scholarly journals Effects of Piano Training in Unilateral Cerebral Palsy Using Probabilistic and Deterministic Tractography: A Case Report

2021 ◽  
Vol 15 ◽  
Author(s):  
Ana Alves-Pinto ◽  
Mónica Emch ◽  
Renée Lampe

Cerebral palsy (CP) is an umbrella term encompassing motor and often additional disabilities, resulting from insult to the developing brain and remaining throughout life. Imaging-detected alterations in white matter microstructure affect not only motor but also sensorimotor pathways. In this context, piano training is believed to promote sensorimotor rehabilitation for the multiplicity of skills and neuronal processes it involves and integrates. However, it remains unknown how this contribution may occur. Here, effects of 1.5 years of piano training in an adolescent with unilateral CP were investigated through tests of manual function and by comparing fractional anisotropy, mean diffusivity, radial and axial diffusivity in neuronal pathways pre- vs. post-training. In the absence of a control condition and of data from a larger cohort, both probabilistic neighborhood and deterministic tractography were employed to reduce bias associated with a single-case analysis and/or with user-input. No changes in manual function were detected with the tests performed. In turn, the two tractography methods yielded similar values for all studied metrics. Furthermore, post-hoc analyses yielded increased fractional anisotropy accompanied by decreases in mean diffusivity in the bilateral dorsal cingulate that were at least as large as and more consistent than in the bilateral corticospinal tract. This suggests contributions of training to the development of non-motor processes. Reduced anisotropy and correspondingly high mean diffusivity were observed for the bilateral corticospinal tract as well as for the right arcuate and the inferior longitudinal fasciculus, two sensory processing-related pathways, confirming the importance of sensorimotor rehabilitation in CP.

Cephalalgia ◽  
2015 ◽  
Vol 35 (13) ◽  
pp. 1162-1171 ◽  
Author(s):  
Catherine D Chong ◽  
Todd J Schwedt

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.


2017 ◽  
Vol 32 (6) ◽  
pp. 550-559 ◽  
Author(s):  
Jacquie Hodge ◽  
Bradley Goodyear ◽  
Helen Carlson ◽  
Xing-Chang Wei ◽  
Adam Kirton

Perinatal stroke injures developing motor systems, resulting in hemiparetic cerebral palsy. Diffusion tensor imaging can explore structural connectivity. We used diffusion tensor imaging to assess corticospinal tract diffusion in hemiparetic children with perinatal stroke. Twenty-eight children (6-18 years) with unilateral stroke underwent diffusion tensor imaging. Four corticospinal tract assessments included full tract, partial tract, minitract and region of interest. Diffusion characteristics (fractional anisotropy, mean, axial, and radial diffusivity) were calculated. Ratios (lesioned/nonlesioned) were compared across segments and to validated long-term motor outcomes (Pediatric Stroke Outcome Measure, Assisting Hand Assessment, Melbourne Assessment). Fractional anisotropy and radial diffusivity ratios decreased as tract size decreased, while mean diffusivity showed consistent symmetry. Poor motor outcomes were associated with lower fractional anisotropy in all segments and radial diffusivity correlated with both Assisting Hand Assessment and Melbourne Assessment. Diffusion imaging of segmented corticospinal tracts is feasible in hemiparetic children with perinatal stroke. Correlations with disability support clinical relevance and utility in model development for personalized rehabilitation.


2019 ◽  
Vol 50 (7) ◽  
pp. 1203-1213 ◽  
Author(s):  
Huey-Ling Chiang ◽  
Yung-Chin Hsu ◽  
Chi-Yuan Shang ◽  
Wen-Yih Isaac Tseng ◽  
Susan Shur-Fen Gau

