From the University of Bordeaux (I.K., T.Y., A.R., B.B., V.D., T.T.), INSERM, Neurocentre Magendie, U1215; Neuroimagerie diagnostique et thérapeutique (S.B.), CHU de Bordeaux; University of Bordeaux (R.A.K., B.M., P.C.), CNRS, Bordeaux INP, LABRI, UMR5800, Talence; Univ. Bordeaux (V.P.), CNRS, IMN, UMR 5293; Groupe d'Imagerie Neurofonctionnelle (L.P.), Institut des Maladies Neurodégénératives CNRS UMR 5293, Bordeaux, France; Department of Medical Imaging (M.S.), The University of Arizona, Tucson; Université de Lyon (R.C.), Université Claude Bernard Lyon 1, France; and Instituto de Aplicaciones de las Tecnologías de la Información y de las Comunicaciones Avanzadas (ITACA) (J.V.M.), Universitat Politècnica de València, Spain.
Neurol Neuroimmunol Neuroinflamm. 2024 May;11(3):e200222. doi: 10.1212/NXI.0000000000200222. Epub 2024 Apr 18.
Thalamic atrophy can be used as a proxy for neurodegeneration in multiple sclerosis (MS). Some data point toward thalamic nuclei that could be affected more than others. However, the dynamic of their changes during MS evolution and the mechanisms driving their differential alterations are still uncertain.
We paired a large cohort of 1,123 patients with MS with the same number of healthy controls, all scanned with conventional 3D-T1 MRI. To highlight the main atrophic regions at the thalamic nuclei level, we validated a segmentation strategy consisting of deep learning-based synthesis of sequences, which were used for automatic multiatlas segmentation. Then, through a lifespan-based approach, we could model the dynamics of the 4 main thalamic nuclei groups.
All analyses converged toward a higher rate of atrophy for the posterior and medial groups compared with the anterior and lateral groups. We also demonstrated that focal MS white matter lesions were associated with atrophy of groups of nuclei when specifically located within the associated thalamocortical projections. The volumes of the most affected posterior group, but also of the anterior group, were better associated with clinical disability than the volume of the whole thalamus.
These findings point toward the thalamic nuclei adjacent to the third ventricle as more susceptible to neurodegeneration during the entire course of MS through potentiation of disconnection effects by regional factors. Because this information can be obtained even from standard T1-weighted MRI, this paves the way toward such an approach for future monitoring of patients with MS.
丘脑萎缩可作为多发性硬化症（MS）神经退行性变的替代指标。一些数据表明，某些丘脑核可能比其他核更容易受到影响。然而，它们在 MS 演变过程中的变化动态以及导致其差异改变的机制仍不确定。
我们将 1123 名 MS 患者与相同数量的健康对照者配对，所有患者均接受常规 3D-T1 MRI 扫描。为了突出丘脑核水平的主要萎缩区域，我们验证了一种基于深度学习的序列综合分割策略，该策略用于自动多图谱分割。然后，通过基于寿命的方法，我们可以对 4 个主要丘脑核群的动力学进行建模。
所有分析均表明，与前核和外侧核相比，后核和内侧核的萎缩速度更高。我们还证明，当局灶性 MS 白质病变位于相关的丘脑皮质投射内时，与特定的核群萎缩有关。受影响最严重的后核群，以及前核群的体积，与临床残疾的相关性优于整个丘脑的体积。
这些发现表明，在 MS 的整个病程中，毗邻第三脑室的丘脑核由于区域因素增强了断开连接效应，因此更容易发生神经退行性变。由于即使从标准的 T1 加权 MRI 也可以获得这些信息，因此为未来监测 MS 患者铺平了道路。
