Investigation of MS normal-appearing brain using diffusion tensor MRI with clinical correlations

Area of Science:

• Neuroimaging
• Quantitative MRI
• White Matter Integrity

Background:

• Multiple Sclerosis (MS) involves white matter damage.
• Diffusion Tensor Imaging (DTI) quantifies water diffusion and anisotropy in vivo.
• DTI detects pathological changes in MS brain tissue.

Purpose of the Study:

• Quantitatively assess water diffusion changes in normal-appearing white matter (NAWM) and gray matter in MS patients.
• Correlate these diffusion changes with clinical disability and disease duration.
• Investigate the sensitivity of DTI indices to structural damage in MS.

Main Methods:

• Performed DTI on 39 MS patients and 21 controls.
• Acquired quantitative indices: fractional anisotropy (FA), volume ratio, mean diffusivity (MD).
• Analyzed 30 regions of interest in basal ganglia, cerebellar gray matter, and supratentorial/infratentorial NAWM.

Main Results:

• MS patients showed reduced anisotropy and increased diffusivity in NAWM.
• Increased anisotropy observed in basal ganglia of MS patients.
• FA and MD in cerebral peduncles correlated inversely with Expanded Disability Status Scale (EDSS) and pyramidal scores.
• Disease duration correlated with MD in infratentorial NAWM and FA in cerebral peduncles in progressive MS.

Conclusions:

• Decreased FA in NAWM and increased FA in basal ganglia suggest axonal degeneration from remote lesions.
• DTI indices, particularly FA, are sensitive to structural damage in MS-affected NAWM.
• DTI findings are associated with disability and disease progression in MS.