AbstractBackgroundBrain structural alterations are frequently observed in probands with attention-deficit/hyperactivity disorder (ADHD). Here we examined the microstructural integrity of 76 white matter tracts among unaffected siblings of patients with ADHD to evaluate the potential familial risk and its association with clinical and neuropsychological manifestations.MethodsThe comparison groups included medication-naïve ADHD probands (n = 50), their unaffected siblings (n = 50) and typically developing controls (n = 50, age-and-sex matched with ADHD probands). Whole brain tractography was reconstructed automatically by tract-based analysis of diffusion spectrum imaging (DSI). Microstructural properties of white matter tracts were represented by the values of generalized fractional anisotropy (GFA), fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD) and axial diffusivity (AD).ResultsCompared to the control group, ADHD probands showed higher AD values in the perpendicular fasciculus, superior longitudinal fasciculus I, corticospinal tract, and corpus callosum. The AD values of unaffected siblings were in the intermediate position between those of the ADHD and control groups. These AD values were significantly associated with ADHD symptoms, sustained attention and working memory, for all white matter tracks evaluated except for the perpendicular fasciculus. Higher FA and lower RD values in the right frontostriatal tract connecting ventrolateral prefrontal cortex (FS-VLPFC) were associated with better performance in spatial span only in the unaffected sibling group.ConclusionsAbnormal AD values of specific white matter tracts among unaffected siblings of ADHD probands suggest the presence of familial risk in this population. The right FS-VLPFC may have a role in preventing the expression of the ADHD-related behavioral phenotype.ClinicalTrials.gov numberNCT01682915


Author(s):  
Katri Lahti ◽  
◽  
Riitta Parkkola ◽  
Päivi Jääsaari ◽  
Leena Haataja ◽  
...  

Abstract Background Diffusion tensor imaging is a widely used imaging method of brain white matter, but it is prone to imaging artifacts. The data corrections can affect the measured values. Objective To explore the impact of susceptibility correction on diffusion metrics. Materials and methods A cohort of 27 healthy adolescents (18 boys, 9 girls, mean age 12.7 years) underwent 3-T MRI, and we collected two diffusion data sets (anterior–posterior). The data were processed both with and without susceptibility artifact correction. We derived fractional anisotropy, mean diffusivity and histogram data of fiber length distribution from both the corrected and uncorrected data, which were collected from the corpus callosum, corticospinal tract and cingulum bilaterally. Results Fractional anisotropy and mean diffusivity values significantly differed when comparing the pathways in all measured tracts. The fractional anisotropy values were lower and the mean diffusivity values higher in the susceptibility-corrected data than in the uncorrected data. We found a significant difference in total tract length in the corpus callosum and the corticospinal tract. Conclusion This study indicates that susceptibility correction has a significant effect on measured fractional anisotropy, and on mean diffusivity values and tract lengths. To receive reliable and comparable results, the correction should be used systematically.


2016 ◽  
Author(s):  
Lee B Reid ◽  
Martin V Sale ◽  
Ross Cunnington ◽  
Jason B Mattingley ◽  
Stephen E Rose

AbstractWe have reported reliable changes in behaviour, brain structure and function in 24 healthy right-handed adults who practiced a finger-thumb opposition sequence task with their left hand for 10 mins daily, over four weeks. Here we extend these findings by employing diffusion MRI to investigate white-matter changes in the corticospinal tract, basal-ganglia, and connections of the dorsolateral prefrontal cortex. Twenty-three participant datasets were available with pre-training and post-training scans. Task performance improved in all participants (mean: 52.8%, SD: 20.0%; group p<0.01 FWE) and widespread microstructural changes were detected across the motor system of the ‘trained’ hemisphere. Specifically, region-of-interest based analyses of diffusion MRI (n=21) revealed significantly increased fractional anisotropy in the right caudate nucleus (4.9%; p<0.05 FWE), and decreased mean diffusivity in the left nucleus accumbens (-1.3%; p<0.05 FWE). Diffusion MRI tractography (n=22), seeded by sensorimotor cortex fMRI activation, also revealed increased fractional anisotropy in the right corticomotor tract (mean 3.28%; p<0.05 FWE) predominantly reflecting decreased radial diffusivity. These changes were consistent throughout the entire length of the tract. The left corticomotor tract did not show any changes. FA also increased in white matter connections between the right middle frontal gyrus and both right caudate nucleus (17/22 participants; p<0.05 FWE) and right supplementary motor area (18/22 participants; p<0.05 FWE). Equivalent changes in FA were not seen in the left (‘non-trained’) hemisphere. In combination with our functional and structural findings, this study provides detailed, multifocal evidence for widespread neuroplastic changes in the human brain resulting from motor training.


