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Updated: Jul 9, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Identifying the white matter pathways involved in multiple sclerosis-related tremor using diffusion tensor imaging
Ahmed Bayoumi1, Khader M Hasan2, Jorge Patino1
1Department of Neurology, McGovern Medical School at UTHealth, Houston, TX, USA.
Background:
Tremor affects up to 45% of patients with Multiple Sclerosis (PwMS). Current understanding is based on insights from other neurological disorders, thus, not fully addressing the distinctive aspects of MS pathology.
Objective:
To characterize the brain white matter (WM) correlates of MS-related tremor using diffusion tensor imaging (DTI).
Methods:
In a prospective case-control study, PwMS with tremor were assessed for tremor severity and underwent MRI scans including DTI. PwMS without tremor served as matched controls. After tract selection and segmentation, the resulting diffusivity measures were used to calculate group differences and correlations with tremor severity.
Results:
This study included 72 PwMS. The tremor group (n = 36) exhibited significant changes in several pathways, notably in the right inferior longitudinal fasciculus (Cohen's d = 1.53, q < 0.001) and left corticospinal tract (d = 1.32, q < 0.001), compared to controls (n = 36). Furthermore, specific tracts showed a significant correlation with tremor severity, notably in the left medial lemniscus (Spearman's coefficient [r] = -0.56, p < 0.001), and forceps minor of corpus callosum (r = -0.45, p < 0.01).
Conclusion:
MS-related tremor is associated with widespread diffusivity changes in WM pathways and its severity correlates with commissural and sensory projection pathways, which suggests a role for proprioception or involvement of the dentato-rubro-olivary circuit.
Insights
Multiple Sclerosis (MS) tremor is linked to widespread white matter changes. Diffusion tensor imaging revealed significant alterations in pathways, correlating with tremor severity, suggesting sensory or cerebellar circuit involvement.
Area of Science:
- Neuroimaging
- Neurology
- Biomedical Engineering
Background:
- Tremor affects up to 45% of patients with Multiple Sclerosis (PwMS).
- Existing understanding of MS tremor is limited, often relying on insights from other neurological disorders.
- This highlights a need to address the unique pathology of MS-related tremor.
Purpose of the Study:
- To characterize the brain white matter (WM) correlates of MS-related tremor.
- To utilize diffusion tensor imaging (DTI) for detailed WM analysis in PwMS with tremor.
Main Methods:
- A prospective case-control study design was employed.
- PwMS with tremor were assessed for tremor severity and underwent MRI with DTI.
- Matched controls (PwMS without tremor) were included for comparison.
Main Results:
- Significant white matter diffusivity changes were observed in the tremor group compared to controls.
- Key affected pathways included the right inferior longitudinal fasciculus and left corticospinal tract.
- Tremor severity correlated significantly with diffusivity changes in the left medial lemniscus and forceps minor.
Conclusions:
- MS-related tremor is associated with widespread white matter diffusivity changes.
- The severity of tremor correlates with alterations in commissural and sensory projection pathways.
- Findings suggest a role for proprioception or the dentato-rubro-olivary circuit in MS tremor.
