Abstract
Purpose: To quantify white matter (WM) and gray matter (GM) damage in patients who presented with clinically isolated syndrome (CIS), which is suggestive of multiple sclerosis (MS), by combining volume-based morphometry (VBM) and tract-based spatial statistics (TBSS). Materials and Methods: This prospective HIPAA-compliant study was approved by the institutional review board. Written informed consent was obtained from all participants. In this study, 34 consecutive patients (21 women, 13 men; mean age, 31.7 years ± 7.7 [standard deviation]) who presented with CIS were recruited. The magnetic resonance (MR) examination included dual-echo fast spin-echo, three-dimensional T1, and diffusion-tensor imaging. Sixteen matched healthy volunteers served as control subjects. T2 lesion volumes were assessed with a semiautomatic technique. VBM and TBSS were used for the GM and WM analyses, respectively, to compare regional GM volumes and fractional anisotropy (FA) values in the two groups. Results: TBSS analysis revealed a pattern of diffuse FA reductions in patients with CIS at the cluster level (P <.05). Regions of decreased FA involved most of the WM pathways, including the corticospinal tracts, corpus callosum, and superior and inferior longitudinal fasciculi. There were no significant differences between the two groups in terms of global GM, WM, or cerebrospinal fluid volume or in terms of regional GM volume. Conclusion: Diffuse WM damage not accompanied by any change in GM or WM volume is observed in patients with CIS. This suggests that WM involvement plays a relevant role in the early phases of MS. Subsequently detected GM damage may be secondary to WM alterations.
| Original language | English |
|---|---|
| Pages (from-to) | 227-234 |
| Number of pages | 8 |
| Journal | Radiology |
| Volume | 254 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 2010 |
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ASJC Scopus subject areas
- Radiology Nuclear Medicine and imaging
Cite this
Clinically isolated syndrome suggestive of multiple sclerosis : Voxelwise regional investigation of white and gray matter. / Raz, Eytan; Cercignani, Mara; Sbardella, Emilia; Totaro, Porzia; Pozzilli, Carlo; Bozzali, Marco; Pantano, Patrizia.
In: Radiology, Vol. 254, No. 1, 01.2010, p. 227-234.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Clinically isolated syndrome suggestive of multiple sclerosis
T2 - Voxelwise regional investigation of white and gray matter
AU - Raz, Eytan
AU - Cercignani, Mara
AU - Sbardella, Emilia
AU - Totaro, Porzia
AU - Pozzilli, Carlo
AU - Bozzali, Marco
AU - Pantano, Patrizia
PY - 2010/1
Y1 - 2010/1
N2 - Purpose: To quantify white matter (WM) and gray matter (GM) damage in patients who presented with clinically isolated syndrome (CIS), which is suggestive of multiple sclerosis (MS), by combining volume-based morphometry (VBM) and tract-based spatial statistics (TBSS). Materials and Methods: This prospective HIPAA-compliant study was approved by the institutional review board. Written informed consent was obtained from all participants. In this study, 34 consecutive patients (21 women, 13 men; mean age, 31.7 years ± 7.7 [standard deviation]) who presented with CIS were recruited. The magnetic resonance (MR) examination included dual-echo fast spin-echo, three-dimensional T1, and diffusion-tensor imaging. Sixteen matched healthy volunteers served as control subjects. T2 lesion volumes were assessed with a semiautomatic technique. VBM and TBSS were used for the GM and WM analyses, respectively, to compare regional GM volumes and fractional anisotropy (FA) values in the two groups. Results: TBSS analysis revealed a pattern of diffuse FA reductions in patients with CIS at the cluster level (P <.05). Regions of decreased FA involved most of the WM pathways, including the corticospinal tracts, corpus callosum, and superior and inferior longitudinal fasciculi. There were no significant differences between the two groups in terms of global GM, WM, or cerebrospinal fluid volume or in terms of regional GM volume. Conclusion: Diffuse WM damage not accompanied by any change in GM or WM volume is observed in patients with CIS. This suggests that WM involvement plays a relevant role in the early phases of MS. Subsequently detected GM damage may be secondary to WM alterations.
AB - Purpose: To quantify white matter (WM) and gray matter (GM) damage in patients who presented with clinically isolated syndrome (CIS), which is suggestive of multiple sclerosis (MS), by combining volume-based morphometry (VBM) and tract-based spatial statistics (TBSS). Materials and Methods: This prospective HIPAA-compliant study was approved by the institutional review board. Written informed consent was obtained from all participants. In this study, 34 consecutive patients (21 women, 13 men; mean age, 31.7 years ± 7.7 [standard deviation]) who presented with CIS were recruited. The magnetic resonance (MR) examination included dual-echo fast spin-echo, three-dimensional T1, and diffusion-tensor imaging. Sixteen matched healthy volunteers served as control subjects. T2 lesion volumes were assessed with a semiautomatic technique. VBM and TBSS were used for the GM and WM analyses, respectively, to compare regional GM volumes and fractional anisotropy (FA) values in the two groups. Results: TBSS analysis revealed a pattern of diffuse FA reductions in patients with CIS at the cluster level (P <.05). Regions of decreased FA involved most of the WM pathways, including the corticospinal tracts, corpus callosum, and superior and inferior longitudinal fasciculi. There were no significant differences between the two groups in terms of global GM, WM, or cerebrospinal fluid volume or in terms of regional GM volume. Conclusion: Diffuse WM damage not accompanied by any change in GM or WM volume is observed in patients with CIS. This suggests that WM involvement plays a relevant role in the early phases of MS. Subsequently detected GM damage may be secondary to WM alterations.
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UR - http://www.scopus.com/inward/citedby.url?scp=75349098426&partnerID=8YFLogxK
U2 - 10.1148/radiol.2541090817
DO - 10.1148/radiol.2541090817
M3 - Article
C2 - 20019140
AN - SCOPUS:75349098426
VL - 254
SP - 227
EP - 234
JO - Radiology
JF - Radiology
SN - 0033-8419
IS - 1
ER -