A1 Refereed original research article in a scientific journal
Thalamic Atrophy Predicts 5-Year Disability Progression in Multiple Sclerosis
Authors: Katariina Hänninen, Matias Viitala, Teemu Paavilainen, Jari O. Karhu, Juha Rinne, Juha Koikkalainen, Jyrki Lötjönen, Merja Soilu-Hänninen
Publisher: FRONTIERS MEDIA SA
Publication year: 2020
Journal: Frontiers in Neurology
Journal name in source: FRONTIERS IN NEUROLOGY
Journal acronym: FRONT NEUROL
Article number: ARTN 606
Volume: 11
Number of pages: 8
ISSN: 1664-2295
eISSN: 1664-2295
DOI: https://doi.org/10.3389/fneur.2020.00606
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/49897789
Purpose:Thalamus is among the first brain regions to become atrophic in multiple sclerosis (MS). We studied whether thalamic atrophy predicts disability progression at 5 years in a cohort of Finnish MS patients. Methods:Global and regional brain volumes were measured from 24 newly diagnosed relapsing MS (RMS) patients 6 months after initiation of therapy and from 36 secondary progressive MS (SPMS) patients. The patients were divided into groups based on baseline whole brain parenchymal (BP) and thalamic atrophy. Standard scores (zscores) were computed by comparing individual brain volumes with healthy controls. Azscore cutoff of -1.96 was applied to separate atrophic from normal brain volumes. The Expanded Disability Status Scale (EDSS), brain magnetic resonance imaging (MRI) findings, and relapses were assessed at baseline and at 2 years and EDSS progression at 5 years. Results:Baseline thalamus volume predicted disability in 5 years in a logistic regression model (p= 0.031). At 5 years, EDSS was same or better in 12 of 18 patients with no brain atrophy at baseline but only in 5 of 18 patients with isolated thalamic atrophy [odds ratio (OR) (95% CI) = 5.2 (1.25, 21.57)]. The patients with isolated thalamic atrophy had more escalations of disease-modifying therapies during follow-up. Conclusion:Patients with thalamic atrophy at baseline were at a higher risk for 5-year EDSS increase than patients with no identified brain atrophy. Brain volume measurement at a single time point could help predict disability progression in MS and complement clinical and routine MRI evaluation in therapeutic decision-making.
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