scholarly journals Loss of corticospinal tract integrity in early MS disease stages

2017 ◽  
Vol 4 (6) ◽  
pp. e399 ◽  
Author(s):  
Marc Pawlitzki ◽  
Jens Neumann ◽  
Jörn Kaufmann ◽  
Jan Heidel ◽  
Erhard Stadler ◽  
...  
Keyword(s):  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Group Differences ◽  
Disability Score ◽  
Brain Volumes ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Disease Stages ◽  
Diffusion Tensor Imaging Dti

Objective:We investigated corticospinal tract (CST) integrity in the absence of white matter (WM) lesions using diffusion tensor imaging (DTI) in early MS disease stages.Methods:Our study comprised 19 patients with clinically isolated syndrome (CIS), 11 patients with relapsing-remitting MS (RRMS), and 32 age- and sex-matched healthy controls, for whom MRI measures of CST integrity (fractional anisotropy [FA], mean diffusivity [MD]), T1- and T2-based lesion load, and brain volumes were available. The mean (SD) disease duration was 3.5 (2.1) months, and disability score was low (median Expanded Disability Status Scale 1.5) at the time of the study.Results:Patients with CIS and RRMS had significantly lower CST FA and higher CST MD values compared with controls. These findings were present, irrespective of whether WM lesions affected the CST. However, no group differences in the overall gray or WM volume were identified.Conclusions:In early MS disease stages, CST integrity is already affected in the absence of WM lesions or brain atrophy.

scholarly journals Non-Gaussian diffusion MRI of gray matter is associated with cognitive impairment in multiple sclerosis

2014 ◽  
Vol 21 (7) ◽  
pp. 935-944 ◽  
Author(s):  
M Bester ◽  
JH Jensen ◽  
JS Babb ◽  
A Tabesh ◽  
L Miles ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Gray Matter ◽  
Cognitive Deficits ◽  
Diffusion Tensor ◽  
Diffusion Imaging ◽  
Mean Diffusivity ◽  
Poor Performance ◽  
Relapsing Remitting ◽  
Non Gaussian ◽  
Diffusion Tensor Imaging Dti

Background: Non-Gaussian diffusion imaging by using diffusional kurtosis imaging (DKI) allows assessment of isotropic tissue as of gray matter (GM), an important limitation of diffusion tensor imaging (DTI). Objective: In this study, we describe DKI and DTI metrics of GM in multiple sclerosis (MS) patients and their association with cognitive deficits. Methods: Thirty-four patients with relapsing–remitting MS and 17 controls underwent MRI on a 3T scanner including a sequence for DKI with 30 diffusion directions and 3b values for each direction. Mean kurtosis (MK), mean diffusivity and fractional anisotropy (FA) of cortical and subcortical GM were measured using histogram analysis. Spearman rank correlations were used to characterize associations among imaging measures and clinical/neuropsychological scores. Results: In cortical GM, a significant decrease of MK (0.68 vs. 0.73; p < 0.001) and increase of FA (0.16 vs. 0.13; p < 0.001) was found in patients compared to controls. Decreased cortical MK was correlated with poor performance on the Delis-Kaplan Executive Function System test ( r = 0.66, p = 0.01). Conclusion: Mean kurtosis is sensitive to abnormality in GM of MS patients and can provide information that is complementary to that of conventional DTI-derived metrics. The association between MK and cognitive deficits suggests that DKI might serve as a clinically relevant biomarker for cortical injury.

Brain microstructural injury occurs in patients with RRMS despite ‘no evidence of disease activity’

2018 ◽  
Vol 89 (9) ◽  
pp. 977-982 ◽  
Author(s):  
Asaff Harel ◽  
Dylan Sperling ◽  
Maria Petracca ◽  
Achillefs Ntranos ◽  
Ilana Katz-Sand ◽  
...  
Keyword(s):  
Disease Activity ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Disease Process ◽  
T2 Lesions ◽  
Relapsing Remitting ◽  
Relapsing Remitting Multiple Sclerosis ◽  
Diffusion Tensor Imaging Dti

