Atrophy of Thalamus Better Predictor of Multiple Sclerosis: Study

In people with multiple sclerosis, atrophy occurs in a specific region of the brain - the thalamus - and this is a more accurate marker for the condition than the ones used currently, a new study shows.

Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord, where the immune system of the body starts attacking the protective sheath covering the nerve cells. These damaged cells do not transfer signals properly, causing functional disability. Multiple sclerosis or MS affects women more than men. An estimated 250,000 to 350,000 people in the U.S. have been diagnosed with MS.

A majority of people with MS, about 85 percent of them, have a short-term condition called clinically isolated syndrome (CIS).

Doctors give an MS diagnosis after looking into a combination of factors that are markers for the condition including neurological history, development of attack and lesions in the brain with contrast-enhanced or T2-weighted MRI, according to a news release.

"For some time we've been trying to understand MRI biomarkers that predict MS development from the first onset of the disease. In the last couple of years, research has become much more focused on the thalamus," said Robert Zivadinov, M.D., from the Buffalo Neuroimaging Analysis Center of the University at Buffalo in Buffalo, N.Y.

Researchers said that a volume loss of thalamus in the brain can show the development of the condition. The thalamus is associated with relaying information to the central cortex and with the regulation of sleep and consciousness.

The study included 216 people who had CIS. Researchers looked at the brains of these people using contrast-enhanced MRI and conducted follow-up brain scans after six months, one year and again after two years.

Of the 216 people in the study, 92 people had developed MS after a two-year period. A decrease in thalamus volume and increase in lateral ventricle volumes were independently associated with the development of the condition.

"First, these results show that atrophy of the thalamus is associated with MS. Second, they show that thalamic atrophy is a better predictor of clinically definite MS than accumulation of T2-weighted and contrast-enhanced lesions," Dr. Zivadinov said.

"Thalamic atrophy is an ideal MRI biomarker because it's detectable at very early stage. It has very good predictive value, and you will see it used more and more in the future," Dr. Zivadinov said.

The study is published in the journal Radiology.