Spinal cord tract diffusion tensor imaging reveals disability substrate in demyelinating disease

Area of Science:

• Neuroimaging
• Neurology
• Biomarkers

Background:

• Cervical cord disease impacts neurological function.
• Assessing spinal cord tissue integrity is crucial for understanding disease progression.

Purpose of the Study:

• To evaluate cervical spinal cord tract integrity using diffusion tensor imaging (DTI).
• To correlate DTI-derived measures with specific clinical functions in patients with demyelinating diseases.

Main Methods:

• Cross-sectional study of 37 patients with multiple sclerosis or neuromyelitis optica.
• Clinical assessments included vibratory thresholds, 25-foot timed walk (25FTW), 9-hole peg test (9HPT), and Expanded Disability Status Scale.
• DTI analyzed posterior columns (PCs) and lateral corticospinal tracts (CSTs) from C1 to C6.

Main Results:

• Radial diffusivity (RD) and fractional anisotropy (FA) in PCs correlated with vibration thresholds.
• RD and FA in PCs, and RD in CSTs, were associated with 9HPT and 25FTW performance.
• DTI metrics (RD, FA) in both PCs and CSTs strongly correlated with overall disability (Expanded Disability Status Scale).

Conclusions:

• DTI serves as a sensitive biomarker for spinal cord tissue injury at the tract level.
• RD and FA effectively quantify tissue damage and relate to clinical outcomes in demyelinating diseases.