNBVnormalized brain volumeNCVnormalized cortical volumeNGMVnormalized gray matter volumeNLVVnormalized lateral ventricle volumeNWMVnormalized white matter volumeRRMSrelapsing remitting MSSDGMsubcortical deep gray matterSETStudy of Early Interferon β 1a Treatment in High Risk Subjects after CIS