title: Extent of cerebellum, subcortical and cortical atrophy in patients with MS: a case-control study.
abstract: Cortical and subcortical atrophy occurs in multiple sclerosis (MS) and relates to clinical outcomes. FreeSurfer, a voxel-based automated software for brain reconstruction was used to investigate the extent of subcortical and cortical atrophy in 71 MS and 17 clinically isolated syndrome (CIS) patients, and 38 normal controls (NC), and to relate group differences to disease type and severity. Segmentation was performed on 3D SPGR T1-weighted MRI 1.5T images. Region-specific subcortical tissue volumes were calculated in mm(3) and cortical thickness in mm. Logistic regression and general linear model analyses, adjusted for age and intracranial volume, examined differences between NC, MS and CIS patients and disease subtypes. The MS group was characterized by significantly lower volumes of thalamus (left and right p<0.0001), left inferior lateral ventricle, third ventricle (p<0.0001), ventral diencephalon, pallidum and putamen bilaterally, as well as of right accumbens and brainstem with corresponding bilateral increase in volumes of lateral ventricles (p<0.01). Focal cortical atrophy areas in the thalamus, inferior parietal lobule of left hemisphere and in right precuneus were also significant in the MS sample. Versus CIS patients, RR or progressive MS patients showed significantly lower volumes of subcortical regions and cortical thinning. Hippocampal atrophy appeared only in advanced disease stages. Cerebellum WM volumes were significantly lower in MS and CIS patients vs. NC. Subcortical and cortical atrophy correlated with higher disability as measured by EDSS. This study confirmed selective deep gray matter atrophy (mostly thalamic), revealed cerebellum WM atrophy from the earliest clinical stages, and showed that cortical thinning advances with disease progression.
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York at Buffalo, Buffalo, NY, USA. dramasamy@bnac.net
authors.forename: Deepa Preeti
authors.initials: DP
authors.lastname: Ramasamy
authors.forename: Ralph H B
authors.initials: RH
authors.lastname: Benedict
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Cox
authors.forename: David
authors.initials: D
authors.lastname: Fritz
authors.forename: Nadir
authors.initials: N
authors.lastname: Abdelrahman
authors.forename: Sara
authors.initials: S
authors.lastname: Hussein
authors.forename: Alireza
authors.initials: A
authors.lastname: Minagar
authors.forename: Michael G
authors.initials: MG
authors.lastname: Dwyer
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: D000328:Adult; D001284:Atrophy / Q000473:pathology; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D002531:Cerebellum / Q000473:pathology*; D002540:Cerebral Cortex / Q000473:pathology*; D003711:Demyelinating Diseases / Q000473:pathology*; D018450:Disease Progression; D001330:Electronic Data Processing / Q000379:methods; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000473:pathology*; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D009929:Organ Size; D012720:Severity of Illness Index; D012984:Software