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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Microstructural alterations in different types of lesions and their perilesional white matter in relapsing-remitting
Zhuowei Shi1, Yang Pan1, Zichun Yan1
1Department of Radiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Background And Objectives:
In multiple sclerosis (MS), contrast enhancement lesions and chronic active lesions have been demonstrated to have different degrees of inflammation. Accordingly, they exist different degrees of tissue damage, one is short and acute, and another is slow and longstanding. This study aimed to explore whether diffusion parameters can differentiate different types of lesions, and investigate the microstructural damage between different types of MS lesions by using diffusion magnetic resonance imaging (dMRI) and its correlation with clinical biomarkers of disability and cognitive states.
Methods:
We retrospectively identified 77 contrast enhancement lesions (CELs), 384 iron rim lesions (IRLs), 393 non-iron rim lesions (NIRLs), their corresponding perilesional white matter (PLWM), and 68 normal-appearing white matter (NAWM) from 68 relapsing-remitting MS (RRMS). Additionally, 44 white matter in healthy controls (WM in HCs) were also enrolled in this study. The DTI and DKI parameters were measured in the above white matter, including kurtosis fractional anisotropy (KFA), fractional anisotropy (FA), mean kurtosis (MK), and mean diffusivity (MD). All the patients were assessed with the Digital Span Test (DST), the Symbol Digit Modalities Test (SDMT), the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), and the Expanded Disability Status Scale (EDSS).
Results:
The lowest KFA, FA, MK values and the highest MD values were found in CELs, followed by IRLs, NIRLs, NAWM, and WM in HCs. In KFA and FA values, there were significant differences between each type of lesion, as well as each type of PLWM (P < 0.05). The MK values of CELs and IRLs were significantly lower than NIRLs, but inversely for MD (P < 0.05). There were no differences between CELs and IRLs for MK (P = 1) and MD (P = 0.261). The results of MK and MD values in CELs-PLWM and IRLs-PLWM were similar to the CELs and IRLs. There were no significant differences between NAWM and WM in HCs in all the enrolled diffusion parameters (P >0.05) and the FA values between NIRLs-PLWM and NAWM or between NIRLs-PLWM and WM in HCs were no significant differences (P >0.05). The KFA and MD values in IRLs-PLWM (r =0.443, P =0.021; r =-0.518, P =0.006) were correlated with the DST scores and the KFA of CELs-PLWM (r =0.396, P =0.041) was correlated with SDMT scores.
Conclusion:
Our findings demonstrate that the KFA values have the potential to distinguish different types of MS white matter tissues. Furthermore, the diffusion parameters can reflect the microstructure abnormalities in different MS lesions and might help us better understand the pathological mechanism and lesion evolution.
Insights
Diffusion MRI parameters, particularly kurtosis fractional anisotropy (KFA), can differentiate multiple sclerosis (MS) lesion types. These findings help understand MS lesion evolution and microstructural damage.
Area of Science:
- Neuroimaging
- Radiology
- Biophysics
Background:
- Multiple sclerosis (MS) lesions exhibit varying inflammation and tissue damage, with contrast-enhancing lesions (CELs) and chronic active lesions (e.g., iron rim lesions, IRLs) representing distinct pathological states.
- Understanding the microstructural differences between MS lesion types is crucial for elucidating disease mechanisms and progression.
Purpose of the Study:
- To investigate if diffusion magnetic resonance imaging (dMRI) parameters can differentiate between various types of MS lesions (CELs, IRLs, non-iron rim lesions [NIRLs]).
- To assess microstructural damage within different MS lesions and their corresponding perilesional white matter (PLWM) using dMRI.
- To explore the correlation between dMRI parameters and clinical biomarkers of disability and cognitive function in MS patients.
Main Methods:
- Retrospective analysis of dMRI data (DTI and DKI) from 68 relapsing-remitting MS (RRMS) patients and 44 healthy controls (HCs).
- Measurement of diffusion parameters including kurtosis fractional anisotropy (KFA), fractional anisotropy (FA), mean kurtosis (MK), and mean diffusivity (MD) in CELs, IRLs, NIRLs, PLWM, and normal-appearing white matter (NAWM).
- Clinical assessments included the Digital Span Test (DST), Symbol Digit Modalities Test (SDMT), Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Expanded Disability Status Scale (EDSS).
Main Results:
- Significantly lower KFA, FA, and MK values, and higher MD values were observed in CELs and IRLs compared to NIRLs, NAWM, and healthy white matter (WM in HCs).
- KFA and FA values showed significant differences between all lesion types and their respective PLWM.
- KFA and MD values in IRLs-PLWM correlated with DST scores, and KFA in CELs-PLWM correlated with SDMT scores, indicating a link between microstructural damage and cognitive function.
Conclusions:
- Kurtosis fractional anisotropy (KFA) shows potential in differentiating various MS white matter lesion types.
- dMRI parameters effectively reflect microstructural abnormalities in MS lesions, offering insights into pathological mechanisms and lesion evolution.
- These findings may contribute to a better understanding of the relationship between white matter damage and clinical manifestations in MS.
