RT Journal Article
SR Electronic
T1 Determinants of Deep Gray Matter Atrophy in Multiple Sclerosis: A Multimodal MRI Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 99
OP 106
DO 10.3174/ajnr.A5915
VO 40
IS 1
A1 G. Pontillo
A1 S. Cocozza
A1 R. Lanzillo
A1 C. Russo
A1 M.D. Stasi
A1 C. Paolella
A1 E.A. Vola
A1 C. Criscuolo
A1 P. Borrelli
A1 G. Palma
A1 E. Tedeschi
A1 V.B. Morra
A1 A. Elefante
A1 A. Brunetti
YR 2019
UL http://www.ajnr.org/content/40/1/99.abstract
AB BACKGROUND AND PURPOSE: Deep gray matter involvement is a consistent feature in multiple sclerosis. The aim of this study was to evaluate the relationship between different deep gray matter alterations and the development of subcortical atrophy, as well as to investigate the possible different substrates of volume loss between phenotypes.MATERIALS AND METHODS: Seventy-seven patients with MS (52 with relapsing-remitting and 25 with progressive MS) and 41 healthy controls were enrolled in this cross-sectional study. MR imaging investigation included volumetric, DTI, PWI and Quantitative Susceptibility Mapping analyses. Deep gray matter structures were automatically segmented to obtain volumes and mean values for each MR imaging metric in the thalamus, caudate, putamen, and globus pallidus. Between-group differences were probed by ANCOVA analyses, while the contribution of different MR imaging metrics to deep gray matter atrophy was investigated via hierarchic multiple linear regression models.RESULTS: Patients with MS showed a multifaceted involvement of the thalamus and basal ganglia, with significant atrophy of all deep gray matter structures (P < .001). In the relapsing-remitting MS group, WM lesion burden proved to be the main contributor to volume loss for all deep gray matter structures (P ≤ .006), with a minor role of local microstructural damage, which, in turn, was the main determinant of deep gray matter atrophy in patients with progressive MS (P ≤ .01), coupled with thalamic susceptibility changes (P = .05).CONCLUSIONS: Our study confirms the diffuse involvement of deep gray matter in MS, demonstrating a different behavior between MS phenotypes, with subcortical GM atrophy mainly determined by global WM lesion burden in patients with relapsing-remitting MS, while local microstructural damage and susceptibility changes mainly accounted for the development of deep gray matter volume loss in patients with progressive MS.DDdisease durationDGMdeep gray matterDMTdisease-modifying treatmentEDSSExpanded Disability Status ScaleFAfractional anisotropyHChealthy controlsLLlesion loadMDmean diffusivityPMSprogressive MSQSMQuantitative Susceptibility MappingrCBVrelative CBVRRMSrelapsing-remitting MS