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Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
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Free-Water Imaging in Friedreich Ataxia Using Multi-Compartment Models.

Lara Fernandez1, Louise A Corben2,3,4, Hiba Bilal4

  • 1Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Movement Disorders : Official Journal of the Movement Disorder Society
|November 6, 2023
PubMed
Summary

Free-water imaging using diffusion MRI effectively detects brain changes in Friedreich ataxia (FRDA). Elevated free-water in the brainstem and cerebellum significantly distinguishes FRDA patients from healthy individuals.

Keywords:
Friedreich ataxiabrainstemcerebellumdiffusion MRIfree-watermulti-compartment models

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Area of Science:

  • Neuroimaging
  • Diffusion Magnetic Resonance Imaging (dMRI)
  • Neurodegenerative Diseases

Background:

  • Friedreich ataxia (FRDA) involves neurodegeneration and neuroinflammation in the cerebellum and brainstem.
  • Novel diffusion MRI techniques quantifying free-water may offer greater sensitivity to these pathological processes than standard imaging markers.

Purpose of the Study:

  • To quantify free-water and microstructural changes in FRDA-relevant brain regions.
  • Utilized neurite orientation dispersion and density imaging (NODDI) and bitensor diffusion tensor imaging (btDTI).

Main Methods:

  • Acquired multi-shell dMRI data from 14 individuals with FRDA and 14 controls.
  • Compared free-water measures (FISO from NODDI, FW from btDTI) and microstructural metrics across brain regions.
  • Assessed the sensitivity of free-water measures relative to microstructural markers.

Main Results:

  • Elevated FW observed in FRDA patients within the cerebellar cortex, dentate nuclei, cerebellar peduncles, and brainstem.
  • FISO was elevated primarily in cerebellar lobules.
  • FW measures demonstrated larger effect sizes compared to other markers, particularly in the superior cerebellar peduncles.

Conclusions:

  • Multi-compartment diffusion measures effectively differentiate FRDA patients from controls.
  • Free-water magnitude in the brainstem and cerebellum showed the most significant distinction between groups.
  • Supports the use of free-water imaging for assessing disease expression and progression in FRDA.