Increased radial diffusivity in spinal cord lesions in neuromyelitis optica compared with multiple sclerosis

Background: Multiple sclerosis (MS) and neuromyelitis optica (NMO) both affect spinal cord with notable differences in pathology. Objective: Determine the utility of diffusion tensor imaging (DTI) to differentiate the spinal cord lesions of NMO from MS within and outside T2 lesions. Methods: Subjects greater than or equal to 12 months from a clinical episode of transverse myelitis underwent a novel transaxial cervical spinal cord DTI sequence. Ten subjects with NMO, 10 with MS and 10 healthy controls were included. Results: Within T2 affected white matter regions, radial diffusivity was increased in both NMO and MS compared with healthy controls ( p<0.001, respectively), and to a greater extent in NMO than MS ( p<0.001). Axial diffusivity was decreased in T2 lesions in both NMO and MS compared with controls ( p<0.001, p=0.001), but did not differ between the two diseases. Radial diffusivity and fractional anisotropy within white matter regions upstream and downstream of T2 lesions were different from controls in each disease. Conclusions: Higher radial diffusivity within spinal cord white matter tracts derived from diffusion tensor imaging were appreciated in NMO compared with MS, consistent with the known greater tissue destruction seen in NMO. DTI also detected tissue alterations outside T2 lesions and may be a surrogate of anterograde and retrograde degeneration.

Download Full-text

The cervical spinal cord in neuromyelitis optica patients: A comparative study with multiple sclerosis using diffusion tensor imaging

European Journal of Radiology ◽

10.1016/j.ejrad.2011.11.026 ◽

2012 ◽

Vol 81 (10) ◽

pp. 2697-2701 ◽

Cited By ~ 15

Author(s):

Fernanda Miraldi Clemente Pessôa ◽

Fernanda Cristina Rueda Lopes ◽

João Victor Altamiro Costa ◽

Soniza Vieira Alves Leon ◽

Romeu Côrtes Domingues ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Diffusion Tensor Imaging ◽

Comparative Study ◽

Neuromyelitis Optica ◽

Diffusion Tensor ◽

Cervical Spinal Cord

Download Full-text

Diffusion tensor imaging of normal-appearing white matter in patients with neuromyelitis optica spectrum disorder and multiple sclerosis

European Journal of Neurology ◽

10.1111/ene.13321 ◽

2017 ◽

Vol 24 (7) ◽

pp. 966-973 ◽

Cited By ~ 14

Author(s):

S.-H. Kim ◽

K. Kwak ◽

J.-W. Hyun ◽

A. Joung ◽

S. H. Lee ◽

...

Keyword(s):

Multiple Sclerosis ◽

Diffusion Tensor Imaging ◽

White Matter ◽

Neuromyelitis Optica ◽

Diffusion Tensor ◽

Spectrum Disorder ◽

Neuromyelitis Optica Spectrum Disorder ◽

Normal Appearing White Matter

Download Full-text

Recovery after spinal cord relapse in multiple sclerosis is predicted by radial diffusivity

Multiple Sclerosis Journal ◽

10.1177/1352458510376180 ◽

2010 ◽

Vol 16 (10) ◽

pp. 1193-1202 ◽

Cited By ~ 42

Author(s):

Patrick Freund ◽

Claudia Wheeler-Kingshott ◽

Jonathan Jackson ◽

David Miller ◽

Alan Thompson ◽

...

