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Mean Apparent Propagator MRI: A Potential Imaging Biomarker of Brain Microstructural Alterations in Basic-Type
Qinglei Shi1,2, Mengdi Zhou3, Diwei Shi4
1School of Medicine, Chinese University of Hong Kong (Shenzhen), Shenzhen, China.
Purpose:
This study aimed to investigate brain microstructural alterations in children with basic-type intermittent exotropia (IXT) using mean apparent propagator magnetic resonance imaging (MAP-MRI) and to analyze their correlations with clinical signs.
Methods:
MRI was performed on individuals with basic-type IXT and healthy controls using a 3T Siemens scanner with a 64-channel head coil. Three-dimensional T1-weighted and diffusion-weighted images were acquired. MAP-MRI parametric maps were reconstructed using the Laplace-constrained algorithm, with diffusion tensor imaging maps serving as a reference. Voxel-wise analysis and deterministic fiber tractography were conducted to investigate microstructural changes of cortical regions and visual pathway in basic-type IXT. Receiver operating characteristic analysis was performed to assess the discriminative performance of the MAP-MRI metrics. The correlations between MAP-MRI metrics in significant brain regions and clinical signs were also analyzed.
Results:
Seventy-eight individuals with basic-type IXT and 96 healthy controls were enrolled. MAP-MRI revealed extensive microstructural alterations in brain regions associated with binocular vision and oculomotor control, as well as cognition and emotion regulation (P < 0.01 at both the voxel and cluster levels). Receiver operating characteristic analysis demonstrated that MAP-MRI metrics exhibited excellent discriminative performance, with the highest area under the curve of 0.986. In addition, MAP-MRI metrics were correlated with disease severity and disease duration (P < 0.05).
Conclusions:
MAP-MRI identified widespread microstructural alterations and their associations with clinical signs, providing valuable insights into the neural correlates underlying impaired binocular vision and oculomotor control in children with basic-type IXT. MAP-MRI metrics have the potential to serve as noninvasive imaging biomarkers for detecting IXT-related microstructural changes.
Insights
Mean apparent propagator magnetic resonance imaging (MAP-MRI) reveals widespread brain changes in children with intermittent exotropia (IXT). These MAP-MRI metrics correlate with disease severity, offering potential biomarkers for IXT.
Area of Science:
- Neuroimaging
- Ophthalmology
- Pediatric Neurology
Background:
- Intermittent exotropia (IXT) is a common childhood strabismus affecting binocular vision and oculomotor control.
- Understanding the underlying brain alterations in IXT is crucial for developing effective diagnostic and therapeutic strategies.
Purpose of the Study:
- To investigate brain microstructural alterations in children with basic-type IXT using mean apparent propagator magnetic resonance imaging (MAP-MRI).
- To analyze the correlations between MAP-MRI metrics and clinical signs of IXT.
Main Methods:
- MRI scans (3T Siemens) including 3D T1-weighted and diffusion-weighted images were acquired from 78 children with basic-type IXT and 96 healthy controls.
- MAP-MRI parametric maps were reconstructed, and voxel-wise analysis and fiber tractography were performed to assess microstructural changes in cortical regions and the visual pathway.
- Receiver operating characteristic (ROC) analysis was used to evaluate the discriminative performance of MAP-MRI metrics.
Main Results:
- MAP-MRI identified extensive microstructural alterations in brain regions related to binocular vision, oculomotor control, cognition, and emotion regulation in children with IXT (P < 0.01).
- MAP-MRI metrics demonstrated excellent discriminative performance (AUC = 0.986) in differentiating IXT from controls.
- Significant correlations were found between MAP-MRI metrics and IXT disease severity and duration (P < 0.05).
Conclusions:
- MAP-MRI effectively detects widespread microstructural brain changes associated with IXT in children.
- These findings provide insights into the neural underpinnings of impaired binocular vision and oculomotor control in IXT.
- MAP-MRI metrics show potential as noninvasive imaging biomarkers for IXT-related microstructural alterations.
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