@article{61ef3c43bc034943bca158e48c41cada,
title = "Manual and automated tissue segmentation confirm the impact of thalamus atrophy on cognition in multiple sclerosis: A multicenter study",
abstract = "Background and rationale: Thalamus atrophy has been linked to cognitive decline in multiple sclerosis (MS) using various segmentation methods. We investigated the consistency of the association between thalamus volume and cognition in MS for two common automated segmentation approaches, as well as fully manual outlining. Methods: Standardized neuropsychological assessment and 3-Tesla 3D-T1-weighted brain MRI were collected (multi-center) from 57 MS patients and 17 healthy controls. Thalamus segmentations were generated manually and using five automated methods. Agreement between the algorithms and manual outlines was assessed with Bland-Altman plots; linear regression assessed the presence of proportional bias. The effect of segmentation method on the separation of cognitively impaired (CI) and preserved (CP) patients was investigated through Generalized Estimating Equations; associations with cognitive measures were investigated using linear mixed models, for each method and vendor. Results: In smaller thalami, automated methods systematically overestimated volumes compared to manual segmentations [ρ=(-0.42)-(-0.76); p-values < 0.001). All methods significantly distinguished CI from CP MS patients, except manual outlines of the left thalamus (p = 0.23). Poorer global neuropsychological test performance was significantly associated with smaller thalamus volumes bilaterally using all methods. Vendor significantly affected the findings. Conclusion: Automated and manual thalamus segmentation consistently demonstrated an association between thalamus atrophy and cognitive impairment in MS. However, a proportional bias in smaller thalami and choice of MRI acquisition system might impact the effect size of these findings.",
keywords = "Atrophy, Cognition, Deep grey matter, MRI, Multiple Sclerosis, Segmentation, Thalamus",
author = "Jessica Burggraaff and Yao Liu and Prieto, {Juan C.} and Jorge Simoes and {de Sitter}, Alexandra and Serena Ruggieri and Iman Brouwer and Lissenberg-Witte, {Birgit I.} and Rocca, {Mara A.} and Paola Valsasina and Stefan Ropele and Claudio Gasperini and Antonio Gallo and Deborah Pareto and Jaume Sastre-Garriga and Christian Enzinger and Massimo Filippi and {de Stefano}, Nicola and Olga Ciccarelli and Hulst, {Hanneke E.} and Wattjes, {Mike P.} and Frederik Barkhof and Uitdehaag, {Bernard M. J.} and Hugo Vrenken and Guttmann, {Charles R. G.}",
note = "Funding Information: The members of the MAGNIMS Study Group Steering Committee are: F. Barkhof and H. Vrenken (VU University Medical Center, Amsterdam, Netherlands), O. Ciccarelli and T. Yousry (Queen Square MS Centre, UCL Institute of Neurology, London, UK), N. De Stefano (University of Siena, Siena, Italy), C. Enzinger (Department of Neurology, Medical University of Graz, Graz, Austria), M. Filippi and M.A. Rocca (San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy), C. Gasperini (San Camillo-Forlanini Hospital, Rome, Italy), L. Kappos (University of Basel, Basel, Switzerland), J. Palace (University of Oxford Hospitals Trust, Oxford, UK), A. Rovira and J. Sastre-Garriga (Hospital Universitari Vall d{\textquoteright}Hebron, Universitat Aut{\`o}noma de Barcelona, Barcelona, Spain). The study was funded by the Nauta fonds through a travel grant. The MS Center Amsteram is supported by the Dutch MS Research Foundation through a program grant (current grant 18-358f). D.B. is supported by project PI18/00823 from the “Fondo de Investigaci{\'o}n Sanitaria Carlos III”. F.B. and O.C. are supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. The acquisition of data in London was funded by supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. A sincere thank you to Tom Verhoeven for his editing of the figures. Funding Information: The members of the MAGNIMS Study Group Steering Committee are: F. Barkhof and H. Vrenken (VU University Medical Center, Amsterdam, Netherlands), O. Ciccarelli and T. Yousry (Queen Square MS Centre, UCL Institute of Neurology, London, UK), N. De Stefano (University of Siena, Siena, Italy), C. Enzinger (Department of Neurology, Medical University of Graz, Graz, Austria), M. Filippi and M.A. Rocca (San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy), C. Gasperini (San Camillo-Forlanini Hospital, Rome, Italy), L. Kappos (University of Basel, Basel, Switzerland), J. Palace (University of Oxford Hospitals Trust, Oxford, UK), A. Rovira and J. Sastre-Garriga (Hospital Universitari Vall d'Hebron, Universitat Aut?noma de Barcelona, Barcelona, Spain). The study was funded by the Nauta fonds through a travel grant. The MS Center Amsteram is supported by the Dutch MS Research Foundation through a program grant (current grant 18-358f). D.B. is supported by project PI18/00823 from the ?Fondo de Investigaci?n Sanitaria Carlos III?. F.B. and O.C. are supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. The acquisition of data in London was funded by supported by the National Institute for Health Research University College London Hospitals Biomedical Research Centre. A sincere thank you to Tom Verhoeven for his editing of the figures. Publisher Copyright: {\textcopyright} 2020 The Authors Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = jan,
day = "1",
doi = "https://doi.org/10.1016/j.nicl.2020.102549",
language = "English",
volume = "29",
journal = "NeuroImage: Clinical",
issn = "2213-1582",
publisher = "Elsevier BV",
}