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      <h1 class="highwire-cite-title" id="page-title">Thalamic Anisotropy and Functional Disability</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">O. Rapalino</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">August 2009,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">30 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(7) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1387; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A1706 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-1807--6779619419" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">O. Rapalino </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=O.%2BRapalino%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rapalino%20O&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AO.%2BRapalino%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view"><span class="highwire-journal-article-marker-start"></span><p id="p-1">The thalami are highly organized complexes of gray matter nuclei and white matter tracts, widely interconnected with the cerebral cortex and other gray matter structures, that play a central role in sensory relay and limbic and other important functional systems. Although the thalami predominantly contain gray matter nuclei, there are many myelinated and unmyelinated tracts in the thalami, many of them belonging to projection systems and intrathalamic circuits.<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> The thalamic nuclear organization is compartmentalized by bands of white matter tracts (internal and external medullary laminae) traversing the thalami and separating different nuclear groups.<sup><a id="xref-ref-1-2" class="xref-bibr" href="#ref-1">1</a>,<a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> The significant number of axonal tracts combined with the described laminated and compartmentalized cytoarchitectural organization of the thalami are likely responsible for the observed anisotropy in diffusion tensor imaging studies.<sup><a id="xref-ref-3-1" class="xref-bibr" href="#ref-3">3</a>,<a id="xref-ref-4-1" class="xref-bibr" href="#ref-4">4</a></sup></p><p id="p-2">Because of the central role of the thalami in many physiologic systems, it is not surprising to find an increasing number of studies using a variety of different MR imaging modalities (conventional volumetric assessment, magnetization transfer, MR spectroscopy, and diffusion tensor imaging) that demonstrate the central role of thalamic involvement in the pathophysiology of various pathologic conditions (including multiple sclerosis, schizophrenia, and head trauma, to name a few).<sup><a id="xref-ref-5-1" class="xref-bibr" href="#ref-5">5</a>–<a id="xref-ref-7-1" class="xref-bibr" href="#ref-7">7</a></sup> In particular, thalamic involvement is becoming increasingly recognized as a significant step in the development of clinical disability and memory impairment in multiple sclerosis.<sup><a id="xref-ref-8-1" class="xref-bibr" href="#ref-8">8</a></sup> Tovar-Moll et al<sup><a id="xref-ref-9-1" class="xref-bibr" href="#ref-9">9</a></sup> in an article published in the current issue of the <em>American Journal of Neuroradiology</em> demonstrate thalamic abnormalities in diffusion tensor metrics that correlate with clinical disability scores, in keeping with similar studies published on the subject.<sup><a id="xref-ref-10-1" class="xref-bibr" href="#ref-10">10</a>,<a id="xref-ref-11-1" class="xref-bibr" href="#ref-11">11</a></sup> Most interesting, Tovar-Moll et al reported increased fractional anisotropy (FA) and mean diffusivity (MD) values in the thalamus in comparison with matched controls. The significance of these tensor measurements is clearly a matter for further research to elucidate whether the increased FA values are attributable to neural plasticity changes,<sup><a id="xref-ref-11-2" class="xref-bibr" href="#ref-11">11</a></sup> whereas the increased MD values reflect the presence of demyelination and neuronal damage (direct or indirect due to wallerian degeneration).</p><p id="p-3">Overall, the article by Tovar-Moll et al<sup><a id="xref-ref-9-2" class="xref-bibr" href="#ref-9">9</a></sup> highlights the potential of diffusion tensor imaging techniques in the evaluation of gray matter pathology, particularly of the thalamus, and contributes to our understanding of the pathophysiology of multiple sclerosis.</p><div class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.1"><div class="cit-metadata"><cite>Kandel ER, Schwartz JH, Jessell TM. <span class="cit-source">Principles of Neural Science.</span> 4th ed. New York: McGraw-Hill, Health Professions Division;<span class="cit-pub-date">2000</span> :<span class="cit-vol">xli</span> ,<span class="cit-fpage">1414</span></cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2 in text" id="ref-2">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.2" data-doi="10.1007/s11055-007-0154-9"><div class="cit-metadata"><cite>Berezhnaya LA. <strong>Primary structural modules of the dorsal nuclei of the thalamus and motor cortex in humans.</strong> <span class="cit-source">Neurosci Behav Physiol</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">37</span>:<span class="cit-fpage">89</span>–95</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1007/s11055-007-0154-9&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17187198&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F7%2F1387.