Thalamus Atrophy in the Peri-Pregnancy Period in Clinically Stable Multiple Sclerosis Patients: Preliminary Results

Abstract

Radiological activity in the post-partum period in MS patients is a well-known phenomenon, but there is no data concerning the influence of pregnancy on regional brain atrophy. The aim of this article was to investigate local brain atrophy in the peri-pregnancy period (PPP) in patients with MS. Thalamic volume (TV); corpus callosum volume (CCV) and classical MRI activity (new gadolinium enhancing lesions (Gd+), new T2 lesions, T1 lesions volume (T1LV) and T2 lesions volume (T2LV)) were analyzed in 12 clinically stable women with relapsing–remitting MS and with MRI performed in the PPP. We showed that there was a significant decrease in TV (p = 0.021) in the PPP. We also observed a significant increase in the T1 lesion volume (p = 0.028), new gadolinium-enhanced and new T2 lesions (in 46% and 77% of the scans, respectively) in the post-partum period. Our results suggest that the PPP in MS may be associated not only with classical MRI activity but, also, with regional brain atrophy.

Differences in Brain Atrophy Pattern between People with Multiple Sclerosis and Systemic Diseases with Central Nervous System Involvement Based on Two-Dimensional Linear Measures

“…Brain and spinal cord atrophy are considered as hallmarks of neurodegeneration in MS [8][9][10]. Both white and grey matter volume loss as well as local atrophy of particular brain structures (e.g., thalamus) have been repeatedly demonstrated as strong correlates of physical and cognitive disability progression in MS [11][12][13][14]. However, little is known about brain atrophy in SDCNS patients.…”

Pregnancy‐induced brain magnetic resonance imaging changes in women with multiple sclerosis

“…Thus far, little is known about the effect of pregnancy on radiological disease activity. Some studies have reported an increased occurrence of new or contrast‐enhancing lesions on brain magnetic resonance imaging (MRI) early after delivery [9,13–17]. On the other hand, to date only two studies have investigated brain volume loss (BVL) after pregnancy, and showed either an absence of accelerated BVL [13] or thalamic but not corpus callosum volume reduction [17], despite an increase in lesion burden.…”

“…Some studies have reported an increased occurrence of new or contrast‐enhancing lesions on brain magnetic resonance imaging (MRI) early after delivery [9,13–17]. On the other hand, to date only two studies have investigated brain volume loss (BVL) after pregnancy, and showed either an absence of accelerated BVL [13] or thalamic but not corpus callosum volume reduction [17], despite an increase in lesion burden. In contrast, a few studies on healthy women showed substantial BVL during pregnancy [18–21], with a reduction beginning in early pregnancy and culminating at delivery [18].…”

“…Thus far, little is known about the effect of pregnancy on radiological disease activity. Some studies have reported an increased occurrence of new or contrast-enhancing lesions on brain magnetic resonance imaging (MRI) early after delivery [9,[13][14][15][16][17].…”

“…On the other hand, to date only two studies have investigated brain volume loss (BVL) after pregnancy, and showed either an absence of accelerated BVL [13] or thalamic but not corpus callosum volume reduction [17], despite an increase in lesion burden.…”