White-matter-nulled MPRAGE at 7T reveals thalamic lesions and atrophy of specific thalamic nuclei in multiple sclerosis.

BACKGROUND

Investigating the degeneration of specific thalamic nuclei in multiple sclerosis (MS) remains challenging.

METHODS

White-matter-nulled (WMn) MPRAGE, MP-FLAIR, and standard T1-weighted magnetic resonance imaging (MRI) were performed on MS patients ( = 15) and matched controls ( = 12). Thalamic lesions were counted in individual sequences and lesion contrast-to-noise ratio (CNR) was measured. Volumes of 12 thalamic nuclei were measured using an automatic segmentation pipeline specifically developed for WMn-MPRAGE.

RESULTS

WMn-MPRAGE showed more thalamic MS lesions ( = 35 in 9 out of 15 patients) than MP-FLAIR ( = 25) and standard T1 ( = 23), which was associated with significant improvement of CNR ( < 0.0001). MS patients had whole thalamus atrophy ( = 0.003) with lower volumes found for the anteroventral ( < 0.001), the pulvinar ( < 0.0001), and the habenular ( = 0.004) nuclei.

CONCLUSION

WMn-MPRAGE and automatic thalamic segmentation can highlight thalamic MS lesions and measure patterns of focal thalamic atrophy.