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Updated: Sep 27, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Advanced diffusion-weighted imaging models better characterize white matter neurodegeneration and clinical outcomes
Loredana Storelli1, Elisabetta Pagani1, Alessandro Meani1
1Neuroimaging Research Unit, Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy.
Background:
White matter (WM) atrophy is relevant in multiple sclerosis (MS), but the methods of analysis currently used are not specific for microstructural changes. The aims of this study were to assess the use of advanced diffusion-weighted imaging (DWI) techniques proposed as measures of baseline and longitudinal WM atrophy in MS and to analyze whether these measures helped explain MS clinical disability (including cognitive impairment) better than volumetric and diffusion tensor (DT)-derived measures.
Methods:
3DT1-weighted and DWI sequences were applied to 86 MS and 55 healthy controls (HC) at baseline and after one-year. Intra-cellular volume (vic) maps were computed from neurite orientation dispersion and density imaging model. Voxel-wise fiber-bundle cross-section (FCS) atrophy in MS compared to HC was estimated. Maps of fractional anisotropy and mean diffusivity were also obtained from DWI for a comparison with the proposed advanced DW-derived measures (vic and FCS).
Results:
Both at baseline and after 1-year, only FCS measure showed a significant atrophy in relapsing-remitting (RR) MS compared to HC and in progressive MS compared to RRMS, mainly located in specific WM tracts (corticospinal tract, splenium of the corpus callosum, left optic radiation, bilateral cingulum, middle cerebellar peduncle and anterior commissure, p value < 0.05). Global baseline FCS and vic were the selected predictors of clinical (R-sq = 0.33, p = 0.007) and cognitive scores (R-sq = 0.29, p = 0.0014) in a linear regression model.
Conclusion:
Voxel-based FCS was able to detect WM tracts atrophy in MS clinical phenotypes with greater anatomical specificity compared to other measures (volumetric and DT-derived measures of WM damage). FCS and vic measured at baseline in the WM were the best predictors of clinical disability and cognitive impairment.
Insights
Advanced diffusion imaging techniques, specifically fiber-bundle cross-section (FCS) and intra-cellular volume (vic), can detect white matter atrophy in multiple sclerosis (MS) and predict clinical disability. These novel measures offer greater specificity than traditional methods.
Area of Science:
- Neuroimaging
- Neurology
- Medical Physics
Background:
- White matter (WM) atrophy is a key feature of multiple sclerosis (MS), but current analysis methods lack microstructural specificity.
- Advanced diffusion-weighted imaging (DWI) techniques offer potential for more precise WM atrophy assessment in MS.
Purpose of the Study:
- To evaluate advanced DWI techniques, neurite orientation dispersion and density imaging (NODDI)-derived intra-cellular volume (vic) and voxel-wise fiber-bundle cross-section (FCS) atrophy, as measures of baseline and longitudinal WM atrophy in MS.
- To compare the ability of these advanced DWI measures to explain MS clinical disability, including cognitive impairment, against traditional volumetric and diffusion tensor (DT)-derived measures.
Main Methods:
- Acquired 3DT1-weighted and DWI sequences from 86 MS patients and 55 healthy controls (HC) at baseline and one-year follow-up.
- Computed intra-cellular volume (vic) maps using the NODDI model and estimated voxel-wise fiber-bundle cross-section (FCS) atrophy.
- Obtained fractional anisotropy and mean diffusivity maps for comparison with vic and FCS measures.
Main Results:
- FCS demonstrated significant WM atrophy in relapsing-remitting MS (RRMS) and progressive MS compared to HC and RRMS, respectively, with specific tract localization (p < 0.05).
- Global baseline FCS and vic were significant predictors of clinical disability (R-sq = 0.33) and cognitive scores (R-sq = 0.29) in linear regression models.
Conclusions:
- Voxel-based FCS provides anatomically specific detection of WM tract atrophy in MS phenotypes, outperforming volumetric and DT-derived measures.
- Baseline FCS and vic measurements in WM are superior predictors of clinical disability and cognitive impairment in MS patients.
