scholarly journals Diffusion tensor imaging revealed different pathological processes of white matter hyperintensities

2019 ◽  
Author(s):  
Zhigang Min ◽  
Hairong Shan ◽  
Long Xu ◽  
Daihai Yuan ◽  
Xuexia Sheng ◽  
...  

Abstract Background The purpose of this study was to verify the pathological heterogeneity of white matter hyperintensities (WMHs). We compared diffusion tensor imaging (DTI) metrics within different brain regions using identical grading protocols, and subsequently investigated the microstructural changes in these areas as the WMH progressed. Methods Seventy-three patients with WMH and 18 healthy controls who received DTI were included in this study. We measured fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (DA), and radial diffusivity (DR) of periventricular and deep WMH in six brain regions and grouped these measures according to the Fazekas scale. We then compared the DTI metrics of different regions with the same Fazekas scale grade. Results Significantly lower FA values (all p<0.001), and higher MD (all p<0.001) and DR values (all p<0.001) were associated with WMH observed within the periventricular white matter around the frontal horn (pFH) and the frontal lateral ventricle (pFLV) compared to other regions with the same Fazekas grades. However, in the normal white matter of the pFH and pFLV, FA was not significantly lower than all other regions. Furthermore, in these areas, MD, DA, and DR were not significantly higher than in all other regions. Conclusion Distinct pathological processes occurred within frontal periventricular WMH and other regions; these processes may represent the effects of severe demyelination within the frontal periventricular white matter.

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhi-gang Min ◽  
Hai-rong Shan ◽  
Long Xu ◽  
Dai-hai Yuan ◽  
Xue-xia Sheng ◽  
...  

Abstract Background Although increasing evidence showed the correlations between white matter hyperintensities (WMHs) and cognitive impairment, the relationship between them is still modest. Many researchers began to focus on the variation caused by the heterogeneity of WMH. We tried to explore the pathological heterogeneity in WMH by using diffusion tensor imaging (DTI), so as to provide a new insight into the future research. Methods Diffusion weighted images (DWIs) of the brain were acquired from 73 patients with WMH and 18 healthy controls, which were then modeled by DTI. We measured fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of white matter of the periventricular frontal lobe (pFL), periventricular occipital lobe (pOL), periventricular parietal lobe (pPL) and deep centrum ovales (dCO), and grouped these measures according to the Fazekas scale. Then we compared the DTI metrics of different regions with the same Fazekas scale grade. Results Significantly lower FA values (all p < 0.001), and higher MD (all p < 0.001) and RD values (all p < 0.001) were associated with WMH observed in the periventricular frontal lobe (pFL) compared to all other regions with the same Fazekas grades. The AD of WMH in the pFL was higher than that of pPL and dCO, but the differences between groups was not as high as of MD and RD, as indicated by the effect size. In the normal control group, DTI metrics between pFL and other regions were not significantly different or less significant different. The difference of DTI metrics of WMH between pPL, pOL and dCO was lower than that of normal white matter, as indicated by the effect size. Conclusion Distinct pathological processes can be revealed by DTI between frontal periventricular WMH and other regions. These processes may represent the effects of severe demyelination within the frontal periventricular WMH.


Author(s):  
Elisabeth A. Wilde ◽  
Kareem W. Ayoub ◽  
Asim F. Choudhri

Diffusion tensor imaging (DTI) is a method of specifying and visualizing the functional integrity of white matter tracts that contribute to the functional and structural connectivity among different brain regions through the examination of water diffusion through tissue. It has gained rapid popularity in the past two decades, particularly for elucidating the process of normal white matter development and the effects of aging on it, as well as providing some insights into the possible neuroanatomical correlates of numerous psychiatric and neurologic disorders. This chapter outlines the instrumentation and the procedures employed in deriving estimates of the functional integrity of anatomical connections in the brain, and issues regarding the reliability and validity of the different DTI procedures are systematically addressed.


CNS Spectrums ◽  
2011 ◽  
Vol 16 (5) ◽  
pp. 101-109 ◽  
Author(s):  
Leonardo F. Fontenelle ◽  
Ivanei E. Bramati ◽  
Jorge Moll ◽  
Mauro V. Mendlowicz ◽  
Ricardo de Oliveira-Souza ◽  
...  

