Neural diffusion tensor imaging metrics correlate with clinical measures in people with relapsing-remitting MS

Abstract

Background and purpose Diffusion tensor imaging (DTI) can detect microstructural changes of white matter in multiple sclerosis (MS) and might clarify mechanisms responsible for disability. Thus, we aimed to compare DTI metrics in relapsing-remitting MS patients (RRMS) with healthy controls (HCs), and explore the correlations between DTI metrics, total brain white matter (TBWM) and white matter lesion (WML) with clinical parameters compared to volumetric measures. Material and methods 37 RRMS patients and 19 age/sex-matched HCs were included. All participants had clinical assessments, structural and diffusion scans on a 3T MRI. Volumetric and white matter DTI metrics; fractional anisotropy (FA), mean, radial and axial diffusivities (MD, RD and AD) were estimated and correlated with clinical parameters. The mean group differences were calculated using t-tests, and univariate correlations with Pearson correlation coefficients. Results Compared to HCs, statistically significant increases in MD (+3.6%), RD (+4.8%), AD (+2.7%) and a decrease in FA (−4.3%) for TBWM in RRMS was observed ( p < .01). MD and RD in TBWM and AD in WML correlated moderately with disability status. Volumetric segmentation indicated a decrease in the total brain volume, GM and WM(−5%) with a reciprocal increase in CSF(+26%) in RRMS( p < .01). Importantly, DTI parameters showed a medium correlation with cognitive domains in contrast to white matter-related volumetric measurements in RRMS(Pearson correlation, p < .05). Conclusions Our study shows a correlation of DTI metrics with clinical symptoms of MS, in particular cognition. More generally, these findings indicated that DTI is a useful and unique technique for evaluating the clinical features of white matter disease and warrants further investigation into its clinical role.

Stability of longitudinal DTI metrics in MS with treatment of injectables, fingolimod and dimethyl fumarate

“…The major findings of this study highlight a marked reduction of FA and significantly increased diffusivities in NAWM and WML of people with RRMS compared to HCs, even after controlling for age and other covariates. This is in concordance with our previous findings in a subset of this group 20 and other studies 21 However, while this finding persists over time, DTI parameters do not change significantly faster in pw-RRMS than HCs when stable on DMTs. This indicates that decreases in FA and AD over time (and increases in RD and MD) for both groups likely reflect ageing processes 22 or variance inherent in test-retest studies of DTI.…”

Brain connectivity changes underlying depression and fatigue in relapsing-remitting multiple sclerosis: a systematic review

“…Fifteen studies were identified that evaluated the relationship between fatigue and dMRI measures, all of which used DTI and one used HARDI [139]. Seven out of fifteen studies did not report any significant findings (Table 1) [66, 105, 108, 110, 138, 139, 150] and 8/15 found significant associations (Tables 1 and 3).…”

“…The remaining 5/11 studies either controlled for fatigue status [29, 47, 101] or included fatigue as a covariate or a clinical symptom of no interest [98, 99]. Of the 41 publications reporting results of MRI measures in relation to fatigue only , 29/41 included depression assessments [35, 104–107, 109, 110, 114–119, 122–124, 126–131, 146–151], with 14/29 excluding participants with high depression scores [35, 104, 105, 110, 114, 117–119, 122, 124, 126, 127, 129, 131] and 10/29 controlling for depression status [106, 107, 109, 123, 128, 130, 145, 146, 150, 151], or both (5/29) [115, 116, 147–149].…”

Editorial for “A Fully‐Automatic Method to Segment Choroid Plexuses in Multiple Sclerosis Using Conventional MRI Sequences”

“…1,2 These inflammatory changes in MS patients are associated with CP enlargement, which is linked to a poorer pathophysiological progression, higher Expanded Disability Status Scale score, increased relapse rate, and worsening of clinical disability. 3,4 The research community has invested significant efforts in developing and validating imaging segmentation techniques in MS. 5,6 Despite manual segmentation being considered the gold standard for CP segmentation, it poses several challenges, including time-consuming procedures and intra-and inter-rater variability. 7 Notably, developing automatic methods for CP segmentation is crucial to study these structures on large cohorts of subjects.…”

“…Inflammatory changes within choroid plexuses (CPs) have been evidenced in multiple sclerosis (MS) 1,2 . These inflammatory changes in MS patients are associated with CP enlargement, which is linked to a poorer pathophysiological progression, higher Expanded Disability Status Scale score, increased relapse rate, and worsening of clinical disability 3,4 …”