ObjectivesThe accuracy of ‘no evidence of disease activity’ (NEDA) in predicting long-term clinical outcome in patients with relapsing remitting multiple sclerosis (RRMS) is unproven, and there is growing evidence that NEDA does not rule out disease worsening. We used diffusion tensor imaging (DTI) to investigate whether ongoing brain microstructural injury occurs in patients with RRMS meeting NEDA criteria.MethodsWe performed a retrospective study to identify patients with RRMS visiting our centre over a 3-month period who had undergone prior longitudinal DTI evaluation at our facility spanning ≥2 years. Patients meeting NEDA criteria throughout the evaluation period were included in the NEDA group, and those not meeting NEDA criteria were included in an ‘evidence of disease activity’ (EDA) group. Fractional anisotropy (FA) and mean diffusivity (MD) maps were created, and annual rates of change were calculated.ResultsWe enrolled 85 patients, 39 meeting NEDA criteria. Both NEDA and EDA groups showed longitudinal DTI worsening. Yearly FA decrease was lower in the NEDA group (0.5%, p<0.0001) than in the EDA group (1.2%, p=0.003), while yearly MD increase was similar in both groups (0.8% for NEDA and EDA, both p<0.01). There was no statistical difference in deterioration within and outside of T2 lesions. DTI parameters correlated with disability scores and fatigue complaints.ConclusionsWhite matter microstructural deterioration occurs in patients with RRMS over short-term follow-up in patients with NEDA, providing further evidence of the limitations of conventional measures and arguing for DTI in monitoring of the disease process.

scholarly journals Disruption of neurite morphology parallels MS progression

2018 ◽  
Vol 5 (6) ◽  
pp. e502 ◽  
Author(s):  
Barbara Spanò ◽  
Giovanni Giulietti ◽  
Valerio Pisani ◽  
Manuela Morreale ◽  
Elisa Tuzzi ◽  
...  
Keyword(s):  
Brain Tissue ◽  
Disease Severity ◽  
Diffusion Mri ◽  
Diffusion Tensor ◽  
Compartment Model ◽  
Dispersion Index ◽  
Brain Areas ◽  
Neurite Density ◽  
Relapsing Remitting ◽  
Diffusion Tensor Imaging Dti

ObjectivesTo apply advanced diffusion MRI methods to the study of normal-appearing brain tissue in MS and examine their correlation with measures of clinical disability.MethodsA multi-compartment model of diffusion MRI called neurite orientation dispersion and density imaging (NODDI) was used to study 20 patients with relapsing-remitting MS (RRMS), 15 with secondary progressive MS (SPMS), and 20 healthy controls. Maps of NODDI were analyzed voxel-wise to assess the presence of abnormalities within the normal-appearing brain tissue and the association with disease severity. Standard diffusion tensor imaging (DTI) parameters were also computed for comparing the 2 techniques.ResultsPatients with MS showed reduced neurite density index (NDI) and increased orientation dispersion index (ODI) compared with controls in several brain areas (p < 0.05), with patients with SPMS having more widespread abnormalities. DTI indices were also sensitive to some changes. In addition, patients with SPMS showed reduced ODI in the thalamus and caudate nucleus. These abnormalities were associated with scores of disease severity (p < 0.05). The association with the MS functional composite score was higher in patients with SPMS compared with patients with RRMS.ConclusionsNODDI and DTI findings are largely overlapping. Nevertheless, NODDI helps interpret previous findings of increased anisotropy in the thalamus of patients with MS and are consistent with the degeneration of selective axon populations.

Diffusion tensor imaging in multiple sclerosis: a tool for monitoring changes in normal-appearing white matter

2004 ◽  
Vol 10 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Emmanuelle Cassol ◽  
Jean-Philippe Ranjeva ◽  
Danielle Ibarrola ◽  
Claude Mékies ◽  
Claude Manelfe ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Diffusion Tensor ◽  
Lesion Load ◽  
Normal Appearing White Matter ◽  
Relapsing Remitting ◽  
One Year ◽  
Diffusion Tensor Imaging Dti

Our objectives were to determine the reproducibility of diffusion tensor imaging (DTI) in volunteers and to evaluate the ability of the method to monitor longitudinal changes occurring in the normal-appearing white matter (NAWM) of patients with multiple sclerosis (MS). DTI was performed three-mo nthly for one year in seven MS patients: three relapsing-remitting (RRMS), three secondary progressive (SPMS) and one relapsing SP. They were selected with a limited cerebral lesion load. Seven age- and sex-matched controls also underwent monthly examinations for three months. Diffusivity and anisotropy were quantified over the segmented whole supratentorial white matter, with the indices of trace (Tr) and fractional anisotropy (FA). Results obtained in volunteers show the reproducibility of the method. Patients had higher trace and lower anisotropy than matched controls (P B-0.0001). O ver the follow-up, both Tr and FA indicated a recovery after the acute phase in RRMS and a progressive shift towards abnormal values in SPMS. A lthough this result is not statistically significant, it suggests that DTI is sensitive to microscopic changes occurring in tissue of normal appearance in conventional images and could be useful for monitoring the course of the disease, even though it was unable to clearly distinguish between the various physiopathological processes involved.

