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Damage of the lateral geniculate nucleus in MS: assessing the missing node of the visual pathway

Item Type:Article
Title:Damage of the lateral geniculate nucleus in MS: assessing the missing node of the visual pathway
Creators Name:Papadopoulou, A. and Gaetano, L. and Pfister, A. and Altermatt, A. and Tsagkas, C. and Morency, F. and Brandt, A.U. and Hardmeier, M. and Chakravarty, M.M. and Descoteaux, M. and Kappos, L. and Sprenger, T. and Magon, S.
Abstract:OBJECTIVE: To study if the thalamic lateral geniculate nucleus (LGN) is affected in multiple sclerosis (MS) due to anterograde degeneration from optic neuritis (ON) or retrograde degeneration from optic radiation (OR) pathology, and if this is relevant for visual function. METHODS: In this cross-sectional study, LGN volume of 34 patients with relapsing-remitting MS and 33 matched healthy controls (HC) was assessed on MRI using atlas-based automated segmentation (MAGeT). ON history, thickness of the ganglion cell–inner plexiform layer (GC-IPL), OR lesion volume, and fractional anisotropy (FA) of normal-appearing OR (NAOR-FA) were assessed as measures of afferent visual pathway damage. Visual function was tested, including low-contrast letter acuity (LCLA) and Hardy-Rand-Rittler (HRR) plates for color vision. RESULTS: LGN volume was reduced in patients vs HC (165.5 ± 45.5 vs 191.4 ± 47.7 mm(3), B = −25.89, SE = 5.83, p < 0.001). It was associated with GC-IPL thickness (B = 0.95, SE = 0.33, p = 0.006) and correlated with OR lesion volume (Spearman ρ = −0.53, p = 0.001), and these relationships remained after adjustment for normalized brain volume. There was no association between NAOR-FA and LGN volume (B = −133.28, SE = 88.47, p = 0.137). LGN volume was not associated with LCLA (B = 5.5 × 10(−5), SE = 0.03, p = 0.998), but it correlated with HRR color vision (ρ = 0.39, p = 0.032). CONCLUSIONS: LGN volume loss in MS indicates structural damage with potential functional relevance. Our results suggest both anterograde degeneration from the retina and retrograde degeneration from the OR lesions as underlying causes. LGN volume is a promising marker reflecting damage of the visual pathway in MS, with the advantage of individual measurement per patient on conventional MRI.
Keywords:Cross-Sectional Studies, Geniculate Bodies, Magnetic Resonance Imaging, Multiple Sclerosis, Nerve Degeneration, Ocular Vision, Vision Tests, Visual Pathways
Publisher:American Academy of Neurology
Page Range:e2240-e2249
Date:7 May 2019
Official Publication:https://doi.org/10.1212/WNL.0000000000007450
External Fulltext:View full text on PubMed Central
PubMed:View item in PubMed

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