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Thalamic volume is lower in multiple sclerosis (MS) patients than in normal subjects and is related to cognitive impairment. "We should rethink MS as not just a disease of white matter demyelination," Dr. Rohit Bakshi from Brigham and Women's Hospital, Harvard Medical School, Boston, told Reuters Health. "Clearly there is gray matter involvement and tissue destruction occurring."

Dr. Bakshi and colleagues investigated thalamic volume and its relationship to cognitive function in 79 MS patients and 16 normal subjects. Their findings are published in the September 18th issue of Neurology.

Thalamic volume was 17.8 per cent lower in MS patients than in normal subjects, the authors report, and a significant 16.8 per cent difference persisted after adjusting for age, sex, and intracranial volume in each individual.

Thalamic atrophy in MS patients was associated with impairment on tests of processing speed/working memory and visuospatial memory, the researchers note. Thalamic fraction accounted for the greatest amount of variance in all models predicting neuropsychological test performance.

"We don't know enough yet to determine if patients (with thalamic atrophy) should be treated differently in terms of immunotherapeutic medications," Dr. Bakshi said. "However, our results suggest that when a patient is found to have thalamic atrophy on MRI scans, they should be carefully screened and tested for cognitive impairment, which could affect patient management, coping, and quality of life."

"Now more than ever we can see the importance of MRI technology towards the understanding of this complex challenging disease," Dr. Bakshi concluded.