Cephalalgia ◽  
2019 ◽  
Vol 39 (9) ◽  
pp. 1121-1133 ◽  
Author(s):  
Catherine D Chong ◽  
Jacob Peplinski ◽  
Visar Berisha ◽  
Katherine Ross ◽  
Todd J Schwedt

Objectives Often, persistent post-traumatic headache and migraine are phenotypically similar. However, the similarities and differences in the neuropathological underpinnings of persistent post-traumatic headache and migraine require further understanding. We used diffusion tensor imaging (DTI) and a novel method for detecting subtle changes in fibertract integrity by measuring node-by-node parameters along each tract to compare fibertract profiles between those with migraine and those with persistent post-traumatic headache, and compared both cohorts to a group of controls. Methods Eighteen fibertracts were reconstructed for 131 subjects, including 49 patients with persistent post-traumatic headache attributed to mild traumatic brain injury, 41 with migraine, and 41 controls. Node-by-node diffusion parameters of mean diffusivity and radial diffusivity were calculated along each tract. Mean diffusivity and radial diffusivity measurements were averaged along quartiles of each tract for statistical interpretation and group comparison. Using a post-hoc analysis, correlations between tract quartile measurements and headache frequency were calculated. Results There were significant differences between migraine and persistent post-traumatic headache cohorts for quartile measurements of mean diffusivity or radial diffusivity in the bilateral anterior thalamic radiations, cingulum (angular bundles and cingulate gyri), inferior longitudinal fasciculi, and uncinate fasciculi, the left corticospinal tract, and the right superior longitudinal fasciculi-parietal portion. For migraine patients, there was a significant positive correlation between headache frequency and forceps major mean diffusivity, whereas for persistent post-traumatic headache there was a positive correlation between headache frequency and cingulum angular bundle mean diffusivity and radial diffusivity. Conclusions Quartile measurements of radial diffusivity and mean diffusivity indicate unique differences in fibertract profiles between those with migraine vs. persistent post-traumatic headache. Although for both migraine and persistent post-traumatic headache there was a positive relationship between fibertract alterations and headache frequency, there were disease-specific differences between headache frequency and fibertract injury patterns. These findings might suggest potential differences in the neuropathological mechanisms underlying migraine and persistent post-traumatic headache.


2020 ◽  
Vol 10 (3) ◽  
pp. 177 ◽  
Author(s):  
Chan-Hyuk Park ◽  
Hyeong Ryu ◽  
Chang-Hwan Kim ◽  
Kyung-Lim Joa ◽  
Myeong-Ok Kim ◽  
...  

We report diffusion tensor tractography (DTT) of the corticospinal tract (CST) in a patient with paresis of all four limbs following subarachnoid hemorrhage (SAH) with intraventricular hemorrhage (IVH) after the rupture of an anterior communicating artery (ACoA) aneurysm rupture. The 73-year-old female was admitted to our emergency room in a semi-comatose mental state. After coil embolization—an acute SAH treatment—she was transferred to our rehabilitation department with motor weakness development, two weeks after SAH. Upon admission, she was alert but she complained of motor weakness (upper limbs: MRC 3/5, and lower limbs: MRC 1/5). Four weeks after onset, DTT showed that the bilateral CSTs failed to reach the cerebral cortex. The left CST demonstrated a wide spread of fibers within the corona radiata as well as significantly lower tract volume (TV) and higher fractional anisotropy (FA) as well as mean diffusivity (MD) compared to the controls. On the other hand, the right CST shifted to the posterior region at the corona radiata, and MD values of the right CST were significantly higher when compared to the controls. Changes in both CSTs were attributed to vasogenic edema and compression caused by untreated hydrocephalus. We demonstrate in this case, two different pathophysiological entitles, contributing to this patient’s motor weakness after SAH.


