Thalamus structure and function determine severity of cognitive impairment in multiple sclerosis

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Abstract

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.

Original languageEnglish
Pages (from-to)776-83
Number of pages8
JournalNeurology
Volume84
Issue number8
DOIs
Publication statusPublished - 24 Feb 2015

Cite this

@article{afd300f8b69347e9bcdc0db0c1fd3ebd,
title = "Thalamus structure and function determine severity of cognitive impairment in multiple sclerosis",
abstract = "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.",
keywords = "Adult, Cognition Disorders, Cohort Studies, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Neuropsychological Tests, Severity of Illness Index, Thalamus, Journal Article, Research Support, Non-U.S. Gov't",
author = "Schoonheim, {Menno M} and Hulst, {Hanneke E} and Brandt, {Roemer B} and Myrte Strik and Wink, {Alle Meije} and Uitdehaag, {Bernard M J} and Frederik Barkhof and Geurts, {Jeroen J G}",
note = "{\circledC} 2015 American Academy of Neurology.",
year = "2015",
month = "2",
day = "24",
doi = "10.1212/WNL.0000000000001285",
language = "English",
volume = "84",
pages = "776--83",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "8",

}

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

N1 - © 2015 American Academy of Neurology.

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 - Male

KW - Middle Aged

KW - Multiple Sclerosis

KW - Neuropsychological Tests

KW - Severity of Illness Index

KW - Thalamus

KW - Journal Article

KW - Research Support, Non-U.S. Gov't

U2 - 10.1212/WNL.0000000000001285

DO - 10.1212/WNL.0000000000001285

M3 - Article

VL - 84

SP - 776

EP - 783

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 8

ER -