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-3-1" title="View reference 3 in text" id="ref-3">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.3"><div class="cit-metadata"><cite>Duan Y, Li X, Xi Y. <strong>Thalamus segmentation from diffusion tensor magnetic resonance imaging.</strong> <span class="cit-source">Int J Biomed Imaging</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">2007</span>:<span class="cit-fpage">90216</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=18274658&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F7%2F1387.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-4-1" title="View reference 4 in text" id="ref-4">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.4"><div class="cit-metadata"><cite>DaSilva AF, Tuch DS, Wiegell MR, et al. <strong>A primer on diffusion tensor imaging of anatomical substructures.</strong> <span class="cit-source">Neurosurg Focus</span> <span class="cit-pub-date">2003</span>;<span class="cit-vol">15</span>:<span class="cit-fpage">E4</span></cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=15347222&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F7%2F1387.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-5-1" title="View reference 5 in text" id="ref-5">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.5"><div class="cit-metadata"><cite>Tao G, Datta S, Nelson F, et al. <strong>Deep gray matter atrophy in multiple sclerosis: a tensor based morphometry.</strong> <span class="cit-source">J Neurol Sci</span> <span class="cit-pub-date">2009</span>  Jan 23. [Epub ahead of print]</cite></div><div class="cit-extra"></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-30.7.1387.6" data-doi="10.1097/CCM.0b013e31819cf050"><div class="cit-metadata"><cite>Tollard E, Galanaud D, Perlbarg V, et al. <strong>Experience of diffusion tensor imaging and 1H spectroscopy for outcome prediction in severe traumatic brain injury: preliminary results.</strong> <span class="cit-source">Crit Care Med</span> <span class="cit-pub-date">2009</span>;<span class="cit-vol">37</span>:<span class="cit-fpage">1448</span>–55</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/CCM.0b013e31819cf050&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=19242330&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F7%2F1387.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-7-1" title="View reference 7 in text" id="ref-7">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.7"><div class="cit-metadata"><cite>Qiu A, Zhong J, Graham S, et al. <strong>Combined analyses of thalamic volume, shape and white matter integrity in first-episode schizophrenia.</strong> <span class="cit-source">Neuroimage</span> <span class="cit-pub-date">2009</span>  Apr 16. [Epub ahead of print]</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-8-1" title="View reference 8 in text" id="ref-8">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.8" data-doi="10.1212/01.wnl.0000276992.17011.b5"><div class="cit-metadata"><cite>Houtchens MK, Benedict RH, Killiany R, et al. <strong>Thalamic atrophy and cognition in multiple sclerosis.</strong> <span class="cit-source">Neurology</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">69</span>:<span class="cit-fpage">1213</span>–23</cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6OToibmV1cm9sb2d5IjtzOjU6InJlc2lkIjtzOjEwOiI2OS8xMi8xMjEzIjtzOjQ6ImF0b20iO3M6MjA6Ii9ham5yLzMwLzcvMTM4Ny5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-9-1" title="View reference 9 in text" id="ref-9">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.9"><div class="cit-metadata"><cite>Tovar-Moll F, Evangelou TE, Chiu AW, et al. <strong>Thalamic involvement and its impact on clinical disability in patients with multiple sclerosis: a diffusion tensor imaging study at 3T.</strong> <span class="cit-source">AJNR Am J Neuroradiol</span> <span class="cit-pub-date">2009</span>;<span class="cit-vol">30</span>:<span class="cit-fpage">1381</span>–87</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-10-1" title="View reference 10 in text" id="ref-10">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.10"><div class="cit-metadata"><cite>Bodini B, Khaleeli Z, Cerciqnani M, et al. <strong>Exploring the relationship between white matter and gray matter damage in early primary progressive multiple sclerosis: an in vivo study with TBSS and VBM.</strong> <span class="cit-source">Hum Brain Mapp</span> <span class="cit-pub-date">2009</span>  Jan 26. [Epub ahead of print]</cite></div><div class="cit-extra"></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-11-1" title="View reference 11 in text" id="ref-11">↵</a><div class="cit ref-cit ref-other" id="cit-30.7.1387.11" data-doi="10.1016/j.neuroimage.2007.04.038"><div class="cit-metadata"><cite>Audoin B, Guye M, Reuter F, et al. <strong>Structure of WM bundles constituting the working memory system in early multiple sclerosis: a quantitative DTI tractography study.</strong> <span class="cit-source">Neuroimage</span> <span class="cit-pub-date">2007</span>;<span class="cit-vol">36</span>:<span class="cit-fpage">1324</span>–30. Epub 2007 Apr 27</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1016/j.neuroimage.2007.04.038&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=17513134&amp;link_type=MED&amp;atom=%2Fajnr%2F30%2F7%2F1387.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">American Society of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 30</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 7 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">August 2009 </div></div>
      
      
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