Longitudinal quantitative streamline tractography: Robust estimation of white matter connectivity differences

Longitudinal probing of structural connectivity via diffusion magnetic resonance imaging (dMRI) is experiencing uptake. However, the detection of biological effects is significantly hampered by the limitations of cross-sectional streamline tractography, where even small changes in the dMRI signal can produce drastically different trajectories and, therefore, quantitative parameterisation; if not properly dealt with, such effects will manifest as spurious longitudinal change, which can obscure subtle biological differences. To address this challenge, we here introduce a novel quantitative streamline tractography framework tailored for longitudinal analysis, wherein an individual's streamline trajectories remain fixed throughout the analysis, allowing only their ascribed density weights to vary between sessions. We present two strategies by which these quantitative streamline weights can be determined, both extensions of the widely adopted SIFT2 method. The performance of this framework is benchmarked against cross-sectional reconstruction with and without SIFT2 optimisation, in both in silico dMRI phantoms with known ground truths and three distinct human in vivo cohorts with clear a priori expectations of biological effects. We demonstrate that the proposed framework drastically reduces methodological imprecisions in synthetic dMRI phantoms and enhances statistical sensitivity and specificity to biological effects in human cohorts, enabling more robust quantification of longitudinal structural connectivity differences.