Background: Grey matter involvement is suggested to have a role in
pathophysiology of multiple sclerosis (MS). Objective: Our aim is to detect the thalamic involvement using 1.5
Tesla Diffusion tensor imaging (DTI) and its relationship with cognitive
impairment, clinical disability and fatigue in MS patients. Methods: 31 patients with MS (23 RRMS and 8 SPMS) with mean age
34.4±8.5 SD were studied. We recruited also 18 age, sex and education level
matched healthy controls. They all underwent clinical assessment, cognitive
assessment using California verbal learning test, brief visuospatial memory
test, paced auditory serial addition task (PASAT), symbol digit modalities
test, controlled oral word association test, assessment of fatigue using
fatigue severity scale, and radiological assessment using 1.5 T DTI. Fractional
anisotropy (FA) and apparent diffusion coefficient (ADC) were measured over
regions of interest over the thalamus. Results: Patients with MS had higher thalamic FA (P<0.01) and
ADC (P<0.01) than controls. Patients showed significantly worse performance
in all cognitive tests than controls. There was significant correlation between
total EDSS and mean thalamic FA. In addition, there were good positive correlations
between disease duration, number of attacks and mean FA over the thalamus.
There were significant correlations between performance in neuropsychological
tests, disease duration, number of attacks and total EDSS. Conclusion: DTI was able to detect abnormalities in normal-appearing
thalamus of patients with MS. Thalamic involvement had significant relations
with cognitive impairment and clinical disability in patients with MS. [Egypt J Neurol Psychiat
Neurosurg. 2015; 52(2): 139-145]
Key Words: Multiple Sclerosis, Thalamus, Cognitive
Impairment, Fatigue, DTI.