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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 mm3, 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.
Glossary
- cR2=
- conditional R2;
- FA=
- fractional anisotropy;
- GC-IPL=
- ganglion cell and inner plexiform layers;
- HC=
- healthy controls;
- HRR=
- Hardy-Rand-Rittler;
- LA=
- letter acuity;
- LCLA=
- low-contrast letter acuity;
- LGN=
- lateral geniculate nucleus;
- LMM=
- linear mixed effect models;
- MAGeT=
- Multiple Automatically Generated Templates algorithm;
- MGN=
- medial geniculate nucleus;
- MPRAGE=
- magnetization-prepared rapid gradient echo;
- mR2=
- marginal R2;
- MS=
- multiple sclerosis;
- MS-NON=
- multiple sclerosis without optic neuritis;
- MS-ON=
- multiple sclerosis with optic neuritis;
- NAOR-FA=
- fractional anisotropy of the normal-appearing optic radiations;
- NBV=
- normalized brain volume;
- OCT=
- optical coherence tomography;
- ON=
- optic neuritis;
- OR=
- optic radiations;
- OT=
- optic tract;
- RNFL=
- retinal nerve fiber layer;
- RRMS=
- relapsing-remitting multiple sclerosis;
- T1W=
- T1-weighted;
- TE=
- echo time;
- TR=
- repetition time;
- V1=
- primary visual cortex;
- VBM=
- voxel-based morphometry;
- WML=
- white matter lesions
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
↵* These authors contributed equally to this work.
- Received July 4, 2018.
- Accepted in final form January 10, 2019.
- © 2019 American Academy of Neurology
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