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Given their role in multiple sclerosis (MS), we applied radiomics to thalamic nuclei and examined their associations with cognitive performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      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\u2010dimensional T1\u2010weighted 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                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0103) identified thalamus\u2010derived RF associated with SDMT, which were retested in a replication set (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a063). Their associations with PASAT in a second MS cohort (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0176) 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty\u2010eight RF\u2013region of interest (ROI) pairs were associated with SDMT in the replication set (false discovery rate [FDR]\u00a0&lt;\u00a00.05). Of these, 24 were also associated with PASAT (FDR\u00a0\u2264\u00a00.03), and 2 with DSST. Only ventral nuclei volume showed replicated associations among volumetrics. Only four putamen\u2010derived pairs were associated with SDMT (FDR\u00a0=\u00a00.04). LASSO results confirmed RF outperformed volumes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RF extracted from the thalamus is strongly associated with cognitive performance in PwMS, outperforming volumetric measures and supporting their potential as sensitive imaging biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70069","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T03:48:32Z","timestamp":1753069712000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Radiomic Approach to Clinical MRI Refines the Thalamus\u2010Cognition Link in Multiple Sclerosis"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2298-1589","authenticated-orcid":false,"given":"Korhan","family":"Buyukturkoglu","sequence":"first","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lin","family":"Lu","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Levi","family":"Davis","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Renan E.","family":"Orellana","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charles C.","family":"White","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rongyi","family":"Sun","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sinem","family":"Ozcelik","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nina M.","family":"Isenstein","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaho B.","family":"Onomichi","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rifat","family":"Iqbal","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binsheng","family":"Zhao","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yaakov","family":"Stern","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Burcu","family":"Zeydan","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Orhun H.","family":"Kantarci","sequence":"additional","affiliation":[{"name":"Mayo Clinic  Rochester Minnesota USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claire S.","family":"Riley","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philip L.","family":"De Jager","sequence":"additional","affiliation":[{"name":"The Neurological Institute\u2010Columbia University Irving Medical Center  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(20)30277-5"},{"key":"e_1_2_7_3_1","unstructured":"T. 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