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Updated: Apr 8, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Injury to white matter tracts in relapsing-remitting multiple sclerosis: A possible therapeutic window within the
Achiron Asaf1, Stone Evan1, Achiron Anat1
1Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Ramat-Gan, Israel.
Abstract:
DTI studies in multiple sclerosis (MS) reveal white matter (WM) injury that occurs with disease progression. In the present study we aimed to elucidate the relationship of microstructural WM damage in patients with varying periods of disease duration. DTI scans were acquired from 90 MS patients and 25 healthy controls. Patients were grouped to short (<1 year), moderate (1 up to 6 years) and long (6-10 years) disease duration periods. Statistical analyses of the fractional anisotropy (FA) data were performed using tract-based spatial statistics (TBSS). Whole-brain skeletal FA measurements showed a significant decrease between healthy controls and the short MS disease duration group, as well as between moderate disease duration and long disease duration groups, but failed to show a significant difference between short and moderate disease duration groups. Voxelwise analysis revealed clusters of diffuse FA reductions in 40 WM tracts when comparing healthy controls and MS short disease duration group, with the point of maximal significant difference located in the left inferior longitudinal fasciculus. Comparing short with long disease duration groups, progressive FA reduction was demonstrated across 30 WM tracts, with the point of maximal significant difference migrating to the body of the corpus callosum. A non-linear pattern of WM microstructure disruption occurs in RRMS. Alterations are seen early in the disease course within 1 year from onset, reach a plateau within the next 5 years, and only later additional WM changes are detected. An important period of a possible therapeutic window therefore exists within the early disease stage.
Insights
White matter injury in multiple sclerosis (MS) progresses non-linearly. Early microstructural damage occurs within one year, plateauing around five years, indicating a crucial early therapeutic window for MS patients.
Area of Science:
- Neuroimaging
- Neurology
- White Matter Research
Background:
- Multiple sclerosis (MS) is characterized by white matter (WM) injury that worsens with disease progression.
- Diffusion Tensor Imaging (DTI) is a key technique for assessing microstructural integrity in MS.
- Understanding the temporal dynamics of WM damage is crucial for effective MS management.
Purpose of the Study:
- To investigate the relationship between microstructural white matter damage and disease duration in multiple sclerosis (MS) patients.
- To identify specific white matter tracts affected early in the disease course.
- To determine if a therapeutic window exists for early intervention in MS.
Main Methods:
- DTI scans were acquired from 90 MS patients and 25 healthy controls.
- MS patients were categorized into short (<1 year), moderate (1-6 years), and long (6-10 years) disease duration groups.
- Tract-Based Spatial Statistics (TBSS) was used to analyze fractional anisotropy (FA) data for whole-brain and voxelwise comparisons.
Main Results:
- Significant decreases in whole-brain skeletal FA were observed between healthy controls and the short MS group, and between moderate and long duration groups.
- Voxelwise analysis revealed widespread FA reductions in 40 WM tracts in early MS, particularly in the left inferior longitudinal fasciculus.
- Progressive FA reduction across 30 WM tracts was noted from short to long disease duration, with maximal changes shifting to the corpus callosum.
Conclusions:
- White matter microstructure disruption in relapsing-remitting MS (RRMS) follows a non-linear pattern.
- WM alterations are evident within the first year of MS onset and stabilize for approximately five years.
- These findings highlight a critical early therapeutic window within the initial stages of MS for potential interventions.
