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Updated: Aug 8, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Diffusion tensor imaging metrics associated with future disability in multiple sclerosis
E Lopez-Soley1, E Martinez-Heras2, E Solana3
1Center of Neuroimmunology, Laboratory of Advanced Imaging in Neuroimmunological Diseases, Hospital Clinic Barcelona, Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Universitat de Barcelona, Calle Villarroel 170, 08036, Barcelona, Spain.
Abstract:
The relationship between brain diffusion microstructural changes and disability in multiple sclerosis (MS) remains poorly understood. We aimed to explore the predictive value of microstructural properties in white (WM) and grey matter (GM), and identify areas associated with mid-term disability in MS patients. We studied 185 patients (71% female; 86% RRMS) with the Expanded Disability Status Scale (EDSS), timed 25-foot walk (T25FW), nine-hole peg test (9HPT), and Symbol Digit Modalities Test (SDMT) at two time-points. We used Lasso regression to analyse the predictive value of baseline WM fractional anisotropy and GM mean diffusivity, and to identify areas related to each outcome at 4.1 years follow-up. Motor performance was associated with WM (T25FW: RMSE = 0.524, R2 = 0.304; 9HPT dominant hand: RMSE = 0.662, R2 = 0.062; 9HPT non-dominant hand: RMSE = 0.649, R2 = 0.139), and SDMT with GM diffusion metrics (RMSE = 0.772, R2 = 0.186). Cingulum, longitudinal fasciculus, optic radiation, forceps minor and frontal aslant were the WM tracts most closely linked to motor dysfunction, and temporal and frontal cortex were relevant for cognition. Regional specificity related to clinical outcomes provide valuable information that can be used to develop more accurate predictive models that could improve therapeutic strategies.
Insights
Brain diffusion changes in white and grey matter predict disability in multiple sclerosis (MS) patients. Specific white matter tracts link to motor function, while grey matter regions correlate with cognitive performance.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- The link between brain microstructural changes and disability in multiple sclerosis (MS) is not fully understood.
- Investigating diffusion metrics in white matter (WM) and grey matter (GM) can offer insights into MS progression.
Purpose of the Study:
- To explore the predictive value of WM and GM microstructural properties for mid-term disability in MS patients.
- To identify specific brain regions associated with clinical outcomes in MS.
Main Methods:
- 185 MS patients underwent diffusion tensor imaging and clinical assessments (EDSS, T25FW, 9HPT, SDMT) at baseline and follow-up.
- Lasso regression analyzed baseline WM fractional anisotropy and GM mean diffusivity for prediction of outcomes at 4.1 years.
- Specific WM tracts and GM cortical regions were identified in relation to motor and cognitive function.
Main Results:
- WM diffusion metrics predicted motor performance (T25FW, 9HPT), with cingulum, longitudinal fasciculus, optic radiation, forceps minor, and frontal aslant being key WM tracts.
- GM diffusion metrics predicted cognitive function (SDMT), with temporal and frontal cortical regions showing relevance.
- The study found regional specificity in the relationship between diffusion metrics and clinical outcomes.
Conclusions:
- Brain diffusion microstructural changes in specific WM tracts and GM regions are predictive of motor and cognitive disability in MS.
- These findings highlight the potential for diffusion imaging biomarkers in developing improved predictive models and therapeutic strategies for MS.
