Investigations into thalamus pathology, a known predictor of disease progression and cognitive impairment in multiple sclerosis, have yielded inconsistent results in neuromyelitis optica spectrum disorder. We found significant thalamic atrophy, but normal multicomponent relaxometry parameters in patients compared to healthy controls, providing further evidence that despite volume loss, microstructural alterations are likely subtle. Associations between MRI metrics (thalamic volume and T1 relaxation time, linked with changes in water content) and performance on two measures of information processing speed support the hypothesis that damage to the thalamus may be involved in cognitive impairment in this population.
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