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Updated: Jul 11, 2026
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Differentiating Pathology of Acute Disseminated Encephalomyelitis From Multiple Sclerosis in Children Using Diffusion
Esra Pehlivan1, Martin Kinuthia Mwangi2, Vihas Abraham1
1Division of Pediatric and Developmental Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri.
Insights
Diffusion Basis Spectrum Imaging (DBSI) reveals distinct white matter differences in pediatric-onset multiple sclerosis (POMS) compared to acute disseminated encephalomyelitis (ADEM), highlighting axonal injury and demyelination in POMS.
Area of Science:
- Neuroimaging
- Pediatric Neurology
- Radiology
Background:
- Pediatric-onset multiple sclerosis (POMS) and acute disseminated encephalomyelitis (ADEM) are distinct neurological conditions in children.
- Differentiating POMS and ADEM is crucial for appropriate treatment and prognosis.
- Advanced neuroimaging techniques are needed to elucidate underlying pathologic differences.
Purpose of the Study:
- To investigate the pathologic differences between POMS and ADEM using Diffusion Tensor Imaging (DTI) and Diffusion Basis Spectrum Imaging (DBSI).
- To compare DTI and DBSI diffusivity measures in pediatric patients diagnosed with POMS and ADEM.
Main Methods:
- Fifteen children with POMS and eight with ADEM underwent both DTI and DBSI scans.
- Group comparisons and longitudinal associations of DTI and DBSI measures were analyzed.
- Statistical analysis focused on diffusivity measures over time.
Main Results:
- DBSI revealed significant differences between POMS and ADEM, with lower fractional anisotropy in POMS indicating axonal injury.
- POMS showed higher DBSI fiber fraction and radial diffusivity, suggesting demyelination and higher axonal density.
- No significant differences in DTI measures were observed between POMS and ADEM over time.
Conclusions:
- DBSI is a valuable tool for quantitatively assessing axonal injury, demyelination, and inflammation in pediatric CNS white matter diseases.
- DBSI offers advantages over DTI in differentiating POMS and ADEM.
- Larger prospective studies are needed to validate these findings.
Background:
To investigate the pathologic differences in patients with pediatric-onset multiple sclerosis (POMS) and acute disseminated encephalomyelitis (ADEM) using diffusion tensor imaging (DTI) and diffusion basis spectrum imaging (DBSI).
Methods:
Fifteen children with POMS and eight children with ADEM underwent DTI and DBSI. The comparison of DTI and DBSI diffusivity measures of POMS (31 scans) and ADEM (17 scans) was performed as group comparison and association over time.
Results:
In univariate analysis of average measures of DBSI and DTI over time, DBSI fractional anisotropy is lower in POMS than ADEM (P = 0.002), indicative of axonal injury of POMS. Higher DBSI fiber fraction (P = 0.046) and DBSI radial diffusivity (P = 0.016) but lower DBSI nonrestricted fraction (P = 0.005) in patients with POMS suggests higher axonal density, demyelination, and lower extra-axonal edema in POMS. However, there are no significant differences in DTI measures between POMS and ADEM over time.
Conclusion:
DBSI may be useful to monitor and quantitatively compare coexisting axonal injury, demyelination, and inflammation in central nervous system white matter tracts in children with POMS and ADEM, overcoming the disadvantages of DTI. Larger prospective longitudinal studies are required to confirm these results.
