Damage of the lateral geniculate nucleus in MS: Assessing the missing node of the visual pathway
2019
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 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.
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