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Diffusion Tensor Imaging ◽

Diffusion Tensor ◽

Cervical Cord ◽

Radial Diffusivity ◽

Cross Sectional ◽

Axial Diffusivity ◽

Clinical Recovery ◽

Over Time

Background: The aim of this study was to determine whether the diffusion tensor-derived radial diffusivity and axial diffusivity, measured in the cortico-spinal tract in the cervical cord, predict clinical recovery after a cord relapse in patients with multiple sclerosis, and change over time. Methods: Fourteen patients were clinically assessed at the onset of a cervical cord relapse and after 1, 3 and 6 months. Patients and 13 age-matched healthy controls underwent spinal cord diffusion tensor imaging at each time point. The directional diffusivities from diffusion tensor imaging, termed radial diffusivity and axial diffusivity, were calculated in regions of interest placed in the lateral columns, where the cortico-spinal tract is located, and in the anterior and posterior columns. Regression analyses identified predictors of clinical outcome, adjusting for age, gender, cord cross-sectional area and baseline clinical score, and estimated the differences in the rate of change in diffusion tensor imaging measures between groups over time, adjusting for changes in cord cross-sectional area. Results: Lower radial diffusivity of the cortico-spinal tract at baseline was associated with better clinical outcome. As patients improved clinically during the follow-up, they showed greater decrease in radial diffusivity of the cortico-spinal tract than controls. Conclusions: The predictive role of radial diffusivity and its dynamic changes over time suggest that this index reflects spinal cord pathological processes, including resolution of inflammation and remyelination, that contribute to clinical recovery in multiple sclerosis. This suggests that radial diffusivity may be useful in trials that promote recovery after spinal cord injury and could be applied to other neurological diseases affecting the spinal cord.

Download Full-text

Diffusion tensor imaging for assessment of normally appearing white matter of the brain and spinal cord in cases of multiple sclerosis: a multi-parametric correlation in view of patient’s clinical status

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0031-x ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Mohamed ElSayed Kamel Abdulaziz ElSayed ◽

Mohamed Mohamed Badawy El-Toukhy ◽

Ramy Edward Asaad ◽

Omar Amin El-Serafy

Keyword(s):

Multiple Sclerosis ◽

Spinal Cord ◽

Diffusion Tensor Imaging ◽

White Matter ◽

Diffusion Tensor ◽

Clinical Status ◽

Brain And Spinal Cord ◽

The Brain

Download Full-text

Quantitative diffusion tensor imaging analysis does not distinguish pediatric canines with mucopolysaccharidosis I from control canines

The Neuroradiology Journal ◽

10.1177/1971400917718844 ◽

2017 ◽

Vol 30 (5) ◽

pp. 454-460

Author(s):

Dana M Middleton ◽

Jonathan Y Li ◽

Steven D Chen ◽

Leonard E White ◽

Patricia I Dickson ◽

...

Keyword(s):

Diffusion Tensor Imaging ◽

White Matter ◽

Fractional Anisotropy ◽

Imaging System ◽

Diffusion Tensor ◽

Brain Regions ◽

Magnetic Resonance Imaging System ◽

Radial Diffusivity ◽

Mucopolysaccharidosis I ◽

Diffusivity Measurements

Purpose We compared fractional anisotropy and radial diffusivity measurements between pediatric canines affected with mucopolysaccharidosis I and pediatric control canines. We hypothesized that lower fractional anisotropy and higher radial diffusivity values, consistent with dysmyelination, would be present in the mucopolysaccharidosis I cohort. Methods Six canine brains, three affected with mucopolysaccharidosis I and three unaffected, were euthanized at 7 weeks and imaged using a 7T small-animal magnetic resonance imaging system. Average fractional anisotropy and radial diffusivity values were calculated for four white-matter regions based on 100 regions of interest per region per specimen. A 95% confidence interval was calculated for each mean value. Results No difference was seen in fractional anisotropy or radial diffusivity values between mucopolysaccharidosis affected and unaffected brains in any region. In particular, the 95% confidence intervals for mucopolysaccharidosis affected and unaffected canines frequently overlapped for both fractional anisotropy and radial diffusivity measurements. In addition, in some brain regions a large range of fractional anisotropy and radial diffusivity values were seen within the same cohort. Conclusion The fractional anisotropy and radial diffusivity values of white matter did not differ between pediatric mucopolysaccharidosis affected canines and pediatric control canines. Possible explanations include: (a) a lack of white matter tissue differences between mucopolysaccharidosis affected and unaffected brains at early disease stages; (b) diffusion tensor imaging does not detect any existing differences; (c) inflammatory processes such as astrogliosis produce changes that offset the decreased fractional anisotropy values and increased radial diffusivity values that are expected in dysmyelination; and (d) our sample size was insufficient to detect differences. Further studies correlating diffusion tensor imaging findings to histology are warranted.

Download Full-text