• Online Features  This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (54)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Neurology  • Multiple Sclerosis/ Demyelinating Disease  • Radiologic Imaging  • Magnetic Resonance Imaging  • Immunologic Disorders  • Alert me on articles by topic  Social Bookmarking   What's this?

A Voxel-Based Morphometry Study

Jorge Sepulcre, MD; Jaume Sastre-Garriga, MD; Mara Cercignani, PhD; Gordon T. Ingle, MRCP; David H. Miller, FRCP; Alan J. Thompson, FRCP

Arch Neurol. 2006;63:1175-1180.

Background  Gray matter (GM) atrophy has been reported in multiple sclerosis (MS). However, little is known about its regional distribution.

Objective  To investigate the regional distribution of GM atrophy in clinically early primary progressive MS (PPMS).

Design and Patients  Thirty-one patients with PPMS within 5 years of symptom onset (mean age, 43.2 years; median Expanded Disability Status Scale score, 4.5) and 15 healthy control subjects (mean age, 43.7 years) were studied. All subjects underwent a 3-dimensional inversion-recovery fast spoiled gradient-recalled echo sequence that was repeated after 1 year in patients only. Magnetic resonance images underwent an optimized voxel-based morphometric analysis that segments magnetic resonance data volumes in a normalized space and quantifies tissue atrophy on a voxel-by-voxel basis. A lesion mask was created for each patient and used in normalization and segmentation steps to minimize bias from lesions. A multisubject design was used in the cross-sectional study to compare patients with PPMS and controls. A 1-way analysis of variance (within-subjects) design was used in the longitudinal study.

Results  At baseline, patients with PPMS displayed bilateral thalamic atrophy compared with controls. In addition, a significant association between lesion load and decreased GM volume was found for the thalami. Loss of GM in the putamen, caudate, thalami, and cortical and infratentorial areas was observed in patients after 1 year of follow-up.

Conclusions  Atrophy is most obvious in deep GM in clinically early PPMS. This may reflect increased sensitivity of these regions to neurodegeneration. Cortical and infratentorial atrophy developed as the disease evolved.

Author Affiliations: Institute of Neurology, University College of London, London, England.

CiteULike    Connotea    Delicious    Digg    Facebook    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Reduced head and brain size for age and disproportionately smaller thalami in child-onset MS
Kerbrat et al.
Neurology 2012;78:194-201.
ABSTRACT | FULL TEXT  

Thalamic Damage Predicts the Evolution of Primary-Progressive Multiple Sclerosis at 5 Years
Mesaros et al.
Am. J. Neuroradiol. 2011;32:1016-1020.
ABSTRACT | FULL TEXT  

Voxelwise Assessment of the Regional Distribution of Damage in the Brains of Patients with Multiple Sclerosis and Fatigue
Riccitelli et al.
Am. J. Neuroradiol. 2011;32:874-879.
ABSTRACT | FULL TEXT  

Complementary roles of grey matter MTR and T2 lesions in predicting progression in early PPMS
Tur et al.
J. Neurol. Neurosurg. Psychiatry 2011;82:423-428.
ABSTRACT | FULL TEXT  

Thalamic Damage and Long-term Progression of Disability in Multiple Sclerosis
Rocca et al.
Radiology 2010;257:463-469.
ABSTRACT | FULL TEXT  

MR Imaging of Gray Matter Involvement in Multiple Sclerosis: Implications for Understanding Disease Pathophysiology and Monitoring Treatment Efficacy
Filippi and Rocca
Am. J. Neuroradiol. 2010;31:1171-1177.
ABSTRACT | FULL TEXT  

Atrophy mainly affects the limbic system and the deep grey matter at the first stage of multiple sclerosis
Audoin et al.
J. Neurol. Neurosurg. Psychiatry 2010;81:690-695.
ABSTRACT | FULL TEXT  

Voxel-Based Morphometry: An Automated Technique for Assessing Structural Changes in the Brain
Whitwell
J. Neurosci. 2009;29:9661-9664.
FULL TEXT  

MRI measures show significant cerebellar gray matter volume loss in multiple sclerosis and are associated with cerebellar dysfunction
Anderson et al.
Mult Scler 2009;15:811-817.
ABSTRACT  

Fatigue in multiple sclerosis is associated with the disruption of frontal and parietal pathways
Sepulcre et al.
Mult Scler 2009;15:337-344.
ABSTRACT  

Contribution of White Matter Lesions to Gray Matter Atrophy in Multiple Sclerosis: Evidence From Voxel-Based Analysis of T1 Lesions in the Visual Pathway
Sepulcre et al.
Arch Neurol 2009;66:173-179.
ABSTRACT | FULL TEXT  

Regional grey matter atrophy in clinically isolated syndromes at presentation
Henry et al.
J. Neurol. Neurosurg. Psychiatry 2008;79:1236-1244.
ABSTRACT | FULL TEXT  

A Magnetic Resonance Imaging Voxel-Based Morphometry Study of Regional Gray Matter Atrophy in Patients With Benign Multiple Sclerosis
Mesaros et al.
Arch Neurol 2008;65:1223-1230.
ABSTRACT | FULL TEXT  

Evidence of thalamic gray matter loss in pediatric multiple sclerosis
Mesaros et al.
Neurology 2008;70:1107-1112.
ABSTRACT | FULL TEXT  

Magnetization transfer ratio measurement in multiple sclerosis normal-appearing brain tissue: limited differences with controls but relationships with clinical and MR measures of disease
Vrenken et al.
Mult Scler 2007;13:708-716.
ABSTRACT  

Diagnostic accuracy of retinal abnormalities in predicting disease activity in MS
Sepulcre et al.
Neurology 2007;68:1488-1494.
ABSTRACT | FULL TEXT