Whole brain white matter changes revealed by multiple diffusion metrics in multiple sclerosis: a TBSS study.

Area of Science:

• Neuroimaging
• Neurology
• Radiology

Background:

• Multiple Sclerosis (MS) is a chronic inflammatory disease affecting the central nervous system.
• White matter damage is a hallmark of MS pathology, impacting neurological function.
• Diffusion Tensor Imaging (DTI) offers insights into white matter microstructure.

Purpose of the Study:

• To investigate whole brain white matter changes in MS using multiple diffusion indices.
• To analyze diffusion data with Tract-Based Spatial Statistics (TBSS).

Main Methods:

• Included 41 relapsing-remitting MS patients and 41 healthy controls.
• Acquired diffusion-weighted images using a 1.5 T MR scanner.
• Performed voxel-wise analysis of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) via TBSS.

Main Results:

• MS patients exhibited decreased FA and increased MD, AD, and RD in white matter skeletons compared to controls.
• TBSS revealed widespread abnormal diffusion changes across the whole brain white matter.
• Significant correlations were found between diffusion metrics and clinical variables (EDSS, disease duration, lesion load).

Conclusions:

• Widespread white matter abnormalities are evident in MS patients using multiple diffusion metrics.
• Increased radial diffusivity (RD) predominantly underlies the observed diffusion changes.
• RD plays a key role in detecting subtle pathological changes in MS.