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Updated: Mar 1, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
White-matter integrity on DTI and the pathologic staging of Alzheimer's disease
Kejal Kantarci1, Melissa E Murray2, Christopher G Schwarz1
1Department of Radiology, Mayo Clinic, Rochester, MN, USA.
Abstract:
Pattern of diffusion tensor MRI (DTI) alterations were investigated in pathologically-staged Alzheimer's disease (AD) patients (n = 46). Patients with antemortem DTI studies and a range of AD pathology at autopsy were included. Patients with a high neurofibrillary tangle (NFT) stage (Braak IV-VI) had significantly elevated mean diffusivity (MD) in the crus of fornix and ventral cingulum tracts, precuneus, and entorhinal white matter on voxel-based analysis after adjusting for age and time from MRI to death (p < 0.001). Higher MD and lower fractional anisotropy in the ventral cingulum tract, entorhinal, and precuneus white matter was associated with higher Braak NFT stage and clinical disease severity. There were no MD and fractional anisotropy differences among the low (none and sparse) and high (moderate and frequent) β-amyloid neuritic plaque groups. The NFT pathology of AD is associated with DTI alterations involving the medial temporal limbic connections and medial parietal white matter. This pattern of diffusion abnormalities is also associated with clinical disease severity.
Insights
Alzheimer's disease (AD) neurofibrillary tangle pathology is linked to diffusion tensor imaging (DTI) changes in specific brain white matter tracts. These DTI alterations correlate with disease severity.
Area of Science:
- Neuroimaging
- Neuropathology
- Gerontology
Background:
- Alzheimer's disease (AD) is a neurodegenerative disorder characterized by distinct pathological hallmarks.
- Diffusion tensor imaging (DTI) can detect microstructural white matter changes in vivo.
Purpose of the Study:
- To investigate the pattern of DTI alterations in relation to pathological staging of Alzheimer's disease.
- To correlate DTI findings with neurofibrillary tangle (NFT) load and clinical disease severity.
Main Methods:
- Retrospective analysis of DTI data from 46 pathologically-staged Alzheimer's disease patients.
- Voxel-based analysis of mean diffusivity (MD) and fractional anisotropy (FA) adjusted for age and time from MRI to autopsy.
- Correlation of DTI metrics with Braak NFT stage and clinical severity scores.
Main Results:
- High NFT stage (Braak IV-VI) showed significantly elevated MD in the crus of fornix, ventral cingulum, precuneus, and entorhinal white matter.
- Higher MD and lower FA in these tracts correlated with increased NFT stage and clinical disease severity.
- No significant DTI differences were observed between low and high beta-amyloid plaque groups.
Conclusions:
- Neurofibrillary tangle pathology in Alzheimer's disease is associated with DTI alterations in medial temporal limbic and medial parietal white matter.
- The observed diffusion abnormalities pattern reflects NFT burden and correlates with clinical disease severity.
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