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Updated: Apr 5, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
A study of MRI changes in Wilson disease and its correlation with clinical features and outcome
A Ranjan1, J Kalita1, S Kumar2
1Department of Neurology, Sanjay Gandhi Post Graduate medical Sciences, Lucknow, India.
Objective:
To evaluate the sensitivity of different MRI sequences in Wilson disease (WD) with neurological manifestations and its correlation with clinical features and outcome.
Methods:
34 WD patients with neurological manifestation with a median age of 14 years were included. Their Mini Mental State Examination (MMSE) score, movement disorders and laboratory findings were noted. Cranial MRI in T1, T2, FLAIR and DW sequences were done. Outcome at 6 months was categorized into improved (>1 grade improvement), static or worsening.
Results:
MRI was abnormal in all and revealed involvement of putamen in 29 (85.3%), caudate in 23 (67.6%), brainstem and globus pallidus in 21 (61.8%) each, thalamus in 20 (58.8%), cerebral cortex in 9 (26.5%), subcortical white matter in 8 (23.5%), and cerebellum in 2 (5.9%) patients. The overall sensitivity of T2 and FLAIR was 97.1% each, DWI 38.2% and T1 31.4%. None had contrast enhancement and 4 had reduced ADC value. Choreoathetosis correlated with thalamic, pallidal and putaminal lesions; MMSE with subcortical white mater. MRI load correlated with age, tremor, psychiatric disorder, choreoathetosis, and severity of WD. At 6 months 9 (26.5%) patients improved, 18 (52.9%) remained static and 6 (17.6%) deteriorated.
Conclusion:
In neurologic WD, putaminal involvement is the commonest; T2 and FLAIR sequences have similar sensitivity and number of MRI lesions correlated with disease severity but not with outcome.
Insights
Magnetic Resonance Imaging (MRI) T2 and FLAIR sequences are highly sensitive for detecting neurological Wilson disease (WD). While MRI findings correlate with disease severity, they do not predict patient outcomes.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Wilson disease (WD) is a genetic disorder causing copper accumulation.
- Neurological manifestations are common in WD and require accurate diagnostic tools.
- Magnetic Resonance Imaging (MRI) plays a crucial role in assessing brain involvement.
Purpose of the Study:
- To determine the sensitivity of various MRI sequences in neurologically affected WD patients.
- To correlate MRI findings with clinical features and disease progression.
- To evaluate the diagnostic utility of different MRI techniques in WD.
Main Methods:
- 34 patients with neurological WD underwent cranial MRI (T1, T2, FLAIR, DWI).
- Clinical assessments included Mini Mental State Examination (MMSE) and movement disorder evaluation.
- Patient outcomes were assessed at 6 months post-imaging.
Main Results:
- All patients showed abnormal MRI findings, with putamen involvement in 85.3%.
- T2 and FLAIR sequences demonstrated the highest sensitivity (97.1%) for detecting lesions.
- MRI lesion load correlated with disease severity and specific clinical symptoms but not with 6-month outcome.
Conclusions:
- Putaminal lesions are the most frequent MRI finding in neurologic WD.
- T2 and FLAIR MRI sequences are highly sensitive for diagnosing neurological WD.
- While MRI reflects disease severity, it is not a reliable predictor of short-term outcomes in WD.
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