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Updated: Aug 21, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
White matter structural and network topological changes in moyamoya disease with limb paresthesia: A study based on
Rujing Sun1, Shi-Yu Zhang1, Xu Cheng1
1Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Purpose:
To investigate the structural and network topological changes in the white matter (WM) in MMD patients with limb paresthesia by performing diffusion kurtosis imaging (DKI).
Materials And Methods:
A total of 151 MMD patients, including 46 with left-limb paresthesia (MLP), 52 with right-limb paresthesia (MRP), and 53 without paresthesia (MWP), and 28 healthy controls (HCs) underwent whole-brain DKI, while the surgical patients were reexamined 3-4 months after revascularization. The data were preprocessed to calculate the fractional anisotropy (FA) and mean kurtosis (MK) values. Voxel-wise statistics for FA and MK images were obtained by using tract-based spatial statistics (TBSS). Next, the whole-brain network was constructed, and global and local network parameters were analyzed using graph theory. All parameters were compared among the HC, MWP, MLP, and MRP groups, and changes in the MMD patients before and after revascularization were also compared.
Results:
The TBSS analysis revealed significant reductions in FA and MK in extensive WM regions in the three patient groups. In comparison with the MWP group, the MLP group showed reductions in FA and MK in both right and left WM, mainly in the right WM, while the MRP group mainly showed a reduction in FA in the left WM region and demonstrated no significant change in MK. The graph theoretical analysis showed decreased global network efficiency, increased characteristic path length, and increased sigma in the MWP, MRP, and MLP groups in comparison with the HC group. Among local network parameters, the nodal efficiency decreased in the bilateral MFG and IFGtriang, while the degree decreased in the MFG.L and bilateral IFGtriang. Patients with right-limb paresthesia showed the lowest nodal efficiency and degree in MFG.L and IFGtriang.L, while those with left-limb paresthesia showed the lowest nodal efficiency in MFG.R and IFGtriang.R and the lowest degree in IFGtriang.R.
Conclusion:
A DKI-based whole-brain structural and network analysis can be used to detect changes in WM damage and network topological changes in MMD patients with limb paresthesia. FA is more sensitive than MK in detecting WM injury, while MFG and IFGtriang are the key nodes related to the development of acroparesthesia.
Insights
Diffusion kurtosis imaging (DKI) reveals white matter (WM) damage and network alterations in Moyamoya disease (MMD) patients with limb paresthesia. Fractional anisotropy (FA) is more sensitive than mean kurtosis (MK) in detecting WM injury.
Area of Science:
- Neuroimaging
- Neuroscience
- Radiology
Background:
- Moyamoya disease (MMD) is a rare cerebrovascular disorder characterized by progressive stenosis of the internal carotid arteries.
- Limb paresthesia is a common neurological symptom in MMD patients, potentially linked to white matter (WM) abnormalities.
- Understanding the structural and network changes in WM is crucial for diagnosing and managing MMD with paresthesia.
Purpose of the Study:
- To investigate white matter (WM) structural and network topological changes in Moyamoya disease (MMD) patients experiencing limb paresthesia using diffusion kurtosis imaging (DKI).
- To compare these changes between MMD patients with and without paresthesia, and with healthy controls.
- To assess the impact of revascularization surgery on WM integrity and network topology.
Main Methods:
- Whole-brain DKI was performed on 151 MMD patients (46 left-limb paresthesia, 52 right-limb paresthesia, 53 without paresthesia) and 28 healthy controls.
- Fractional anisotropy (FA) and mean kurtosis (MK) values were calculated and analyzed using tract-based spatial statistics (TBSS).
- Graph theory was employed to analyze global and local network parameters, comparing MMD subgroups and assessing pre- and post-revascularization changes.
Main Results:
- Significant reductions in FA and MK were observed in extensive WM regions across all MMD patient groups compared to controls.
- Patients with limb paresthesia exhibited more pronounced FA and MK reductions, particularly in specific white matter tracts.
- Graph analysis revealed decreased global network efficiency and altered local network parameters (nodal efficiency, degree) in MMD patients, with specific nodes (MFG, IFGtriang) identified as critical.
Conclusions:
- DKI-based structural and network analysis effectively detects WM damage and topological alterations in MMD patients with limb paresthesia.
- Fractional anisotropy (FA) demonstrates higher sensitivity than mean kurtosis (MK) in identifying WM injury.
- The medial frontal gyrus (MFG) and inferior frontal gyrus triangular part (IFGtriang) are key network nodes associated with the development of acroparesthesia in MMD.
