title: Thalamic lesions in multiple sclerosis by 7T MRI: Clinical implications and relationship to cortical pathology.
abstract: OBJECTIVE
  Pathology in both cortex and deep gray matter contribute to disability in multiple sclerosis (MS). We used the increased signal-to-noise ratio of 7-tesla (7T) MRI to visualize small lesions within the thalamus and to relate this to clinical information and cortical lesions.
  
  
  METHODS
  We obtained 7T MRI scans on 34 MS cases and 15 healthy volunteers. Thalamic lesion number and volume were related to demographic data, clinical disability measures, and lesions in cortical gray matter.
  
  
  RESULTS
  Thalamic lesions were found in 24/34 of MS cases. Two lesion subtypes were noted: discrete, ovoid lesions, and more diffuse lesional areas lining the periventricular surface. The number of thalamic lesions was greater in progressive MS compared to relapsing-remitting (mean ±SD, 10.7 ±0.7 vs. 3.0 ±0.7, respectively, p < 0.001). Thalamic lesion burden (count and volume) correlated with EDSS score and measures of cortical lesion burden, but not with white matter lesion burden or white matter volume.
  
  
  CONCLUSIONS
  Using 7T MRI allows identification of thalamic lesions in MS, which are associated with disability, progressive disease, and cortical lesions. Thalamic lesion analysis may be a simpler, more rapid estimate of overall gray matter lesion burden in MS.
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA dharri90@jhmi.edu.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Harrison
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA.
authors.forename: Jiwon
authors.initials: J
authors.lastname: Oh
authors.affiliation: Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Uniformed Services University of the Health Sciences, USA.
authors.forename: Snehashis
authors.initials: S
authors.lastname: Roy
authors.affiliation: Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), USA/Department of Neuroscience, Johns Hopkins School of Medicine, USA.
authors.forename: Emily T
authors.initials: ET
authors.lastname: Wood
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Whetstone
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA.
authors.forename: Michaela A
authors.initials: MA
authors.lastname: Seigo
authors.affiliation: F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, USA/Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA.
authors.forename: Craig K
authors.initials: CK
authors.lastname: Jones
authors.affiliation: Center for Neuroscience and Regenerative Medicine, Henry Jackson Foundation, Uniformed Services University of the Health Sciences, USA.
authors.forename: Dzung
authors.initials: D
authors.lastname: Pham
authors.affiliation: F.M. Kirby Research Center for Functional Brain Imaging, Kennedy Krieger Institute, USA/Department of Neuroscience, Johns Hopkins School of Medicine, USA/Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: van Zijl
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA/Translational Neuroradiology Unit, National Institute of Neurological Disorders and Stroke (NINDS), National Institutes of Health (NIH), USA/Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, USA.
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Reich
authors.affiliation: Department of Neurology, Johns Hopkins University School of Medicine, Johns Hopkins School of Medicine, USA.
authors.forename: Peter A
authors.initials: PA
authors.lastname: Calabresi
mesh_terms: D000328:Adult; D002540:Cerebral Cortex / Q000473:pathology; D005260:Female; D066128:Gray Matter / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000473:pathology*; D013788:Thalamus / Q000473:pathology*; D066127:White Matter / Q000473:pathology
keywords: MRI; multiple sclerosis