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CSF contamination contributes to apparent microstructural alterations in mild cognitive impairment.

Rok Berlot1, Claudia Metzler-Baddeley2, Derek K Jones2

  • 1Department of Clinical Neuroscience, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London SE5 8AF, UK; Department of Neurology, University Medical Centre Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia.

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Summary

Cerebrospinal fluid contamination (CSFC) significantly impacts diffusion MRI findings in mild cognitive impairment (MCI). Correcting for CSFC using free-water elimination reveals true microstructural changes and alters the apparent pattern of white matter involvement in disease.

Keywords:
AtrophyDiffusion MRIMild cognitive impairmentPartial volume effectsTract-based spatial statisticsTractography

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Area of Science:

  • Neuroimaging
  • Neurology
  • Biomedical Engineering

Background:

  • Diffusion MRI is crucial for detecting microstructural changes in neurological diseases.
  • Ageing and neurodegeneration cause atrophy, leading to cerebrospinal fluid contamination (CSFC) artifacts in diffusion MRI.
  • Understanding CSFC's influence is vital for accurate disease assessment.

Purpose of the Study:

  • To investigate the impact of CSFC on apparent microstructural changes in mild cognitive impairment (MCI).
  • To analyze CSFC effects at multiple spatial scales: individual tracts, white matter skeleton, and histograms.
  • To evaluate the efficacy of free-water elimination for correcting CSFC-induced artifacts.

Main Methods:

  • Diffusion MRI scans were acquired from 25 individuals with MCI and 20 healthy controls.
  • A voxel-by-voxel free-water elimination method was employed for post-acquisition CSFC correction.
  • Analysis included tract-level, tract-based spatial statistics (TBSS), and white matter histogram approaches.

Main Results:

  • CSFC significantly influenced apparent microstructural differences between MCI patients and controls, affecting up to two-thirds of diffusivity measure differences.
  • The apparent spatial pattern of white matter involvement in MCI shifted after CSFC correction.
  • TBSS showed robustness across most of the white matter skeleton, with localized CSFC effects; fornix microstructure differences were exaggerated by CSFC.

Conclusions:

  • CSFC introduces significant quantitative and spatial artifacts in diffusion MRI studies of MCI.
  • Free-water elimination is a valuable method for distinguishing true microstructural alterations from volumetric changes caused by atrophy.
  • Accurate interpretation of diffusion MRI in atrophic conditions like MCI requires robust CSFC correction.