2021 ◽  
Vol 8 ◽  
Author(s):  
Zhiyuan Sheng ◽  
Jinliang Yu ◽  
Zhongcan Chen ◽  
Yong Sun ◽  
Xingyao Bu ◽  
...  

Introduction: Tractography has demonstrated utility for surgical resection in the setting of primary brain tumors involving eloquent white matter (WM) pathways.Methods: Twelve patients with glioma in or near eloquent motor areas were analyzed. The motor status was recorded before and after surgery. Two different tractography approaches were used to generate the motor corticospinal tract (CST): Constrained spherical deconvolution probabilistic tractography (CSD-Prob) and single tensor deterministic tractography (Tens-DET). To define the degree of disruption of the CST after surgical resection of the tumor, we calculated the percentage of the CST affected by surgical resection, which was then correlated with the postoperative motor status. Moreover, the fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of the CST generated by the CSD-Prob and the Tens-DET was measured and compared between the ipsilesional and contralesional side.Results: The CST was identified in all patients and its trajectory was displaced by the tumor. Only the CSD-Prob approach showed the CST with the characteristic fan-like projections from the precentral gyrus to the brainstem. Disruption of the CST was identified in 6/6 with postoperative motor deficit by CSD-Prob approach and in 5/6 in the Tens-DET. The degree of disruption was significantly associated with the motor deficit with the CSD-Prob approach (rho = −0.88, p = 0.021). However, with the Tens-DET approach the CST disruption did not show significant association with the motor function (rho = −0.27, p = 0.6). There was a significant decrease in FA (p = 0.006) and a significant increase in MD (p = 0.0004) and RD (p = 0.005) on the ipsilesional CST compared with the contralesional CST only with the CSD-Prob approach.Conclusion: CSD-Prob accurately represented the known anatomy of the CST and provided a meaningful estimate of microstructural changes of the CST affected by the tumor and its macrostructural damage after surgery. Newer surgical planning stations should include advanced models and algorithms of tractography in order to obtain more meaningful reconstructions of the WM pathways during glioma surgery.


