Abstract Details

Title In Vivo Detection of Thalamo-Cortical Pathology in Patients with Clinical Isolated Syndrome

Topic MS and Related Diseases

Presentation(s) P06 - (-)

Poster/Presentation
Number 113

Objective

Background BACKGROUND: The thalamo-cortical pathway is responsible for a complex set of higher brain functions including the processing of sensory, cognitive and motor information. Previous imaging and histopathological studies have indicated thalamo-cortical dysfunction in patients with multiple sclerosis (MS). It is currently unknown how early these pathological changes begin and here we have hypothesized that thalamo-cortical pathological changes could be already evident at the first clinical manifestation of the disease.

Design/Methods DESIGN/METHODS: 18 patients with CIS had one 11C-PK11195 PET scan (marker of microglial activation) and one MRI for volumetric analysis, within 2 months of CIS diagnosis. Eight age-matched healthy individuals served as the control group.

Results RESULTS: CIS patients had a 20% increase in mean thalamic 11C-PK11195 uptake compared to a group of healthy individuals (p=0.0095). The mean normalized thalamus volume was decreased by 17% in CIS patients compared to healthy controls (p=0.02) and no correlation between 11C-PK11195 and volume loss was found (p=0.62). No difference in 11C-PK11195 uptake was found in the cortical areas that receive reciprocal projections from thalamus (e.g. somatosensory, motor, visual and auditory areas) between CIS patients and controls (all p>0.1). The mean normalized volume was decreased by 26% in the somatosensory areas (p=0.04), by 25% in the primary cortex (p= 0.05), by 22% in premotor cortex (p= 0.06) and by 15% in the transverse temporal gyrus (p= 0.05) in CIS patients relative to controls.

Conclusions CONCLUSIONS: Our findings demonstrate that inflammatory changes and regional atrophy occur in the thalamo-cortical pathway in CIS patients. The identification of disrupted thalamo-cortical pathway may have particular clinical relevance for understanding physical and neurophysiological changes at the early stage of the disease.

Authors/Disclosures
PRESENTER	No disclosure on file
Paolo Giannetti	No disclosure on file
Marios Politis, MD (Neurodegeneration Imaging Group)	No disclosure on file
	No disclosure on file
	No disclosure on file
Hooman Kamel, MD (Weill Cornell Medical College)	Dr. Kamel has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for JAMA Neurology. Dr. Kamel has received personal compensation in the range of $50,000-$99,999 for serving as a Endpoint adjudication committee with Boehringer-Ingelheim.
	No disclosure on file
	No disclosure on file
Matthew E. Fink, MD, FAAN (Weill Cornell Medical Center)	Dr. Fink has received personal compensation in the range of $10,000-$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Relias LLC.
Richard S. Nicholas, FRCP (Imperial College Healthcare Trust)	Dr. Nicholas has nothing to disclose.
Paola Piccini, MD (Hammersmith Hospital)	No disclosure on file

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