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2016 ; 95
(13
): e3208
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Gray Matter Involvement in Radiologically Isolated Syndrome
#MMPMID27043685
Labiano-Fontcuberta A
; Mato-Abad V
; Álvarez-Linera J
; Hernández-Tamames JA
; Martínez-Ginés ML
; Aladro Y
; Ayuso L
; Domingo-Santos Á
; Benito-León J
Medicine (Baltimore)
2016[Mar]; 95
(13
): e3208
PMID27043685
show ga
The unanticipated magnetic resonance imaging (MRI) detection in the brain of
asymptomatic subjects of white matter lesions suggestive of multiple sclerosis
has recently been named as radiologically isolated syndrome (RIS). The
pathophysiological processes of RIS remain largely unknown and questions as to
whether gray matter alterations actually occur in this entity are yet to be
investigated in more detail. By means of a 3 T multimodal MRI approach, we
searched for cortical and deep gray matter changes in a cohort of RIS patients.
Seventeen RIS patients, 17 clinically isolated syndrome (CIS) patients (median
disease duration from symptom onset?=?12 months), and 17 healthy controls
underwent MRI and neuropsychological testing. Normalized deep gray matter volumes
and regional cortical thickness were assessed using FreeSurfer. SIENAX was used
to obtain normalized global and cortical brain volumes. Voxelwise morphometry
analysis was performed by using SPM8 software to localize regions of brain tissue
showing significant changes of fractional anisotropy or mean diffusivity.
Although no differences were observed between CIS and healthy controls groups,
RIS patients showed significantly lower normalized cortical volume (673?±?27.07
vs 641?±?35.88 [cm³?×?10³, Tukey P test?=?0.009) and mean thalamic volume
(0.0051?±?0.4 vs 0.0046?±?0.4?mm, P?=?0.014) compared with healthy controls. RIS
patients also showed significant thinning in a number of cortical areas, that
were primarily distributed in frontal and temporal lobes (P?0.05, uncorrected).
Strong correlations were observed between T2-white matter lesion volume and
regional cortical thickness (rho spearman ranging from 0.60 to 0.80). Our data
suggest that white matter lesions on T2-weighted images are not the only hallmark
of RIS. Future longitudinal studies with larger samples are warranted to better
clarify the effect of RIS-related white matter lesions on gray matter tissue.