The association between the 1H-MR spectroscopy biomarker of astrogliosis and the PET biomarker of microglia in the thalamus in multiple sclerosis

Motivation: Thalamic innate immune activation in multiple sclerosis (MS) is implicated in neurodegeneration and thalamic atrophy, and potentially accelerating functional decline. Understanding its drivers could aid in developing targeted interventions. Goal(s): To investigate the links between thalamic innate immune activation and thalamic atrophy, using multimodal imaging metrics to explore innate immune activation and neurodegenerative mechanisms in patients with MS. Approach: We investigated associations among 1H-MRS, ER176-TSPO-PET biomarkers, and thalamic volume in patients with MS patients and non-MS controls. Results: In patients with MS, higher mIns/tCr correlated with higher ER176-TSPO-PET SUVR and lower thalamic volume, supporting multimodal imaging for assessing underlying disease processes in MS. Impact: This study demonstrates the utility of combining MRS, PET, and MRI to explore innate immune activation and neurodegeneration in multiple sclerosis, potentially guiding targeted interventions by offering a comprehensive view of thalamic involvement in disease development and progression.