Volumetric correlations between thalamus and thalamic subnuclei with cerebellum and their relationship with disease modifying treatments status in patients with relapsing remitting multiple sclerosis within one year follow up.
| Abstract: |
- Introduction: Magnetic resonance imaging (MRI) is a routinely used imaging tool in both clinical practice and research as it allows the visualization of the central nervous system (CNS) in healthy and diseased states, such as in Multiple Sclerosis (MS). The thalamus and cerebellum have been shown to be affected early in the course of different MS phenotypes, including patients with early disease and recent diagnosis of Relapsing Remitting MS, even in the absence of visible lesions with conventional MR but with changes at a microstructural and functional level, measured with advance neuroimaging techniques, such as Positron Emission Tomography (PET). This strongly suggests that there is a neurodegenerative component early in the disease course beyond the neuroinflammation that can be appreciated in the normal appearing grey and white matter.
- Purpose: The current study sought to examine three hypotheses. The first one involves the correlation of the disease progression, clinical disability, and volumetric cerebellar changes independent of parameters such as total lesion burden or cerebral NAWM volumes at the same time points. The second hypothesis involves the potential confounding effect of spinal cord pathology, which is common in MS, on the cerebello-thalamic interplay in MS Lastly, the study examines whether the new generation of disease modifying therapies (DMTs) decelerates the rate of thalamic and cerebellar atrophy progression over time as compared to the old generation of DMTs or patients on no treatment in early-stage RRMS.
- Methods: The researcher selected 327 RRMS patients with varying disability severities from the Future MS dataset. Demographical, clinical, and volumetric analysis data were analyzed. The data analysis for this study was generated using the Microsoft Excel statistical package.
- Conclusion: The findings indicate that while a correlation between cerebellar and thalamic volumes and disability progression was established, no definite correlation of the volumetrics trend direction was observed among the no-DMT, old-generation DMT, and new-generation DMTs groups of MS patients within a one-year study period. Future studies assessing the evolution of changes at the microstructural level of specific anatomical structures may be warranted for predictive purposes or to assess treatment response.
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