Assessing brain injury topographically using MR neurite orientation dispersion and density imaging in multiple sclerosis

Abstract

Background and Purpose Axonal injury is a key player of disability in persons with multiple sclerosis (pwMS). Yet, detecting and measuring it in vivo is challenging. The neurite orientation dispersion and density imaging (NODDI) proposes a novel framework for probing axonal integrity in vivo. NODDI at 3.0 Tesla was used to quantify tissue damage in pwMS and its relationship with disease progression. Methods Eighteen pwMS (4 clinically isolated syndrome, 11 relapsing remitting, and 3 secondary progressive MS) and nine age‐ and sex‐matched healthy controls underwent a brain MRI, inclusive of clinical sequences and a multi‐shell diffusion acquisition. Parametric maps of axial diffusivity (AD), neurite density index (ndi), apparent isotropic volume fraction (ivf), and orientation dispersion index (odi) were fitted. Anatomically matched regions of interest were used to quantify AD and NODDI‐derived metrics and to assess the relations between these measures and those of disease progression. Results AD, ndi, ivf, and odi significantly differed between chronic black holes (cBHs) and T2‐lesions, and between the latter and normal appearing white matter (NAWM). All metrics except ivf significantly differed between NAWM located next to a cBH and that situated contra‐laterally. Only NAWM odi was significantly associated with T2‐lesion volume, the timed 25‐foot walk test and disease duration. Conclusions NODDI is sensitive to tissue injury but its relationship with clinical progression remains limited.

Neurite Orientation Dispersion and Density Imaging in Multiple Sclerosis: A Systematic Review

“…One study even indicated comparable ODI values in MS WM lesions and NWM of controls 43 . Similar incongruent results were observed when investigating ODI in WM lesions compared to NAWM 16,18,30 . Moreover, ODI showed heterogeneity when comparing the NAWM of patients and the NWM of HC.…”

“…Studies also reported reduced NDI values in MS NAWM compared to WM in HC. These findings suggest an overall NDI reduction in WM tissues and lesions in MS, 16,26,28,30,32,36,37,40,41 although two independent studies reported null NDI effects between MS and control cohorts 18,31 …”

“…Participants were age‐matched in four studies, 24,28,37,39 sex‐matched in one study 36 . Meanwhile, 15 studies controlled for both age and gender 16,18,23,26,27,29–31,33–35,40–43 …”

“…They reported that NODDI values are more sensitive to MS changes and can detect abnormalities in brain regions exhibiting normal FA distributions 16,17 . Despite these promising results, it is still unclear whether NODDI represents a suitable technique to detect consistent MS alterations 18 . Recently, Alotaibi et al performed a systematic review of NODDI findings in MS, including only seven studies 13 .…”

Transcallosal and Corticospinal White Matter Disease and Its Association With Motor Impairment in Multiple Sclerosis

“…However, NODDI-clinical correlations have found to be inconsistent thus far ( 6 ). We have also shown that the NODDI-derived metrics do not improve these correlations when compared with the DTI-derived axial diffusivity (AD) ( 7 ).…”