Vulnerability of Thalamic Nuclei at CSF Interface During the Entire Course of Multiple Sclerosis
Neurol Neuroimmunol Neuroinflamm. 2024-05-01; 11(3):
DOI: 10.1212/NXI.0000000000200222
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Koubiyr I(1), Yamamoto T(1), Blyau S(1), Kamroui RA(1), Mansencal B(1), Planche V(1), Petit L(1), Saranathan M(1), Casey R(1), Ruet A(1), Brochet B(1), Manjón JV(1), Dousset V(1), Coupé P(1), Tourdias T(1); for OFSEP investigators(1).
Author information:
(1)From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM,
Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.),
CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux
INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe
d’Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives
CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The
University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude
Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la
Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat
Politècnica de València, Spain.
BACKGROUND AND OBJECTIVES: Thalamic atrophy can be used as a proxy for
neurodegeneration in multiple sclerosis (MS). Some data point toward thalamic
nuclei that could be affected more than others. However, the dynamic of their
changes during MS evolution and the mechanisms driving their differential
alterations are still uncertain.
METHODS: We paired a large cohort of 1,123 patients with MS with the same number
of healthy controls, all scanned with conventional 3D-T1 MRI. To highlight the
main atrophic regions at the thalamic nuclei level, we validated a segmentation
strategy consisting of deep learning-based synthesis of sequences, which were
used for automatic multiatlas segmentation. Then, through a lifespan-based
approach, we could model the dynamics of the 4 main thalamic nuclei groups.
RESULTS: All analyses converged toward a higher rate of atrophy for the
posterior and medial groups compared with the anterior and lateral groups. We
also demonstrated that focal MS white matter lesions were associated with
atrophy of groups of nuclei when specifically located within the associated
thalamocortical projections. The volumes of the most affected posterior group,
but also of the anterior group, were better associated with clinical disability
than the volume of the whole thalamus.
DISCUSSION: These findings point toward the thalamic nuclei adjacent to the
third ventricle as more susceptible to neurodegeneration during the entire
course of MS through potentiation of disconnection effects by regional factors.
Because this information can be obtained even from standard T1-weighted MRI,
this paves the way toward such an approach for future monitoring of patients
with MS.