scholarly journals Diffusion Tensor Imaging Evaluation of Corticospinal Tract Hyperintensity in Upper Motor Neuron-Predominant ALS Patients

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Venkateswaran Rajagopalan ◽  
Didier Allexandre ◽  
Guang H. Yue ◽  
Erik P. Pioro
Keyword(s):  
Diffusion Tensor Imaging ◽  
Motor Neuron ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Internal Capsule ◽  
Proton Density ◽  
Imaging Evaluation ◽  
Axonal Pathology ◽  
Als Patients

Amyotrophic lateral sclerosis (ALS) patients with predominant upper motor neuron (UMN) signs occasionally have hyperintensity of corticospinal tract (CST) on T2- and proton-density-(PD-) weighted brain images. Diffusion tensor imaging (DTI) was used to assess whether diffusion parameters along intracranial CST differ in presence or absence of hyperintensity and correspond to UMN dysfunction. DTI brain scans were acquired in 47 UMN-predominant ALS patients with (n=21) or without (n=26) CST hyperintensity and in 10 control subjects. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were measured in four regions of interests (ROIs) along CST. Abnormalities (P<0.05) were observed in FA, AD, or RD in CST primarily at internal capsule (IC) level in ALS patients, especially those with CST hyperintensity. Clinical measures corresponded well with DTI changes at IC level. The IC abnormalities suggest a prominent axonopathy in UMN-predominant ALS and that tissue changes underlying CST hyperintensity have specific DTI changes, suggestive of unique axonal pathology.

scholarly journals Evidence of Neural Microstructure Abnormalities in Type I Chiari Malformation: Associations Among Fiber Tract Integrity, Pain, and Cognitive Dysfunction

Pain Medicine ◽  
2020 ◽  
Vol 21 (10) ◽  
pp. 2323-2335
Author(s):  
James R Houston ◽  
Michelle L Hughes ◽  
Ilana J Bennett ◽  
Philip A Allen ◽  
Jeffrey M Rogers ◽  
...  
Keyword(s):  
White Matter ◽  
Chiari Malformation ◽  
Diffusion Tensor ◽  
Digit Span ◽  
Mean Diffusivity ◽  
Self Report ◽  
Group Differences ◽  
Type I ◽  
Digit Symbol ◽  
Span Tasks

Abstract Background Previous case–control investigations of type I Chiari malformation (CMI) have reported cognitive deficits and microstructural white matter abnormalities, as measured by diffusion tensor imaging (DTI). CMI is also typically associated with pain, including occipital headache, but the relationship between pain symptoms and microstructure is not known. Methods Eighteen female CMI patients and 18 adult age- and education-matched control participants underwent DTI, were tested using digit symbol coding and digit span tasks, and completed a self-report measure of chronic pain. Tissue microstructure indices were used to examine microstructural abnormalities in CMI as compared with healthy controls. Group differences in DTI parameters were then reassessed after controlling for self-reported pain. Finally, DTI parameters were correlated with performance on the digit symbol coding and digit span tasks within each group. Results CMI patients exhibited greater fractional anisotropy (FA), lower radial diffusivity, and lower mean diffusivity in multiple brain regions compared with controls in diffuse white matter regions. Group differences no longer existed after controlling for self-reported pain. A significant correlation between FA and the Repeatable Battery for the Assessment of Neuropsychological Status coding performance was observed for controls but not for the CMI group. Conclusions Diffuse microstructural abnormalities appear to be a feature of CMI, manifesting predominantly as greater FA and less diffusivity on DTI sequences. These white matter changes are associated with the subjective pain experience of CMI patients and may reflect reactivity to neuroinflammatory responses. However, this hypothesis will require further deliberate testing in future studies.

scholarly journals Magnetic resonance diffusion tensor imaging in psychiatry: a narrative review of its potential role in diagnosis

2020 ◽  
Author(s):  
Piotr Podwalski ◽  
Krzysztof Szczygieł ◽  
Ernest Tyburski ◽  
Leszek Sagan ◽  
Błażej Misiak ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Magnetic Resonance ◽  
Potential Role ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Water Molecules ◽  
Mental Diseases ◽  
The Brain ◽  
Diffusion Tensor Imaging Dti

