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Focal cortical thinning in patients with stable relapsing-remitting multiple sclerosis: cross-sectional-based novel estimation of gray matter kinetics

  • Diagnostic Neuroradiology
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Abstract

Purpose

The aim of our study is to identify radiological patterns of cortical gray matter atrophy (CGMA) that correlate with disease duration in patients with relapsing-remitting multiple sclerosis (RRMS).

Methods

RRMS patients were randomly selected from the Sheba Multiple Sclerosis (MS) center computerized data registry based on stratification of disease duration up to 10 years. Patients were scanned by 3.0 T (Signa, GE) MRI, using a T1 weighted 3D high resolution, FSPGR, MS protocol. Neurological disability was assessed by the Expanded Disability Status Scale (EDSS). FreeSurfer was used to obtain brain volumetric segmentation and to perform cortical thickness surface-based analysis. Clusters of change in cortical thickness with correlation to disease duration were produced.

Results

Two hundred seventy-one RRMS patients, mean ± SD age 33.0 ± 7.0 years, EDSS 1.6 ± 1.2, disease duration 5.0 ± 3.4 years. Cortical thickness analysis demonstrated focal areas of cerebral thinning that correlated with disease duration. Seven clusters accounting for 11.7% of the left hemisphere surface and eight clusters accounting for 10.6% of the right hemisphere surface were identified, with cluster-wise probability of p < 0.002 and p < 0.02, respectively.The clusters included bilateral involvement of areas within the cingulate, precentral, postcentral, paracentral, superior-parietal, superior-frontal gyri and insular cortex. Mean and cluster-wise cortical thickness negatively correlated with EDSS score, p < 0.001, with stronger Spearman rho for cluster-wise measurements.

Conclusions

We identified CGMA patterns in sensitive brain regions which give insight and better understanding of the progression of cortical gray matter loss in relation to dissemination in space and time. These patterns may serve as markers to modulate therapeutic interventions to improve the management of MS patients.

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Acknowledgements

The authors thank Ms. Yael Nissan for data assessment.

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Authors and Affiliations

  1. Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel

    Lior Orbach, Shay Menascu, Chen Hoffmann, Shmuel Miron & Anat Achiron

  2. Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel

    Lior Orbach, Shay Menascu, Chen Hoffmann & Anat Achiron

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  1. Lior Orbach
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Correspondence to Lior Orbach.

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Funding

No funding was received for this study.

Conflict of interest disclosure

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the Sheba Medical Center IRB Committee and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required; however, patient confidentiality was observed by removing any identifying information from the study database.

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Orbach, L., Menascu, S., Hoffmann, C. et al. Focal cortical thinning in patients with stable relapsing-remitting multiple sclerosis: cross-sectional-based novel estimation of gray matter kinetics. Neuroradiology 60, 179–187 (2018). https://doi.org/10.1007/s00234-017-1964-2

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  • DOI: https://doi.org/10.1007/s00234-017-1964-2

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