TY - JOUR
T1 - Thalamic atrophy is associated with development of clinically definite multiple sclerosis
AU - Zivadinov, Robert
AU - Havrdová, Eva
AU - Bergsland, Niels
AU - Tyblova, Michaela
AU - Hagemeier, Jesper
AU - Seidl, Zdenek
AU - Dwyer, Michael G.
AU - Vaneckova, Manuela
AU - Krasensky, Jan
AU - Carl, Ellen
AU - Kalincik, Tomas
AU - Horáková, Dana
PY - 2013/9
Y1 - 2013/9
N2 - Purpose: To investigate the association between the development of thalamic and cortical atrophy and the conversion to clinically definite multiple sclerosis (CDMS) in patients with clinically isolated syndrome (CIS). Materials and Methods: This prospective study was approved by the institutional review board. Informed consent was given by 216 CIS patients, and patients were treated with 30 μg of intramuscular interferon β1a once a week. They were assessed with a magnetic resonance (MR) imaging examination at baseline, 6 months, 1 year, and 2 years. Patients were evaluated within 4 months of an initial demyelinating event, had two or more brain lesions on MR images, and had two or more oligoclonal bands in cerebrospinal fluid. MR imaging measures of progression included cumulative number and volume of contrast agent-enhanced (CE) new and enlarged T2 lesions, and changes in whole-brain, tissue-specific global, and regional gray matter volumes. Regression and mixed-effect model analyses were used. Results: Over 2 years, 92 of 216 patients (42.6%) converted to CDMS; 122 (56.5%) CIS patients fulfilled McDonald 2005 criteria and 153 (70.8%) fulfilled McDonald 2010 criteria for MR imaging dissemination in time and space. The mean time to first relapse was 3.1 months, and mean annual relapse rate was 0.46. In mixed-effect model analysis, the lateral ventricle volume (P = .005), accumulation of CE (P = .007), new total T2 (P = .009) and new enlarging T2 lesions (P = .01) increase, and thalamic (P = .009) and whole-brain (P = .019) volume decrease were associated with development of CDMS. In multivariate regression analysis, decrease in thalamic volumes and increase in lateral ventricle volumes (P = .009) were MR imaging variables associated with the development of CDMS. Conclusion: Measurement of thalamic atrophy and increase in ventricular size in CIS is associated with CDMS development and should be used in addition to the assessment of new T2 and CE lesions.
AB - Purpose: To investigate the association between the development of thalamic and cortical atrophy and the conversion to clinically definite multiple sclerosis (CDMS) in patients with clinically isolated syndrome (CIS). Materials and Methods: This prospective study was approved by the institutional review board. Informed consent was given by 216 CIS patients, and patients were treated with 30 μg of intramuscular interferon β1a once a week. They were assessed with a magnetic resonance (MR) imaging examination at baseline, 6 months, 1 year, and 2 years. Patients were evaluated within 4 months of an initial demyelinating event, had two or more brain lesions on MR images, and had two or more oligoclonal bands in cerebrospinal fluid. MR imaging measures of progression included cumulative number and volume of contrast agent-enhanced (CE) new and enlarged T2 lesions, and changes in whole-brain, tissue-specific global, and regional gray matter volumes. Regression and mixed-effect model analyses were used. Results: Over 2 years, 92 of 216 patients (42.6%) converted to CDMS; 122 (56.5%) CIS patients fulfilled McDonald 2005 criteria and 153 (70.8%) fulfilled McDonald 2010 criteria for MR imaging dissemination in time and space. The mean time to first relapse was 3.1 months, and mean annual relapse rate was 0.46. In mixed-effect model analysis, the lateral ventricle volume (P = .005), accumulation of CE (P = .007), new total T2 (P = .009) and new enlarging T2 lesions (P = .01) increase, and thalamic (P = .009) and whole-brain (P = .019) volume decrease were associated with development of CDMS. In multivariate regression analysis, decrease in thalamic volumes and increase in lateral ventricle volumes (P = .009) were MR imaging variables associated with the development of CDMS. Conclusion: Measurement of thalamic atrophy and increase in ventricular size in CIS is associated with CDMS development and should be used in addition to the assessment of new T2 and CE lesions.
UR - http://www.scopus.com/inward/record.url?scp=84883183367&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883183367&partnerID=8YFLogxK
U2 - 10.1148/radiol.13122424
DO - 10.1148/radiol.13122424
M3 - Article
C2 - 23613615
AN - SCOPUS:84883183367
SN - 0033-8419
VL - 268
SP - 831
EP - 841
JO - Radiology
JF - Radiology
IS - 3
ER -