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Updated: Jun 26, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Skeletonized mean diffusivity and neuropsychological performance in relapsing-remitting multiple sclerosis
Magdalena Chylińska1, Bartosz Karaszewski1, Jakub Komendziński1
1Department of Adult Neurology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland.
Background:
Peak width of Skeletonized Mean Diffusivity (PSMD), as a novel marker of white matter (WM) microstructure damage, is associated with cognitive decline in several WM pathologies (i.e., small vessel disorders). We hypothesized that markers combining alterations in whole WM could be associated with cognitive dysfunction in relapsing-remitting multiple sclerosis (RRMS) patients.
Methods:
We used PSMD based on tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) magnetic resonance (MR) scans. We investigated RRMS patients (n = 73) undergoing interferon beta (IFN-β) therapy. In this cross-sectional study, we investigated the association between neuropsychological data and clinical and MRI variables: PSMD, WM hypointensities, and normalized brain volume (NBV).
Results:
In our cohort, 37 (50.7%) patients were recognized as cognitively impaired (CI) and 36 (49.3%) patients were cognitively normal (CN). In regression analysis, PSMD was a statistically significant contributor in the California Verbal Learning Test (CVLT) list A (p = 0.04) and semantic fluency (p = 0.036). PSMD (p < 0.001, r2 = 0.35), NBV (p = 0.002, r2 = 2.6) and WM hypointensities (p < 0.001, r2 = 0.40) were major contributors to upper extremity disability (9HPT) in the CN subgroup. A significant contributor in the majority of neuropsychological measures was education attainment.
Conclusion:
We investigated PSMD as a new parameter of WM microstructure damage that is a contributor in complex cognitive tasks, CVLT performance, and semantic fluency. PSMD was a statistically significant contributor to upper extremity disability (9HPT) together with WM hypointensities and NBV. Education attainment proved to be relevant in the majority of cognitive domains. Further studies are needed to estimate PSMD relevance as a marker of CI in MS.
Insights
Peak width of Skeletonized Mean Diffusivity (PSMD) is linked to cognitive decline and disability in relapsing-remitting multiple sclerosis (RRMS) patients. This novel white matter damage marker shows potential for assessing cognitive function and physical impairment in MS.
Area of Science:
- Neuroimaging
- Neurology
- Cognitive Science
Background:
- White matter (WM) microstructure damage, assessed by Peak width of Skeletonized Mean Diffusivity (PSMD), is linked to cognitive decline in various WM pathologies.
- Relapsing-remitting multiple sclerosis (RRMS) involves WM damage, potentially impacting cognitive function.
Purpose of the Study:
- To investigate the association between WM microstructure alterations and cognitive dysfunction in RRMS patients.
- To explore PSMD as a potential marker for cognitive impairment and disability in RRMS.
Main Methods:
- Utilized tract-based spatial statistics (TBSS) of diffusion tensor imaging (DTI) to calculate PSMD.
- Assessed 73 RRMS patients undergoing interferon beta (IFN-β) therapy, collecting neuropsychological, clinical, and MRI data (PSMD, WM hypointensities, normalized brain volume).
Main Results:
- 50.7% of patients were cognitively impaired (CI).
- PSMD significantly contributed to performance in the California Verbal Learning Test (CVLT) and semantic fluency.
- PSMD, normalized brain volume (NBV), and WM hypointensities were significant contributors to upper extremity disability (9HPT) in cognitively normal (CN) patients.
- Education attainment was a significant factor in most cognitive measures.
Conclusions:
- PSMD is a significant marker of WM microstructure damage associated with cognitive tasks and upper extremity disability in RRMS.
- Further research is needed to establish PSMD's clinical relevance as a marker for cognitive impairment in MS.
