Our objective was to investigate whether thalamic energy alterations in multiple sclerosis (MS) are associated with microstructural degeneration of thalamo-cortical tracts. In 17 patients and 13 healthy controls (HCs), the apparent diffusion coefficient of creatine-phosphocreatine ADC(tCr) in the thalami, reflecting energy dysregulation, was evaluated with diffusion-weighted magnetic resonance spectroscopy. Integrity of thalamo-cortical and non-thalamic tracts was evaluated by measuring mean diffusivity (MD) with standard diffusion weighted imaging. In patients but not in HCs, lower thalamic ADC(tCr) was associated with higher MD of thalamo-cortical tracts only, suggesting that thalamic energy dysfunction may induce the selective anterograde degeneration of thalamo-cortical networks.
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