A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis Journal Article


Authors: Buyukturkoglu, K.; Lu, L.; Davis, L.; Orellana, R. E.; White, C. C.; Sun, R.; Ozcelik, S.; Isenstein, N. M.; Onomichi, K. B.; Iqbal, R.; Zhao, B.; Stern, Y.; Zeydan, B.; Kantarci, O. H.; Riley, C. S.; De Jager, P. L.
Article Title: A Radiomic Approach to Clinical MRI Refines the Thalamus-Cognition Link in Multiple Sclerosis
Abstract: Background and Purpose: Radiomics extracts imaging features that may not be detectable through conventional volumetric analyses. Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance. Methods: A total of 601 individuals were included (342 people with MS [PwMS] from two cohorts and 259 healthy controls [HC]). Radiomic features (RF) and volumes were extracted from the whole thalamus, five thalamic nuclei, and the putamen segmented on three-dimensional T1-weighted images. Cognitive performance was assessed using the Symbol Digit Modalities Test (SDMT) and Paced Auditory Serial Addition Test (PASAT) in PwMS and the Digit Symbol Substitution Test (DSST) in HC. In the first MS cohort, multivariate linear regression in a discovery set (N = 103) identified thalamus-derived RF associated with SDMT, which were retested in a replication set (N = 63). Their associations with PASAT in a second MS cohort (N = 176) and DSST in HC were also evaluated. We then tested whether the same RFs, when extracted from the putamen, was associated with SDMT. Least Absolute Shrinkage and Selection Operator (LASSO) models assessed the combined predictive value of RF and volumes. Results: Twenty-eight RF–region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR] < 0.05). Of these, 24 were also associated with PASAT (FDR ≤ 0.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen-derived pairs were associated with SDMT (FDR = 0.04). LASSO results confirmed RF outperformed volumes. Conclusion: RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers. © 2025 American Society of Neuroimaging.
Keywords: cognition; thalamus; radiomics; thalamic nuclei; digit symbol substitution test (dsst); paced auditory serial addition test (pasat); symbol digit modalities test (sdmt)
Journal Title: Journal of Neuroimaging
Volume: 35
Issue: 4
ISSN: 1051-2284
Publisher: Wiley Blackwell  
Date Published: 2025-01-01
Start Page: e70069
Language: English
DOI: 10.1111/jon.70069
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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