Cortical atrophy is relevant in multiple sclerosis at clinical onset |
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| Authors: | Massimiliano Calabrese MD Matteo Atzori MD Valentina Bernardi MD Aldo Morra MD Chiara Romualdi PhD Luciano Rinaldi MD PhD Matthew J. M. McAuliffe PhD Luigi Barachino PhD Paola Perini MD Bruce Fischl PhD Leontino Battistin MD PhD Paolo Gallo MD PhD |
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| Affiliation: | (1) The Multiple Sclerosis Centre of Veneto Region, First Neurology Clinic, Dept. of Neurosciences, University Hospital of Padova, Via Giustiniani 5, 35128 Padova, Italy;(2) Neuroradiology Unit, Euganea Medica, Albignasego, Padova, Italy;(3) CRIBI – Biotechnology Centre and Dept. of Biology, University of Padova, Padova, Italy;(4) Biomedical Imaging Research Services, Section at the NIH, Bethesda, MD, USA;(5) Nuclear Magnetic Resonance Center, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA;(6) MIT Artificial Intelligence Laboratory, MIT, Cambridge, MA, USA;(7) Athinoula A Martinos Center, MGH, Dept. of Radiology, Harvard Medical School and Computers Science and AI Lab, MIT, Cambridge, MA, USA;(8) IRCCS San Camillo, Lido di Venezia, Italy |
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| Abstract: | Introduction Increasing evidence suggests relevant cortical gray matter pathology in patients with Multiple Sclerosis (MS), but how early this pathology begins; its impact on clinical disability and which cortical areas are primarily affected needs to be further elucidated. Methods 115 consecutive patients (10 Clinically Isolated Syndrome (CIS), 32 possible MS (p-MS), 42 Relapsing Remitting MS (RR-MS), 31 Secondary Progressive MS (SP-MS)), and 40 age/gender-matched healthy volunteers (HV) underwent a neurological examination and a 1.5 T MRI. Global and regional Cortical Thickness (CTh) measurements, brain parenchyma fraction and T2 lesion load were analyzed. Results We found a significant global cortical thinning in p-MS (2.22 ± 0.09 mm), RR-MS (2.16 ± 0.10 mm) and SP-MS (1.98 ± 0.11 mm) compared to CIS (2.51 ± 0.11 mm) and HV (2.48 ± 0.08 mm). The correlations between mean CTh and white matter (WM) lesion load was only moderate in MS (r = −0.393, p = 0.03) and absent in p-MS (r = −0.147, p = 0.422). Analysis of regional CTh revealed that the majority of cortical areas were involved not only in MS, but also in p-MS. The type of clinical picture at onset (in particular, pyramidal signs/symptoms and optic neuritis) correlated with atrophy in the corresponding cortical areas. Discussion Cortical thinning is a diffuse and early phenomenon in MS already detectable at clinical onset. It correlates with clinical disability and is partially independent from WM inflammatory pathology. Electronic Supplementary Material Electronic Supplementary material is available for this article at and accessible for authorised users. Received in revised from: 8 August 2006 |
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| Keywords: | multiple sclerosis cortical thickness cortical atrophy neuronal degeneration |
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