2014 ◽  
Author(s):  
Λουκία Τζαρούχη

ΣκοπόςΝευρολογικές εκδηλώσεις από το κεντρικό νευρικό σύστημα έχουν αναφερθεί στοπρωτοπαθές σύνδρομο Sjögren, ήδη από την αρχική περιγραφή του. Ωστόσο, το εύρος τωνκλινικών, παθολογοανατομικών και απεικονιστικών εκδηλώσεων της προσβολής έχουνανεπαρκώς μελετηθεί. Υπάρχουν ενδείξεις στη βιβλιογραφία σχετικά με την πιθανότηταλανθάνουσας/υποκλινικής προσβολής του κεντρικού νευρικού συστήματος. Σκοπός τηςπαρούσας μελέτης ήταν η εκτίμηση της λανθάνουσας/υποκλινικής προσβολής του κεντρικούνευρικού συστήματος στο πρωτοπαθές σύνδρομο Sjögren, μελετώντας μεταβολές της φαιάς καιλευκής ουσίας σε ασυμπτωματικούς ασθενείς χρησιμοποιώντας νεότερες τεχνικές μαγνητικήςτομογραφίας εγκεφάλου.Υλικό και μέθοδοιΣτο πρώτο σκέλος της παρούσας μελέτης πήραν μέρος 53 τυχαιοποιημένοι ασθενείς μεπρωτοπαθές σύνδρομο Sjögren, 18 μάρτυρες με συστηματική σκλήρυνση συμβατοί ως προς τηνηλικία και τη διάρκεια νόσου και 35 υγιείς μάρτυρες. Η παρουσία εστιακών αλλοιώσεων τηςλευκής ουσίας αξιολογήθηκε μελετώντας εικόνες FLAIR ακολουθίας. Μεταβολές στον όγκοφαιάς και λευκής ουσίας μελετηθήκαν με την εφαρμογή της τεχνικής Voxel-BasedMorphometry (VBM) σε εικόνες 3D-T1 ακολουθίας.Στο δεύτερο σκέλος της μελέτης πήραν μέρος 19 ασθενείς με πρωτοπαθές σύνδρομοSjögren και 16 υγιείς μάρτυρες συμβατοί ως προς την ηλικία. Η ανάλυση των δεδομένων έγινεχρησιμοποιώντας την μέθοδο tract-based spatial statistics (TBSS) για την εκτίμηση μεταβολών της κλασματικής ανισοτροπίας (fractional anisotropy/FA), μέσης (mean diffusivity/MD),εγκάρσιας (radial diffusivity/RD) και επιμήκους (axial diffusivity/AD) διάχυσης.Κριτήρια αποκλεισμού από την μελέτη ήταν το ιστορικό μεταβολικών, νευρολογικώνκαι ψυχιατρικών νοσημάτων και η παρουσία παραγόντων κινδύνου για καρδιαγγειακώνσυμβάντων.ΑποτελέσματαΕστιακές αλλοιώσεις λευκής ουσίας παρατηρήθηκαν σε 38 από τους 53 (71,7%)ασθενείς με πρωτοπαθές σύνδρομο Sjögren, σε 6 από τους 18 (33,3%) ασθενείς με συστηματικήσκλήρυνση και σε 17 από τους 35 (48,6%) μάρτυρες. Ο αριθμός των εστιακών αλλοιώσεων τηςλευκής ουσίας ≥ 2 mm ήταν σημαντικά μεγαλύτερος στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες (p: 0004). Επιπλέον, ο αριθμός των εστιακώναλλοιώσεων <2mm ήταν σημαντικά μεγαλύτερος στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες (p: 0001). Δεν παρατηρήθηκαν στατιστικάσημαντικές διαφορές στον αριθμό εστιακών αλλοιώσεων ≥2mm και στον αριθμό εστιακώναλλοιώσεων <2mm μεταξύ ασθενών με πρωτοπαθές σύνδρομο Sjögren και ασθενών μεσυστηματική σκλήρυνση Στους ασθενείς με πρωτοπαθές σύνδρομο Sjögren, η παρουσίαεστιακών αλλοιώσεων της λευκής ουσίας είχε θετική συσχέτιση με τη διάρκεια νόσου.Μειωμένος όγκος φαιάς ουσίας παρατηρήθηκε στους ασθενείς με πρωτοπαθές σύνδρομοSjögren συγκριτικά με τους υγιείς μάρτυρες αμφοτερόπλευρα σε περιοχές του φλοιού κυρίωςστον ινιακό, τον βρεγματικό και μετωπιαίο λοβό καθώς και στο θάλαμο, τον κερκοφόρο πυρήνακαι τα παρεγκεφαλιδικά ημισφαίρια (p<0.05). Μειωμένος όγκος λευκής ουσίας παρατηρήθηκεστους ασθενείς με πρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες διάχυτα στα εγκεφαλικά ημισφαίρια στους μετωπιαίους λοβούς και ινιακούς λοβούς τη παρεγκεφαλίδακαι το μεσολόβιο (σπληνίο και γόνυ) (p<0.05).