AbstractIntroductionThe aim of this study was to investigate white matter (WM) abnormalities in obsessive-compulsive disorder (OCD) and its relationship to severity of obsessive-compulsive symptoms.MethodsConventional and diffusion tensor imaging were acquired in nine patients with OCD and nine gender- and age-matched healthy volunteers. Changes in fractional anisotropy (FA) and mean diffusivity (MD) were investigated using selected regions of interest (ROIs) analyses and whole brain tract-based spatial statistic analyses. A priori ROIs were placed bilaterally in internal capsule (IC), superior longitudinal fascicule (SLF), cingulate bundle (CB), and corpus calosum (CC).ResultsROIs analyses showed that, as compared to healthy volunteers, patients with OCD exhibited reduced FA values bilaterally in regions of the posterior limb of the IC and in the SLF and increased MD values bilaterally in the posterior limb of the IC, in the left CB, and in the splenium of CC. Voxelwise analysis showed that, as compared to controls, patients with OCD exhibited reduced FA and increased MD in regions of the cortical spinal tract (genu and posterior limb of internal capsule and corona radiata) and the SLF. Severity of OCD correlated with WM alterations in different brain regions, ie, the left (rho=0.70 [MD]) and right (rho=0.70 [MD]) anterior limb of the IC, the left (rho=0.97 [MD]) and right SLF (rho=0.81 [MD]), and the genu of CC (rho=0.66 [MD]; rho=-0.69 [FA]).ConclusionOur findings support the involvement of different WM tracts in OCD and suggest that greater impairment in WM integrity is associated with increased severity of OCD symptoms.


2018 ◽  
Vol 129 (6) ◽  
pp. 1611-1622 ◽  
Author(s):  
Kristy Tan ◽  
Avital Meiri ◽  
Wenzhu B. Mowrey ◽  
Rick Abbott ◽  
James T. Goodrich ◽  
...  

OBJECTIVEThe object of this study was to use diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) to characterize the long-term effects of hydrocephalus and shunting on white matter integrity and to investigate the relationship of ventricular size and alterations in white matter integrity with headache and quality-of-life outcome measures.METHODSPatients with shunt-treated hydrocephalus and age- and sex-matched healthy controls were recruited into the study and underwent anatomical and DTI imaging on a 3-T MRI scanner. All patients were clinically stable, had undergone CSF shunt placement before 2 years of age, and had a documented history of complaints of headaches. Outcome was scored based on the Headache Disability Inventory and the Hydrocephalus Outcome Questionnaire. Fractional anisotropy (FA) and other DTI-based measures (axial, radial, and mean diffusivity; AD, RD, and MD, respectively) were extracted in the corpus callosum and internal capsule with manual region-of-interest delineation and in other regions with TBSS. Paired t-tests, corrected with a 5% false discovery rate, were used to identify regions with significant differences between patients and controls. Within the patient group, linear regression models were used to investigate the relationship between FA or ventricular volume and outcome, as well as the effect of shunt-related covariates.RESULTSTwenty-one hydrocephalus patients and 21 matched controls completed the study, and their data were used in the final analysis. The authors found significantly lower FA for patients than for controls in 20 of the 48 regions, mostly posterior white matter structures, in periventricular as well as more distal tracts. Of these 20 regions, 17 demonstrated increased RD, while only 5 showed increased MD and 3 showed decreased AD. No areas of increased FA were observed. Higher FA in specific periventricular white matter tracts, tending toward FA in controls, was associated with increased ventricular size, as well as improved clinical outcome.CONCLUSIONSThe study shows that TBSS-based DTI is a sensitive technique for elucidating changes in white matter structures due to hydrocephalus and chronic CSF shunting and provides preliminary evidence that DTI may be a valuable tool for tailoring shunt procedures to monitor ventricular size following shunting and achieve optimal outcome, as well as for guiding the development of alternate therapies for hydrocephalus.


Author(s):  
Shawn D’Souza ◽  
Lisa Hirt ◽  
David R Ormond ◽  
John A Thompson

Abstract Gliomas are neoplasms that arise from glial cell origin and represent the largest fraction of primary malignant brain tumours (77%). These highly infiltrative malignant cell clusters modify brain structure and function through expansion, invasion and intratumoral modification. Depending on the growth rate of the tumour, location and degree of expansion, functional reorganization may not lead to overt changes in behaviour despite significant cerebral adaptation. Studies in simulated lesion models and in patients with stroke reveal both local and distal functional disturbances, using measures of anatomical brain networks. Investigations over the last two decades have sought to use diffusion tensor imaging tractography data in the context of intracranial tumours to improve surgical planning, intraoperative functional localization, and post-operative interpretation of functional change. In this study, we used diffusion tensor imaging tractography to assess the impact of tumour location on the white matter structural network. To better understand how various lobe localized gliomas impact the topology underlying efficiency of information transfer between brain regions, we identified the major alterations in brain network connectivity patterns between the ipsilesional versus contralesional hemispheres in patients with gliomas localized to the frontal, parietal or temporal lobe. Results were indicative of altered network efficiency and the role of specific brain regions unique to different lobe localized gliomas. This work draws attention to connections and brain regions which have shared structural susceptibility in frontal, parietal and temporal lobe glioma cases. This study also provides a preliminary anatomical basis for understanding which affected white matter pathways may contribute to preoperative patient symptomology.


