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High-resolution diffusion tensor imaging and T2 mapping detect regional changes within the hippocampus in multiple

Diana Valdés Cabrera1, Gregg Blevins2, Penelope Smyth2

  • 1Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.

NMR in Biomedicine
|April 18, 2023
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High-resolution MRI reveals widespread hippocampal abnormalities in multiple sclerosis (MS) patients, indicating potential demyelination or neuron loss. These changes, particularly evident in those with cognitive impairment, highlight the hippocampus

Keywords:
T2 mappingatrophydemyelinationdiffusion tensor imaginghippocampusinflammationmultiple sclerosis

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Area of Science:

  • Neuroimaging
  • Neurology
  • Radiology

Background:

  • Hippocampal demyelination is common in multiple sclerosis (MS) but challenging to detect in vivo.
  • Diffusion Tensor Imaging (DTI) and T2 mapping offer potential for in vivo detection of hippocampal changes.
  • High spatial resolution is crucial for accurate imaging of the hippocampus.

Purpose of the Study:

  • To evaluate focal hippocampal abnormalities in MS patients with and without cognitive impairment (CI) using high-resolution DTI and T2 mapping.
  • To compare imaging findings between MS patients and healthy controls.
  • To correlate imaging findings with clinical disability and fatigue.

Main Methods:

  • Utilized 1 mm isotropic DTI, T2-weighted, and T2 mapping at 3T in 43 MS patients and 43 controls.
  • Identified abnormal hippocampal regions using mean diffusivity (MD) and T2 thresholds, excluding cerebrospinal fluid voxels.
  • Analyzed whole hippocampus and regional changes, correlating with clinical data.

Main Results:

  • Both MS groups showed higher whole hippocampus mean diffusivity (MD) compared to controls.
  • Lower fractional anisotropy (FA), volume, and higher T2 values were significant only in MS patients with cognitive impairment (CI).
  • Focal elevations in MD and T2 were observed in MS patients, with greater proportional areas affected in CI MS patients.

Conclusions:

  • High-resolution DTI and T2 mapping reveal whole hippocampus abnormalities and regional elevations in MS.
  • These findings suggest demyelination, neuron loss, or inflammation within the hippocampus.
  • Abnormalities are more extensive in MS patients with larger brain lesion volumes and cognitive impairment.