TY - JOUR
T1 - Thalamus structure and function determine severity of cognitive impairment in multiple sclerosis
AU - Schoonheim, Menno M
AU - Hulst, Hanneke E
AU - Brandt, Roemer B
AU - Strik, Myrte
AU - Wink, Alle Meije
AU - Uitdehaag, Bernard M J
AU - Barkhof, Frederik
AU - Geurts, Jeroen J G
PY - 2015/2/24
Y1 - 2015/2/24
N2 - OBJECTIVE: This study investigates whether changes in functional connectivity, diffusivity, and volume of the thalamus can explain different severities of cognitive impairment in multiple sclerosis (MS).METHODS: An inception cohort of 157 patients with MS (104 women, mean age 41 years), 6 years postdiagnosis, was divided into 3 groups: cognitively preserved (CP, n = 108), mildly cognitively impaired (MCI, n = 22), and more severely cognitively impaired (SCI, n = 27). These groups were matched to 47 healthy controls (HC, 28 women, mean age 41 years). Thalamic volume, thalamic skeleton diffusivity (fractional anisotropy [FA] and mean diffusivity [MD]), and thalamic resting-state functional connectivity (FC) were compared between groups.RESULTS: Thalamic volume was significantly lower in all patient groups compared to controls, with lowest volumes in patients with SCI, and no difference between CP and MCI. Thalamic skeleton FA was decreased in SCI compared to HC only; MD was increased in SCI compared to all other groups. Thalamic FC was increased in SCI with a total of 15 regions, mainly sensorimotor, frontal, and occipital parts of the brain. Thalamic volume, FC, and MD remained independent predictors in a linear regression model (R(2) = 0.46), together with male sex and a lower level of education. Lesion and whole-brain volumes were not significant predictors.CONCLUSIONS: These findings indicate that thalamic changes in structure and function are highly informative regarding overall cognitive performance in MS. Increased thalamic FC only became apparent in SCI, possibly as a sign of maladaption.
AB - OBJECTIVE: This study investigates whether changes in functional connectivity, diffusivity, and volume of the thalamus can explain different severities of cognitive impairment in multiple sclerosis (MS).METHODS: An inception cohort of 157 patients with MS (104 women, mean age 41 years), 6 years postdiagnosis, was divided into 3 groups: cognitively preserved (CP, n = 108), mildly cognitively impaired (MCI, n = 22), and more severely cognitively impaired (SCI, n = 27). These groups were matched to 47 healthy controls (HC, 28 women, mean age 41 years). Thalamic volume, thalamic skeleton diffusivity (fractional anisotropy [FA] and mean diffusivity [MD]), and thalamic resting-state functional connectivity (FC) were compared between groups.RESULTS: Thalamic volume was significantly lower in all patient groups compared to controls, with lowest volumes in patients with SCI, and no difference between CP and MCI. Thalamic skeleton FA was decreased in SCI compared to HC only; MD was increased in SCI compared to all other groups. Thalamic FC was increased in SCI with a total of 15 regions, mainly sensorimotor, frontal, and occipital parts of the brain. Thalamic volume, FC, and MD remained independent predictors in a linear regression model (R(2) = 0.46), together with male sex and a lower level of education. Lesion and whole-brain volumes were not significant predictors.CONCLUSIONS: These findings indicate that thalamic changes in structure and function are highly informative regarding overall cognitive performance in MS. Increased thalamic FC only became apparent in SCI, possibly as a sign of maladaption.
KW - Adult
KW - Cognition Disorders
KW - Cohort Studies
KW - Female
KW - Humans
KW - Journal Article
KW - Male
KW - Middle Aged
KW - Multiple Sclerosis
KW - Neuropsychological Tests
KW - Research Support, Non-U.S. Gov't
KW - Severity of Illness Index
KW - Thalamus
U2 - https://doi.org/10.1212/WNL.0000000000001285
DO - https://doi.org/10.1212/WNL.0000000000001285
M3 - Article
C2 - 25616483
SN - 0028-3878
VL - 84
SP - 776
EP - 783
JO - Neurology
JF - Neurology
IS - 8
ER -