Relationship between timed 25-foot walk and diffusion tensor imaging in multiple sclerosis.

Area of Science:

• Neuroimaging
• Neurology
• Biomarkers

Background:

• Gait impairment significantly affects the quality of life for most multiple sclerosis (MS) patients.
• The timed 25-foot walk is a common but variable measure of gait disability.
• Objective biological markers are needed to accurately assess MS-related walking difficulties.

Purpose of the Study:

• To investigate the relationship between gait impairment in MS patients and imaging markers.
• To explore the utility of diffusion tensor imaging (DTI) in quantifying neurological changes related to walking ability.

Main Methods:

• A cohort of MS patients with gait impairment underwent MRI scans of the brain and cervical spinal cord.
• Diffusion tensor imaging (DTI) metrics, including mean diffusivity and fractional anisotropy, were measured in the brain's corticospinal tracts and the spinal cord at C2/3.
• Relationships between baseline timed 25-foot walk performance and various MRI/DTI markers were analyzed.

Main Results:

• Multivariate linear regression revealed significant associations between DTI metrics and gait impairment.
• Brain mean diffusivity in corticospinal tracts was a strong predictor of timed 25-foot walk performance (p=0.004).
• Other significant markers included brain corticospinal tracts axial/radial diffusivity, grey matter volume, white matter volume, and normalized brain volume.

Conclusions:

• Diffusion tensor imaging (DTI) metrics, particularly mean diffusivity in the brain's corticospinal tracts, are associated with gait impairment in multiple sclerosis (MS).
• These findings suggest DTI can serve as an objective biomarker for assessing walking ability in MS patients.