Σημαντικά μικρότερες τιμές κλασματικής ανισοτροπίας παρατηρήθηκαν στους ασθενείςμε πρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες. Μικρότερες τιμέςκλασματικής ανισοτροπίας παρατηρήθηκαν αμφοτερόπλευρα στη φλοιονωτιαία οδό (corticospinaltract), το ανώτερο επίμηκες δεμάτιο (superior longitudinal fasciculus), το δεμάτιο τουπροσαγωγίου (cingulum bundle), την πρόσθια ακτινοβολία του θαλάμου (anterior thalamicradiation), το κατώτερο μετωπο-ινιακό δεμάτιο (inferior fronto-occipital fasciculus), τοαγκιστρωτό δεμάτιο (uncinate fasciculus) και το κατώτερο επίμηκες δεμάτιο (inferiorlongitudinal fasciclulus). Η σύγκριση για διαφορές στις τιμές της μέσης διάχυσης, της εγκάρσιαςκαι επιμήκους διάχυσης ανέδειξε περιοχές με αυξημένη μέση και εγκάρσια διάχυση και περιοχέςμε μειωμένη επιμήκη διάχυση στους ασθενείς με πρωτοπαθές σύνδρομο Sjögren διάχυτα στονεγκέφαλο.ΣυμπεράσματαΤα κύρια ευρήματα της παρούσας μελέτης ήταν η υψηλή επίπτωση εστιακώναλλοιώσεων της λευκής ουσίας σε ασυμπτωματικούς ασθενείς με πρωτοπαθές σύνδρομοSjögren. Η παρουσία των εστιακών αλλοιώσεων της λευκής ουσίας συνοδεύεται από απώλειαόγκου φαιάς ουσίας στο φλοιό, την εν τω βάθει φαιά ουσία και την παρεγκεφαλίδα, καθώς καιαπό απώλεια λευκής ουσίας σε περιοχές του εγκεφάλου αντίστοιχα με την ατροφία της φαιάςουσίας. Ο μηχανισμός της αγγειίτιδας των μικρών αγγείων μέσω της υποαιμάτωσης τουεγκεφαλικού παρεγχύματος μπορεί να εξηγήσει αυτά τα ευρήματα. Επιπλέον, μειωμένες τιμές κλασματικής ανισοτροπίας παρατηρήθηκαν στους ασθενείς μεπρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες σε πολλαπλές οδούς λευκήςουσίας συμπεριλαμβανομένων της φλοιονωτιαίας οδού (corticospinal tract), του ανώτερουεπιμήκους δεματίου (superior longitudinal fasciculus), του δεμάτιου του προσαγωγίου (cingulatefasciculus), της πρόσθιας ακτινοβολίας του θαλάμου (anterior thalamic radiation), τουκατώτερου μετωπο-ινιακού δεματίου (inferior fronto-occipital fasciculus), του αγκιστρωτούδεματίου (uncinate fasciculus) και του κατώτερου επιμήκους συνδέσμου (inferior longitudinalfasciculus). Αυτές οι μεταβολές συνοδεύονται από διάχυτη μείωση των τιμών της επιμήκουςδιάχυσης και αύξηση της μέσης και εγκάρσιας διάχυσης αντίστοιχα στους ασθενείς μεπρωτοπαθές σύνδρομο Sjögren συγκριτικά με τους υγιείς μάρτυρες. Η απώλεια τηςακεραιότητας της λευκής ουσίας μπορεί να οφείλεται είτε στο φαινόμενο της απομυελίνωσηςείτε στο μηχανισμό της Βαλλεριανής εκφύλισης.H παρούσα μελέτη ανέδειξε την παρουσία υποκλινικής, λανθάνουσας προσβολής τουκεντρικού νευρικού συστήματος στο πρωτοπαθές σύνδρομο Sjögren σε μικροσκοπικό επίπεδοπριν την εμφάνιση κλινικών εκδηλώσεων.


Cephalalgia ◽  
2008 ◽  
Vol 28 (10) ◽  
pp. 1061-1068 ◽  
Author(s):  
MA Rocca ◽  
E Pagani ◽  
B Colombo ◽  
P Tortorella ◽  
A Falini ◽  
...  

Using diffusion tensor (DT) tractography, we quantified optic radiation (OR) structural changes in seven migraine patients with (MA) and eight without visual aura (MoA) and their relation to clinical manifestations and T2-visible burden. The corticospinal tract and the corpus callosum were studied as ‘control’ white matter (WM). No difference was found for any of the WM fibre bundles metrics between controls and MoA patients. MA patients had reduced average fractional anisotropy (FA) of both OR compared with controls and reduced average FA of the right OR compared with MoA patients. They also showed higher right OR mean diffusivity than controls. OR metrics were not correlated with clinical and magnetic resonance imaging (MRI) metrics. DT tractography reveals OR changes in MA patients that might represent a phenotypic biomarker of the disease given the lack of correlation with clinical and structural MRI metrics.


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