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Updated: Sep 29, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Longitudinal Assessment of Intravoxel Incoherent Motion Diffusion-Weighted MRI Metrics in Cognitive Decline
Maurizio Bergamino1, Anna Burke2, Leslie C Baxter3
1Barrow Neuroimaging Innovation Center, Barrow Neurological Institute, Phoenix, Arizona, USA.
Background:
Advanced diffusion-based MRI biomarkers may provide insight into microstructural and perfusion changes associated with neurodegeneration and cognitive decline.
Purpose:
To assess longitudinal microstructural and perfusion changes using apparent diffusion coefficient (ADC) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters in cognitively impaired (CI) and healthy control (HC) groups.
Study Type:
Prospective/longitudinal.
Population:
Twelve CI patients (75% female) and 13 HC subjects (69% female).
Field Strength/Sequence:
3 T; Spin-Echo-IVIM-DWI.
Assessment:
Two MRI scans were performed with a 12-month interval. ADC and IVIM-DWI metrics (diffusion coefficient [D] and perfusion fraction [f]) were generated from monoexponential and biexponential fits, respectively. Additionally, voxel-based correlations were evaluated between change in Montreal Cognitive Assessment (ΔMoCA) and baseline imaging parameters.
Statistical Tests:
Analysis of covariance with sex and age as covariates was performed for main effects of group and time (false discovery rate [FDR] corrected) with post hoc comparisons using Bonferroni correction. Partial-η2 and Hedges' g were used for effect-size analysis. Spearman's correlations (FDR corrected) were used for the relationship between ΔMoCA score and imaging. P < 0.05 was considered statistically significant.
Results:
Significant differences were found for the main effects of group (HC vs. CI) and time. For group effects, higher ADC, IVIM-D, and IVIM-f were observed in the CI group compared to HC (ADC: 1.23 ± 0.08. 10-3 vs. 1.09 ± 0.07. 10-3 mm2 /sec; IVIM-D: 0.82 ± 0.01. 10-3 vs. 0.73 ± 0.01. 10-3 mm2 /sec; and IVIM-f: 0.317 ± 0.008 vs. 0.253 ± 0.009). Significantly higher ADC, IVIM-D, and IVIM-f values were observed in the CI group after 12 months (ADC: 1.45 ± 0.05. 10-3 vs. 1.50 ± 0.07. 10-3 mm2 /sec; IVIM-D: 0.87 ± 0.01. 10-3 vs. 0.94 ± 0.02. 10-3 mm2 /sec; and IVIM-f: 0.303 ± 0.007 vs. 0.332 ± 0.008), but not in the HC group at large effect size. ADC, IVIM-D, and IVIM-f negatively correlated with ΔMoCA score (ρ = -0.49, -0.51, and -0.50, respectively).
Data Conclusion:
These findings demonstrate that longitudinal differences between CI and HC cohorts can be measured using IVIM-based metrics.
Level Of Evidence:
2 TECHNICAL EFFICACY STAGE: 2.
Insights
Longitudinal MRI using apparent diffusion coefficient (ADC) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) revealed significant microstructural and perfusion differences between cognitively impaired and healthy individuals. These advanced diffusion MRI biomarkers show promise for tracking cognitive decline.
Area of Science:
- Neuroimaging
- Biomarkers
- Cognitive Neuroscience
Background:
- Advanced diffusion-based MRI biomarkers offer insights into microstructural and perfusion changes linked to neurodegeneration and cognitive decline.
- Understanding these changes is crucial for early detection and monitoring of cognitive impairment.
Purpose of the Study:
- To longitudinally assess microstructural and perfusion changes using apparent diffusion coefficient (ADC) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) parameters.
- To compare these changes between cognitively impaired (CI) and healthy control (HC) groups over a 12-month period.
Main Methods:
- Prospective longitudinal study involving 12 CI patients and 13 HC subjects.
- Acquisition of 3T Spin-Echo-IVIM-DWI MRI scans at baseline and 12-month follow-up.
- Analysis of ADC, IVIM-D (diffusion coefficient), and IVIM-f (perfusion fraction) with statistical comparisons and correlation with cognitive assessment changes (ΔMoCA).
Main Results:
- Significant group (HC vs. CI) and time effects were observed for ADC, IVIM-D, and IVIM-f.
- The CI group exhibited higher baseline ADC, IVIM-D, and IVIM-f compared to the HC group.
- All three metrics (ADC, IVIM-D, IVIM-f) showed significant increases over 12 months in the CI group, with negative correlations to the change in Montreal Cognitive Assessment (ΔMoCA) scores.
Conclusions:
- Longitudinal differences in microstructural and perfusion metrics between CI and HC cohorts can be reliably measured using IVIM-based MRI.
- These findings highlight the potential of IVIM-DWI as a sensitive tool for monitoring disease progression and therapeutic response in cognitive impairment.
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