2009 ◽  
Vol 21 (7) ◽  
pp. 1406-1421 ◽  
Author(s):  
Elizabeth A. Olson ◽  
Paul F. Collins ◽  
Catalina J. Hooper ◽  
Ryan Muetzel ◽  
Kelvin O. Lim ◽  
...  

Healthy participants (n = 79), ages 9–23, completed a delay discounting task assessing the extent to which the value of a monetary reward declines as the delay to its receipt increases. Diffusion tensor imaging (DTI) was used to evaluate how individual differences in delay discounting relate to variation in fractional anisotropy (FA) and mean diffusivity (MD) within whole-brain white matter using voxel-based regressions. Given that rapid prefrontal lobe development is occurring during this age range and that functional imaging studies have implicated the prefrontal cortex in discounting behavior, we hypothesized that differences in FA and MD would be associated with alterations in the discounting rate. The analyses revealed a number of clusters where less impulsive performance on the delay discounting task was associated with higher FA and lower MD. The clusters were located primarily in bilateral frontal and temporal lobes and were localized within white matter tracts, including portions of the inferior and superior longitudinal fasciculi, anterior thalamic radiation, uncinate fasciculus, inferior fronto-occipital fasciculus, corticospinal tract, and splenium of the corpus callosum. FA increased and MD decreased with age in the majority of these regions. Some, but not all, of the discounting/DTI associations remained significant after controlling for age. Findings are discussed in terms of both developmental and age-independent effects of white matter organization on discounting behavior.


2017 ◽  
Vol 30 (5) ◽  
pp. 454-460
Author(s):  
Dana M Middleton ◽  
Jonathan Y Li ◽  
Steven D Chen ◽  
Leonard E White ◽  
Patricia I Dickson ◽  
...  

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.


2005 ◽  
Vol 46 (1) ◽  
pp. 104-109 ◽  
Author(s):  
H. Fukuda ◽  
J. Horiguchi ◽  
C. Ono ◽  
T. Ohshita ◽  
J. Takaba ◽  
...  

Purpose: To determine whether myotonic dystrophy (MyD) patients have diffusion tensor abnormalities suggestive of microstructural changes in normal‐appearing white matter (NAWM). Material and Methods: Conventional and diffusion tensor magnetic resonance images of the brain were obtained in 19 MyD patients and 19 age‐matched normal control subjects. Fractional anisotropy (FA) and mean diffusivity (MD) values were calculated in white matter lesions (WMLs) and NAWM in MyD patients and in the white matter of normal control subjects. Differences between WML and NAWM values and between MyD patient and control subject values were analyzed statistically. Results: Significantly lower FA and higher MD values were found in all regions of interest in the NAWM of MyD patients than in the white matter of control subjects ( P<0.01), as well as significantly lower FA and higher MD values in WMLs than in NAWM of MyD patients ( P<0.05). There was no significant correlation of mean FA or MD values in NAWM with patient age, age at onset, or duration of illness ( P>0.1). Conclusion: Diffusion tensor imaging analysis suggests the presence of diffuse microstructural changes in NAWM of MyD patients that may play an important role in the development of disability.


Author(s):  
Evanthia E. Tripoliti ◽  
Dimitrios I. Fotiadis ◽  
Konstantia Veliou

Diffusion Tensor Imaging (DTI) is a magnetic resonance imaging (MRI) modality which can significantly improve our understanding of the brain structures and neural connectivity. DTI measures are thought to be representative of brain tissue microstructure and are particularly useful for examining organized brain regions, such as white matter tract areas. DTI measures the water diffusion tensor using diffusion weighted pulse sequences which are sensitive to microscopic random water motion. The resulting diffusion weighted images (DWI) display and allow quantification of how water diffuses along axes or diffusion encoding directions. This can help to measure and quantify the tissue’s orientation and structure, making it an ideal tool for examining cerebral white matter and neural fiber tracts. In this chapter the authors discuss the theoretical aspects of DTI, the information that can be extracted from DTI data, and the use of the extracted information for the reconstruction of fiber tracts and the diagnosis of a disease. In addition, a review of known fiber tracking algorithms is presented.


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