Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis
Purpose: Thalamus is among the first brain regions to become atrophic in multiple sclerosis (MS). We studied whether thalamic atrophy predicts disability progression at 5 years in a cohort of Finnish MS patients.Methods: Global and regional brain volumes were measured from 24 newly diagnosed relapsi...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2020-07-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fneur.2020.00606/full |
| _version_ | 1818325652446642176 |
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| author | Katariina Hänninen Matias Viitala Matias Viitala Teemu Paavilainen Jari O. Karhu Juha Rinne Juha Rinne Juha Koikkalainen Jyrki Lötjönen Merja Soilu-Hänninen |
| author_facet | Katariina Hänninen Matias Viitala Matias Viitala Teemu Paavilainen Jari O. Karhu Juha Rinne Juha Rinne Juha Koikkalainen Jyrki Lötjönen Merja Soilu-Hänninen |
| author_sort | Katariina Hänninen |
| collection | DOAJ |
| description | Purpose: Thalamus is among the first brain regions to become atrophic in multiple sclerosis (MS). We studied whether thalamic atrophy predicts disability progression at 5 years in a cohort of Finnish MS patients.Methods: Global and regional brain volumes were measured from 24 newly diagnosed relapsing MS (RMS) patients 6 months after initiation of therapy and from 36 secondary progressive MS (SPMS) patients. The patients were divided into groups based on baseline whole brain parenchymal (BP) and thalamic atrophy. Standard scores (z scores) were computed by comparing individual brain volumes with healthy controls. A z score cutoff of −1.96 was applied to separate atrophic from normal brain volumes. The Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging (MRI) findings, and relapses were assessed at baseline and at 2 years and EDSS progression at 5 years.Results: Baseline thalamus volume predicted disability in 5 years in a logistic regression model (p = 0.031). At 5 years, EDSS was same or better in 12 of 18 patients with no brain atrophy at baseline but only in 5 of 18 patients with isolated thalamic atrophy [odds ratio (OR) (95% CI) = 5.2 (1.25, 21.57)]. The patients with isolated thalamic atrophy had more escalations of disease-modifying therapies during follow-up.Conclusion: Patients with thalamic atrophy at baseline were at a higher risk for 5-year EDSS increase than patients with no identified brain atrophy. Brain volume measurement at a single time point could help predict disability progression in MS and complement clinical and routine MRI evaluation in therapeutic decision-making. |
| first_indexed | 2024-12-13T11:47:53Z |
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| id | doaj.art-deb826b4d54b4e3bb4f44174d4dbd4c2 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-13T11:47:53Z |
| publishDate | 2020-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-deb826b4d54b4e3bb4f44174d4dbd4c22022-12-21T23:47:28ZengFrontiers Media S.A.Frontiers in Neurology1664-22952020-07-011110.3389/fneur.2020.00606543020Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple SclerosisKatariina Hänninen0Matias Viitala1Matias Viitala2Teemu Paavilainen3Jari O. Karhu4Juha Rinne5Juha Rinne6Juha Koikkalainen7Jyrki Lötjönen8Merja Soilu-Hänninen9Neurocenter, Turku University Hospital, University of Turku, Turku, FinlandDepartment of Mathematics and Statistics, University of Turku, Turku, FinlandStellarQ Ltd., Turku, FinlandMedical Imaging Centre of Southwest Finland, Turku, FinlandMedical Imaging Centre of Southwest Finland, Turku, FinlandNeurocenter, Turku University Hospital, University of Turku, Turku, FinlandTurku PET Centre, University of Turku, Turku, FinlandCombinostics Ltd., Tampere, FinlandTurku PET Centre, University of Turku, Turku, FinlandNeurocenter, Turku University Hospital, University of Turku, Turku, FinlandPurpose: Thalamus is among the first brain regions to become atrophic in multiple sclerosis (MS). We studied whether thalamic atrophy predicts disability progression at 5 years in a cohort of Finnish MS patients.Methods: Global and regional brain volumes were measured from 24 newly diagnosed relapsing MS (RMS) patients 6 months after initiation of therapy and from 36 secondary progressive MS (SPMS) patients. The patients were divided into groups based on baseline whole brain parenchymal (BP) and thalamic atrophy. Standard scores (z scores) were computed by comparing individual brain volumes with healthy controls. A z score cutoff of −1.96 was applied to separate atrophic from normal brain volumes. The Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging (MRI) findings, and relapses were assessed at baseline and at 2 years and EDSS progression at 5 years.Results: Baseline thalamus volume predicted disability in 5 years in a logistic regression model (p = 0.031). At 5 years, EDSS was same or better in 12 of 18 patients with no brain atrophy at baseline but only in 5 of 18 patients with isolated thalamic atrophy [odds ratio (OR) (95% CI) = 5.2 (1.25, 21.57)]. The patients with isolated thalamic atrophy had more escalations of disease-modifying therapies during follow-up.Conclusion: Patients with thalamic atrophy at baseline were at a higher risk for 5-year EDSS increase than patients with no identified brain atrophy. Brain volume measurement at a single time point could help predict disability progression in MS and complement clinical and routine MRI evaluation in therapeutic decision-making.https://www.frontiersin.org/article/10.3389/fneur.2020.00606/fullmultiple sclerosisthalamusbrain atrophydisabilityMRIEDSS |
| spellingShingle | Katariina Hänninen Matias Viitala Matias Viitala Teemu Paavilainen Jari O. Karhu Juha Rinne Juha Rinne Juha Koikkalainen Jyrki Lötjönen Merja Soilu-Hänninen Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis Frontiers in Neurology multiple sclerosis thalamus brain atrophy disability MRI EDSS |
| title | Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis |
| title_full | Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis |
| title_fullStr | Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis |
| title_full_unstemmed | Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis |
| title_short | Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis |
| title_sort | thalamic atrophy predicts 5 year disability progression in multiple sclerosis |
| topic | multiple sclerosis thalamus brain atrophy disability MRI EDSS |
| url | https://www.frontiersin.org/article/10.3389/fneur.2020.00606/full |
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