Thalamic involvement and its impact on clinical disability and cognition in patients : With multiple sclerosis a clinical and diffusion tensor imaging study / Ahmed Mohamed Ezzat Ibrahim Metwally Dahshan ; Supervised Ahmed Talaat Alghoneimy , Amr Hasan Elhasany , Mohamed Darwish Homos

Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Neuropsychiatry

Background and purpose: Grey matter involvement is suggested to have a role in pathophysiology of MS. Diffusion tensor imaging (DTI) at 1.5T was used to investigate the presence of damage to the normal-appearing thalamus in MS and its relationship with cognitive impairment, clinical disability and fatigue.Results: Patients with MS had higher thalamic FA (p=<0.001) and ADC (p=<0.001) than volunteers. Patients showed worse performance in all neuropsychological tests than controls except in MMSE. Performance in CVLT-II-SR was correlated with mean ADC over left thalamus (p=0.038). There was significant correlation between total EDSS and Mean thalamic FA. Also there were correlations between disease duration, number of attacks and mean FA over the thalamus. There were significant correlations between performance in neuropsychological tests and disease duration, number of attacks and total EDSS. Regarding fatigue, SPMS patients were more fatigued than RRMS patients (p=0.002). FSS had significant correlations with disease duration, number of attacks and total EDSS. Conclusion: DTI was able to detect abnormalities in normal-appearing thalamus of patients with MS. Thalamic involvement had significant relations with cognitive impairment and clinical disability in patients with MS

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