title: Regional gray matter atrophy in relapsing remitting multiple sclerosis: baseline analysis of multi-center data.
abstract: Regional gray matter (GM) atrophy in multiple sclerosis (MS) at disease onset and its temporal variation can provide objective information regarding disease evolution. An automated pipeline for estimating atrophy of various GM structures was developed using tensor based morphometry (TBM) and implemented on a multi-center sub-cohort of 1008 relapsing remitting MS (RRMS) patients enrolled in a Phase 3 clinical trial. Four hundred age and gender matched healthy controls were used for comparison. Using the analysis of covariance, atrophy differences between MS patients and healthy controls were assessed on a voxel-by-voxel analysis. Regional GM atrophy was observed in a number of deep GM structures that included thalamus, caudate nucleus, putamen, and cortical GM regions. General linear regression analysis was performed to analyze the effects of age, gender, and scanner field strength, and imaging sequence on the regional atrophy. Correlations between regional GM volumes and expanded disability status scale (EDSS) scores, disease duration (DD), T2 lesion load (T2 LL), T1 lesion load (T1 LL), and normalized cerebrospinal fluid (nCSF) were analyzed using Pearson׳s correlation coefficient. Thalamic atrophy observed in MS patients compared to healthy controls remained consistent within subgroups based on gender and scanner field strength. Weak correlations between thalamic volume and EDSS (r=-0.133; p<0.001) and DD (r=-0.098; p=0.003) were observed. Of all the structures, thalamic volume moderately correlated with T2 LL (r=-0.492; P-value<0.001), T1 LL (r=-0.473; P-value<0.001) and nCSF (r=-0.367; P-value<0.001).
authors: Department of Diagnostic and Interventional Imaging, University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, United States. Electronic address: Sushmita.Datta@uth.tmc.edu.
authors: Sushmita
authors: S
authors: Datta
authors: Department of Diagnostic and Interventional Imaging, University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, United States.
authors: Terrell D
authors: TD
authors: Staewen
authors: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States.
authors: Stacy S
authors: SS
authors: Cofield
authors: Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States.
authors: Gary R
authors: GR
authors: Cutter
authors: The Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY 10029, United States.
authors: Fred D
authors: FD
authors: Lublin
authors: Department of Neurology University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, United States.
authors: Jerry S
authors: JS
authors: Wolinsky
authors: Department of Diagnostic and Interventional Imaging, University of Texas Medical School at Houston, 6431 Fannin, Houston, TX 77030, United States.
authors: Ponnada A
authors: PA
authors: Narayana
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D001284:Atrophy / Q000473:pathology; D056324:Diffusion Tensor Imaging / Q000379:methods; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000473:pathology*; D009929:Organ Size; D055815:Young Adult
keywords: CombiRx; Regional atrophy; Relapsing remitting multiple sclerosis; Tensor based morphometry; Unbiased template