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Updated: Jun 7, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Voxel-based analysis of diffusion tensor imaging in patients with subcortical vascular cognitive impairment:
Sook Hui Kim1, Jun Sung Park, Hyun-Jung Ahn
1Department of Neurology, Konkuk University Hospital, Seoul, Korea.
Background And Purpose:
Patients with small vessel disease show high-signal intensity on T2-weighted magnetic resonance (MR) images that represent ischemic cell damage. However, despite a similar degree of ischemic change, the amount and the severity of clinical presentations may vary. We investigated the clinical correlations of ischemic changes using voxel-based morphometric analyses of diffusion tensor imaging (DTI).
Methods:
Twenty-seven MCI and 34 dementia patients were included who all had significant small vessel disease on magnetic resonance imaging (MRI). In all patients, neuropsychological tests, a rating on the Pyramidal and Extrapyramidal scale (PEPS) for motor deficits, and 3-Tesla MRI including DTI scans were performed. Voxel-based analysis of the fractional anisotropy and mean diffusivity maps were computed.
Results:
Cognitive scores correlated with the DTI abnormalities in supratentorial areas with regional specificity according to each cognitive test. Unexpectedly, cognitive deficits in most neuropsychological tests, even in some frontal tasks, were associated with disruption of posterior white matter integrities. Motor deficits correlated with both supra- and infratentorial lesions.
Conclusion:
Our findings suggest that in patients with small vessel disease who show cognitive and motor impairments, a specific distribution of fiber tract damage is more related with clinical deficits than is the severity of the total ischemia.
Insights
In small vessel disease, the location of white matter damage, not just its extent, is key to cognitive and motor deficits. Diffusion tensor imaging reveals specific fiber tract disruptions correlating with clinical symptoms.
Area of Science:
- Neurology
- Neuroimaging
- White Matter Diseases
Background:
- Small vessel disease (SVD) is linked to ischemic changes visible on T2-weighted MRI.
- Clinical presentation severity in SVD can vary despite similar ischemic burden.
Purpose of the Study:
- To investigate the clinical correlations of ischemic changes in SVD patients.
- To utilize voxel-based morphometric analyses of diffusion tensor imaging (DTI) for this investigation.
Main Methods:
- Included 27 MCI and 34 dementia patients with SVD.
- Performed neuropsychological tests, motor deficit ratings (PEPS), and 3-Tesla MRI with DTI.
- Conducted voxel-based analysis of fractional anisotropy and mean diffusivity maps.
Main Results:
- Cognitive scores correlated with DTI abnormalities in supratentorial areas with regional specificity.
- Cognitive deficits, including frontal tasks, were linked to posterior white matter integrity disruption.
- Motor deficits correlated with both supra- and infratentorial lesions.
Conclusions:
- Specific fiber tract damage distribution, rather than total ischemia severity, better explains clinical deficits in SVD.
- DTI analysis provides insights into the relationship between white matter integrity and clinical impairments in SVD.
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