Tract-specific analysis of diffusion MRI at 3T detects cervical spinal cord aberrations in multiple sclerosis

Area of Science:

• Neuroimaging
• Neurology
• Biomedical Engineering

Background:

• Diffusion tensor imaging (DTI) in multiple sclerosis (MS) spinal cords can detect early microstructural damage but lacks specificity.
• Diffusion tensor tractography, widely used in the brain, is under-explored in the MS spinal cord.

Purpose of the Study:

• To investigate the utility of diffusion tensor tractography in the cervical spinal cord of people with relapsing-remitting MS (pwRRMS).
• To determine if tractography offers added value compared to conventional DTI analyses in pwRRMS.

Main Methods:

• Studied 56 pwRRMS and 46 healthy controls (HCs) using 3T MRI.
• Extended lesion load analysis to white matter columns and analyzed streamlines within these columns.
• Quantified diffusion features along white matter streamlines.

Main Results:

• Reduced fractional anisotropy (FA) was observed in white matter columns for females and older participants, but less pronounced in streamlines.
• No significant associations were found between clinical variables and lesion load or streamline-derived microstructural indices.

Conclusions:

• Spinal cord tractography in MS may aid visualization but did not demonstrate added benefit over conventional volume or voxel-based analyses.
• Further research is needed to explore the potential of tractography in MS spinal cord imaging.