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Multiple Sclerosis Health Center

Shrinkage of Brain Region May Signal Onset of MS

Study tied changes in thalamus to tell-tale MS sign
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WebMD News from HealthDay

By Maureen Salamon

HealthDay Reporter

TUESDAY, April 23 (HealthDay News) -- Atrophy of a key brain area may become a new biomarker to predict the onset of multiple sclerosis, researchers say. If so, that would add to established criteria such as the presence of brain lesions to diagnose the progressive, incurable disorder.

Using special MRI images, scientists from three continents found that the thalamus -- which acts as a "relay center" for nervous-system signals -- had atrophied in nearly 43 percent of patients who had suffered an initial neurological episode that often comes before a multiple sclerosis (MS) diagnosis.

"The telling appearance of lesions, which is a hallmark of the disease, is only part of the pathology," said study author Dr. Robert Zivadinov, director of the Buffalo Neuroimaging Analysis Center at the University of Buffalo, in New York. "Our finding is more related to [initiating] clinical trials, to using thalamic volume as a new biomarker for testing and treatment, and to increasing awareness among investigators that this disease is more than just about lesions."

The study was published online April 23 in the journal Radiology.

Believed to be an autoimmune disorder, MS results in lesions on the brain and spinal cord that disrupt nerve signals to various parts of the body. Symptoms, which can come and go, include numbness, tingling, vision disturbances, problems walking, dizziness, and bowel and bladder problems.

More than 2 million people live with MS worldwide, according to the Multiple Sclerosis Foundation.

For the new research, Zivadinov and his team used contrast-enhanced MRI images to evaluate more than 200 patients who had suffered an initial, short-term neurological episode known as clinically isolated syndrome. About 85 percent people who have one of these episodes will go on to be diagnosed with MS within two years, and the diagnosis also relies on a second attack and the detection of new or enlarging lesions using MRI.

The study performed follow-up scans on patients at six months, one year and two years. It found that decreases in the size of the thalamus were independently associated with the development of clinically definite MS, along with an increased volume in another part of the brain known as the lateral ventricles.

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