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Updated: Jan 30, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Unraveling Specific Brain Microstructural Damage in Moyamoya Disease Using Diffusion Magnetic Resonance Imaging and
Shoko Hara1, Masaaki Hori2, Ryo Ueda2
1Department of Neurosurgery, Tokyo Medical and Dental University, Bunkyo-ku, Tokyo, Japan; Department of Radiology, Juntendo University, Bunkyo-ku, Tokyo, Japan.
Background And Purpose:
Chronic ischemia may induce brain microstructural damage and lead to neurocognitive dysfunction in patients with Moyamoya disease (MMD). We applied neurite orientation dispersion and density imaging (NODDI) and 15O-gas positron emission tomography (PET) to elucidate the specific ischemic brain microstructural damage of MMD in the cortex and the white matter.
Materials And Methods:
Thirty-one patients (16-63years old, 9 males) and 20 age- and sex-matched normal controls were enrolled in this study. NODDI evaluates quantitative parameters reflecting neurite and axonal density, network complexity and the interstitial fluid in all participants. Of 31 patients, 12 newly diagnosed patients were evaluated with PET, also. We evaluated correlations between the microstructural parameters of NODDI and the hemodynamic and metabolic parameters of PET, the relationship between NODDI and clinical severity of each hemisphere (Normal, Asymtpomatic, Symptomatic, and Infarcted) as well as neurocognitive performance.
Results:
All NODDI parameters significantly correlated with PET parameters (absolute r = 0.46-0.83, P ≤ .048) and clinical severity (P < .001), suggesting that neurite and axonal density and network complexity decreased, and the interstitial fluid increased, as the ischemic burden became severe. NODDI parameters reflecting neurite and axonal density and network complexity significantly correlated with neurocognitive profiles (r = 0.36-0.64, P ≤ .048), but the interstitial fluid component did not.
Conclusions:
Chronic ischemia in patients with MMD may induce decreased neurite and axonal density, simplified network complexity, and may lead to neurocognitive dysfunction. The increased interstitial fluid accompanying hemodynamic impairment may not be identical to the decreased neurite density and might be driven by another mechanism.
Insights
Moyamoya disease (MMD) patients show reduced brain microstructural integrity, including neurite density and network complexity, linked to neurocognitive decline. Increased interstitial fluid may indicate a separate pathological process in MMD.
Area of Science:
- Neuroimaging
- Neuroscience
- Medical Physics
Background:
- Moyamoya disease (MMD) is associated with chronic ischemia, potentially causing brain microstructural damage and neurocognitive dysfunction.
- Understanding specific microstructural changes in MMD is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate specific ischemic brain microstructural damage in MMD using neurite orientation dispersion and density imaging (NODDI) and 15O-gas positron emission tomography (PET).
- To elucidate the relationship between microstructural parameters, hemodynamic/metabolic status, clinical severity, and neurocognitive performance in MMD patients.
Main Methods:
- Thirty-one MMD patients and 20 healthy controls underwent NODDI scans.
- NODDI parameters assessed neurite density, network complexity, and interstitial fluid.
- Twelve newly diagnosed MMD patients also underwent PET scans.
- Correlations were analyzed between NODDI, PET, clinical severity, and neurocognitive scores.
Main Results:
- All NODDI parameters significantly correlated with PET parameters (r=0.46–0.83, P ≤ .048) and clinical severity (P < .001).
- Decreased neurite/axonal density and network complexity, with increased interstitial fluid, were observed with severe ischemic burden.
- NODDI parameters for density and complexity correlated with neurocognitive profiles (r=0.36–0.64, P ≤ .048), but interstitial fluid did not.
Conclusions:
- Chronic ischemia in MMD leads to reduced neurite/axonal density and network complexity, contributing to neurocognitive dysfunction.
- Increased interstitial fluid in MMD may arise from mechanisms distinct from reduced neurite density.
- NODDI and PET offer valuable insights into MMD-related brain changes.
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