Evaluation of patients with relapsing-remitting multiple sclerosis using tract-based spatial statistics analysis:...

Area of Science:

• Neuroimaging
• Radiology
• Neurology

Background:

• Diffusion kurtosis imaging (DKI) offers insights into myelin and axonal pathology.
• Few studies have utilized DKI with tract-based spatial statistics (TBSS) in multiple sclerosis (MS).

Purpose of the Study:

• To assess DKI and DTI parameters for detecting microstructural changes in relapsing remitting MS (RRMS).
• To compare the sensitivity of DKI and DTI parameters in identifying white matter (WM) damage in RRMS patients.

Main Methods:

• DKI and DTI were performed on 36 RRMS patients and 49 healthy controls.
• Brain tissue integrity was assessed using fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (Da), radial diffusivity (Dr), mean kurtosis (MK), axial kurtosis (Ka), and radial kurtosis (Kr).
• Group differences were analyzed using TBSS (P < 0.01, corrected), and voxel abnormality percentages were calculated to compare parameter sensitivity.

Main Results:

• DKI kurtosis parameters (MK, Kr) and DTI radial diffusivity (Dr) showed high sensitivity in detecting WM abnormalities in RRMS.
• DKI diffusion parameters (FA, MD, Dr) were sensitive in WM regions with coherent fibers.
• DKI kurtosis parameters (MK, Kr) were effective in discerning abnormalities in WM regions with complex fiber arrangements.

Conclusions:

• Diffusion and kurtosis parameters provide complementary information on brain microstructural damage in RRMS.
• Radial diffusivity (Dr) and DKI-derived radial kurtosis (Kr) are potential surrogate markers for pathological changes in RRMS.