White Matter Integrity in General Paresis: An Exploratory Tract-Based Spatial Statistical Analysis.

Area of Science:

• Neuroimaging
• Neurology
• Medical Physics

Background:

• White matter integrity and microstructural changes in General Paresis (GP) are not well-documented.
• General Paresis, a late neurosyphilis manifestation, significantly impacts cognitive function.

Purpose of the Study:

• To investigate white matter (WM) integrity in GP patients using Diffusion Tensor Imaging (DTI) Tract-Based Spatial Statistical Analysis (TBSS).
• To correlate microstructural WM changes with cognitive deficits in GP patients.

Main Methods:

• Prospective cross-sectional study involving 18 GP patients and 24 healthy controls (HC).
• Whole-brain DTI data analyzed using TBSS to assess fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), radial diffusivity (RD), and local diffusion homogeneity (LDHs, LDHk).
• Pearson correlation used to analyze associations between DTI metrics and Mini-Mental State Examination (MMSE) scores.

Main Results:

• GP patients exhibited significantly reduced FA and increased AD, RD, and MD across widespread WM regions.
• Specific WM tracts like forceps minor and inferior fronto-occipital fasciculus showed significant FA reduction and MD increase.
• MMSE scores positively correlated with FA and LDHs/LDHk, and negatively with MD in specific tracts.

Conclusions:

• DTI-TBSS is a sensitive method for detecting extensive white matter impairment in GP.
• Identified microstructural damage is closely linked to cognitive deficits in memory and speech.
• Findings may aid in the early diagnosis and progression monitoring of General Paresis.