Abstract Diffusion tensor imaging (DTI) is an imaging technique that uses magnetic resonance. It measures the diffusion of water molecules in tissues, which can occur either without restriction (i.e., in an isotropic manner) or limited by some obstacles, such as cell membranes (i.e., in an anisotropic manner). Diffusion is most often measured in terms of, inter alia, fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD). DTI allows us to reconstruct, visualize, and evaluate certain qualities of white matter. To date, many studies have sought to associate various changes in the distribution of diffusion within the brain with mental diseases and disorders. A better understanding of white matter integrity disorders can help us recognize the causes of diseases, as well as help create objective methods of psychiatric diagnosis, identify biomarkers of mental illness, and improve pharmacotherapy. The aim of this work is to present the characteristics of DTI as well as current research on its use in schizophrenia, affective disorders, and other mental disorders.

Migraine affects white-matter tract integrity: A diffusion-tensor imaging study

Cephalalgia ◽  
2015 ◽  
Vol 35 (13) ◽  
pp. 1162-1171 ◽  
Author(s):  
Catherine D Chong ◽  
Todd J Schwedt
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Corticospinal Tract ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Imaging Study ◽  
White Matter Tract ◽  
Inferior Longitudinal Fasciculus ◽  
Left And Right ◽  
The Right

Background Specific white-matter tract alterations in migraine remain to be elucidated. Using diffusion tensor imaging (DTI), this study investigated whether the integrity of white-matter tracts that underlie regions of the “pain matrix” is altered in migraine and interrogated whether the number of years lived with migraine modifies fibertract structure. Methods Global probabilistic tractography was used to assess the anterior thalamic radiations, the corticospinal tracts and the inferior longitudinal fasciculi in 23 adults with migraine and 18 healthy controls. Results Migraine patients show greater mean diffusivity (MD) in the left and right anterior thalamic radiations, the left corticospinal tract, and the right inferior longitudinal fasciculus tract. Migraine patients also show greater radial diffusivity (RD) in the left anterior thalamic radiations, the left corticospinal tract as well as the left and right inferior longitudinal fasciculus tracts. No group fractional anisotropy (FA) differences were identified for any tracts. Migraineurs showed a positive correlation between years lived with migraine and MD in the right anterior thalamic radiations ( r = 0.517; p = 0.012) and the left corticospinal tract ( r = 0.468; p = 0.024). Conclusion Results indicate that white-matter integrity is altered in migraine and that longer migraine history is positively correlated with greater alterations in tract integrity.

scholarly journals Diffusion tensor imaging in differentiation metastatic from reactive axillary lymph nodes in patients with breast cancer

2021 ◽  
Author(s):  
Ahmed Abdel Razek ◽  
Waleed Elnahas ◽  
Mahmoud Abd El-Latif
Keyword(s):  
Breast Cancer ◽  
Diffusion Tensor Imaging ◽  
Lymph Nodes ◽  
Diffusion Tensor ◽  
Mean Diffusivity ◽  
Final Diagnosis ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Reactive N ◽  
Diffusion Tensor Imaging Dti

Purpose: To determine if diffusion tensor imaging (DTI) parameters can differentiate metastatic from reactive axillary lymph nodes (ALNs) in patients with breast cancer. Methods: Prospective study was done on 48 patients with breast cancer that were examined by DTI of the breast. The mean diffusivity (MD) and fractional anisotropy (FA) of ALNs were calculated by 2 observers. The final diagnosis was obtained by biopsy. Results: Metastatic nodes (n=50) had significantly lower MD (p = 0.001, 0.001) and higher FA (p = 0.002, 0.01) than reactive (n=20) nodes for both observers respectively. When threshed of MD (0.875, 0.815 X10-3 mm2/s) was used for differentiation of both entities revealed accuracy (80 %, 81.4 %) and had AUC of 0.920 and 0.918 by both observers respectively. When threshold FA (0.565, 0.645) was used for differentiation revealed an accuracy of 87.1%, 81.4% and had AUC of 0.860 and 0.870 by both observers respectively. Combined FA and MD had AUC 0.940, 0.950) with an accuracy of 91.4%, 92.9% for both observers respectively. Conclusion: Combined analysis DTI parameters FA may play a role in differentiation of metastatic from reactive ALNs in patients with breast cancer.

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