title: Gray Matter Involvement in Radiologically Isolated Syndrome.
abstract: The unanticipated magnetic resonance imaging (MRI) detection in the brain of asymptomatic subjects of white matter lesions suggestive of multiple sclerosis has recently been named as radiologically isolated syndrome (RIS). The pathophysiological processes of RIS remain largely unknown and questions as to whether gray matter alterations actually occur in this entity are yet to be investigated in more detail. By means of a 3 T multimodal MRI approach, we searched for cortical and deep gray matter changes in a cohort of RIS patients. Seventeen RIS patients, 17 clinically isolated syndrome (CIS) patients (median disease duration from symptom onset = 12 months), and 17 healthy controls underwent MRI and neuropsychological testing. Normalized deep gray matter volumes and regional cortical thickness were assessed using FreeSurfer. SIENAX was used to obtain normalized global and cortical brain volumes. Voxelwise morphometry analysis was performed by using SPM8 software to localize regions of brain tissue showing significant changes of fractional anisotropy or mean diffusivity. Although no differences were observed between CIS and healthy controls groups, RIS patients showed significantly lower normalized cortical volume (673 ± 27.07 vs 641 ± 35.88 [cm³ × 10³, Tukey P test = 0.009) and mean thalamic volume (0.0051 ± 0.4 vs 0.0046 ± 0.4 mm, P = 0.014) compared with healthy controls. RIS patients also showed significant thinning in a number of cortical areas, that were primarily distributed in frontal and temporal lobes (P < 0.05, uncorrected). Strong correlations were observed between T2-white matter lesion volume and regional cortical thickness (rho spearman ranging from 0.60 to 0.80). Our data suggest that white matter lesions on T2-weighted images are not the only hallmark of RIS. Future longitudinal studies with larger samples are warranted to better clarify the effect of RIS-related white matter lesions on gray matter tissue.
authors.affiliation: From the Department of Neurology, University Hospital "12 de Octubre" (AL-F, AD-S, JB-L); Neuroimaging Laboratory, Center for Biomedical Technology, Rey Juan Carlos University, Móstoles (VM-A, JAH-T); Department of Radiology, Hospital Ruber International (JA-L); Department of Neurology, University Hospital "Gregorio Marañón," Madrid, Spain (MLM-G); Department of Neurology, University Hospital of Getafe, Getafe (YA); Department of Neurology, University Hospital "Principe de Asturias," Alcalá de Henares (LA); Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) (JB-L); and Department of Medicine, Complutense University (JB-L), Madrid, Spain.
authors.forename: Andrés
authors.initials: A
authors.lastname: Labiano-Fontcuberta
authors.forename: Virginia
authors.initials: V
authors.lastname: Mato-Abad
authors.forename: Juan
authors.initials: J
authors.lastname: Álvarez-Linera
authors.forename: Juan Antonio
authors.initials: JA
authors.lastname: Hernández-Tamames
authors.forename: M Luisa
authors.initials: ML
authors.lastname: Martínez-Ginés
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Aladro
authors.forename: Lucía
authors.initials: L
authors.lastname: Ayuso
authors.forename: Ángela
authors.initials: Á
authors.lastname: Domingo-Santos
authors.forename: Julián
authors.initials: J
authors.lastname: Benito-León
mesh_terms: D000328:Adult; D001927:Brain Diseases / Q000473:pathology*; D005260:Female; D066128:Gray Matter / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D013577:Syndrome; D066127:White Matter / Q000473:pathology*