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Updated: Aug 17, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Diffusion kurtosis imaging and diffusion tensor imaging parameters applied to white matter and gray matter of
Hanjing Liu1, Yayun Xiang1, Junhang Liu1
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Objectives:
To compare parameters of diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) to evaluate which can better describe the microstructural changes of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis patients and to characterize the non-Gaussian diffusion patterns of the whole brain and their correlation with neuropsychological impairments in these patients.
Materials And Methods:
DTI and DKI parameters were measured in 57 patients with anti-NMDAR encephalitis and 42 healthy controls. Voxel-based analysis was used to evaluate group differences between white matter and gray matter separately. The modified Rankin Scale (mRS) was used to evaluate the severity of the neurofunctional recovery of patients, the Montreal Cognitive Assessment (MoCA) was used to assess global cognitive performance, and the Hamilton Depression Scale (HAMD) and fatigue severity scale (FSS) were used to evaluate depressive and fatigue states.
Results:
Patients with anti-NMDAR encephalitis showed significantly decreased radial kurtosis (RK) in the right extranucleus in white matter (P < 0.001) and notably decreased kurtosis fractional anisotropy (KFA) in the right precuneus, the right superior parietal gyrus (SPG), the left precuneus, left middle occipital gyrus, and left superior occipital gyrus in gray matter (P < 0.001). Gray matter regions with decreased KFA overlapped with those with decreased RK in the left middle temporal gyrus, superior temporal gyrus (STG), supramarginal gyrus (SMG), postcentral gyrus (POCG), inferior parietal but supramarginal gyrus, angular gyrus (IPL) and angular gyrus (ANG) (P < 0.001). The KFA and RK in the left ANG, IPL and POCG correlated positively with MoCA scores. KFA and RK in the left ANG, IPL, POCG and SMG correlated negatively with mRS scores. KFA in the left precuneus and right SPG as well as RK in the left STG correlated negatively with mRS scores. No significant correlation between KFA and RK in the abnormal brain regions and HAMD and FSS scores was found.
Conclusion:
The microstructural changes in gray matter were much more extensive than those in white matter in patients with anti-NMDAR encephalitis. The brain damage reflected by DKI parameters, which have higher sensitivity than parameters of DTI, correlated with cognitive impairment and the severity of the neurofunctional recovery.
Insights
Diffusion kurtosis imaging (DKI) better describes microstructural changes in anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis than diffusion tensor imaging (DTI). DKI parameters correlate with cognitive impairment and neurofunctional recovery in patients.
Area of Science:
- Neuroimaging
- Radiology
- Neurology
Background:
- Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder causing significant neurological and psychiatric symptoms.
- Understanding the underlying microstructural brain changes is crucial for diagnosis and management.
- Diffusion tensor imaging (DTI) and diffusion kurtosis imaging (DKI) are advanced MRI techniques sensitive to tissue microstructure.
Purpose of the Study:
- To compare the efficacy of DTI and DKI in characterizing microstructural alterations in anti-NMDAR encephalitis.
- To investigate the correlation between non-Gaussian diffusion patterns and neuropsychological deficits in affected patients.
Main Methods:
- DTI and DKI parameters were acquired from 57 patients with anti-NMDAR encephalitis and 42 healthy controls.
- Voxel-based analysis was employed to compare white and gray matter microstructural differences.
- Neuropsychological assessments included the modified Rankin Scale (mRS), Montreal Cognitive Assessment (MoCA), Hamilton Depression Scale (HAMD), and Fatigue Severity Scale (FSS).
Main Results:
- Patients exhibited significantly decreased radial kurtosis (RK) in white matter and kurtosis fractional anisotropy (KFA) in multiple gray matter regions.
- Gray matter microstructural changes were more widespread than white matter alterations.
- Decreased KFA and RK in specific brain regions correlated positively with MoCA scores and negatively with mRS scores, indicating a link to cognitive function and recovery.
Conclusions:
- DKI parameters are more sensitive than DTI parameters in detecting microstructural damage in anti-NMDAR encephalitis.
- DKI can effectively characterize non-Gaussian diffusion patterns and their association with cognitive impairment and neurofunctional recovery.
- These findings highlight DKI's potential as a valuable tool for assessing disease severity and monitoring treatment response in anti-NMDAR encephalitis.
