Peripheral nerve diffusion tensor imaging (DTI): normal values and demographic determinants in a cohort of 60 healthy individuals

Kronlage, Moritz; Schwehr, Véronique; Schwarz, Dániel; Godel, Tim; Uhlmann, Lorenz; Heiland, Sabine; Bendszus, Martin; Bäumer, Philipp

doi:10.1007/s00330-017-5134-z

Cited by 59 publications

(89 citation statements)

References 40 publications

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“…We observed no statistically significant association between age and the FA of the roots of the brachial plexus but this may be due to the narrow age range of participants in our study. Whilst Kronlage [47] found that MD increased with age, we found that MD was slowed by 0.03 × 10 -3 mm 2 /s with each year of life ( Fig. 5).…”

Section: Discussionmentioning

confidence: 57%

“…Specifically, we observed that the MD of the roots of the brachial plexus slowed in the 3rd and 4th decade of life, which has also been observed in the healthy senescent adult brain [46]. It is unclear why Kronlage's work differs but this might be due to discrepancies in the age range of the sample (adults in this review were aged 28-45 years versus 20-80 years in Kronlage's [47]) and aspects of the scanning because Kronlage [47] used non-isotropic voxels (4.0 mm through plane, 1.5 mm 2 in plane) which might underestimate the FA and overestimate the MD [43].…”

Section: Discussionmentioning

confidence: 61%

“…Consequently, advancing aging is typically associated with reduced FA and increased diffusivity in white matter structures [31,46]. Prior work by Kronlage et al [47] on the peripheral nerves in the forearm showed that the FA reduced with age (as in the brain [31]). We observed no statistically significant association between age and the FA of the roots of the brachial plexus but this may be due to the narrow age range of participants in our study.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta-analysis of normative values

Wade

Whittam

Teh

et al. 2020

Clin Transl Imaging

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Purpose Diffusion tensor magnetic resonance imaging (DTI) characterises tissue microstructure and provides proxy measures of myelination, axon diameter, fibre density and organisation. This may be valuable in the assessment of the roots of the brachial plexus in health and disease. Therefore, there is a need to define the normal DTI values. Methods The literature was systematically searched for studies of asymptomatic adults who underwent DTI of the brachial plexus. Participant characteristics, scanning protocols, and measurements of the fractional anisotropy (FA) and mean diffusivity (MD) of each spinal root were extracted by two independent review authors. Generalised linear modelling was used to estimate the effect of experimental conditions on the FA and MD. Meta-analysis of root-level estimates was performed using Cohen’s method with random effects. Results Nine articles, describing 316 adults (1:1 male:female) of mean age 35 years (SD 6) were included. Increments of ten diffusion sensitising gradient directions reduced the mean FA by 0.01 (95% CI 0.01, 0.03). Each year of life reduced the mean MD by 0.03 × 10–3 mm2/s (95% CI 0.01, 0.04). At 3-T, the pooled mean FA of the roots was 0.36 (95% CI 0.34, 0.38; I2 98%). The pooled mean MD of the roots was 1.51 × 10–3 mm2/s (95% CI 1.45, 1.56; I2 99%). Conclusions The FA and MD of the roots of the brachial plexus vary according to experimental conditions and participant factors. We provide summary estimates of the normative values in different conditions which may be valuable to researchers and clinicians alike.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta-analysis of normative values

Wade

Whittam

Teh

et al. 2020

Clin Transl Imaging

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“…The authors suggest the reason for this age dependency is the result of an increased RD and decreased AD as a result of axonal neuropathy and myelin sheath damage. This might also explain the absence of this correlation in our study as neuropathic changes are mostly seen in the periphery [ 61 ].…”

Section: Discussionmentioning

confidence: 93%

Diffusion tensor MRI of the healthy brachial plexus

et al. 2018

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IntroductionDiffusion Tensor MRI (DT-MRI) is a promising tool for the evaluation of brachial plexus pathology. Therefore, we introduce and evaluate a fast DT-MRI protocol (8min33s scanning with 5–10 min postprocessing time) for the brachial plexus.Materials and methodsThirty healthy volunteers within three age-groups (18–35, 36–55, and > 56) received DT-MRI of the brachial-plexus twice. Means of fractional-anisotropy (FA), mean-diffusivity (MD), axial-diffusivity (AD), and radial-diffusivity (RD) for the individual roots and trunks were evaluated. A stepwise forward approach was applied to test for correlations with age, sex, body-mass-index (BMI), bodysurface, height, and bodyweight. Within-subject, intra-rater, and inter-rater repeatability were assessed using Bland-Altman analysis, coefficient of variation (CV), intraclass-correlation (ICC), and minimal detectable difference (MDD).ResultsNo differences between sides and root levels were found. MD, AD, and RD correlated (P < 0.05) with bodyweight. Within-subject quantification proved repeatable with CVs for FA, MD, AD, and RD of 16%, 12%, 11%, and 14%, respectively.DiscussionThe DT-MRI protocol was fast and repeatable. Found correlations should be considered in future studies of brachial plexus pathology.

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“…Beyond this purely morphologic representation, functional MRN techniques, which have originally been developed for central nervous system disorders, are of increasing interest in the investigation of the peripheral nervous system (Kronlage et al, 2018; Godel et al, 2016; Godel et al, 2017; Kronlage et al, 2017). DTI is a functional and quantitative MRI technique that applies magnetic gradients in multiple orientations.…”

Section: Introductionmentioning

confidence: 99%

Diffusion tensor imaging in anterior interosseous nerve syndrome – functional MR Neurography on a fascicular level

Godel

Pham

Kele³

et al. 2019

NeuroImage: Clinical

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PurposeBy applying diffusor tensor imaging (DTI) in patients with anterior interosseous nerve syndrome (AINS), this proof of principle study aims to quantify the extent of structural damage of a peripheral nerve at the anatomical level of individual fascicles.MethodsIn this institutional review board approved prospective study 13 patients with spontaneous AINS were examined at 3 Tesla including a transversal T2-weighted turbo-spin-echo and a spin-echo echo-planar-imaging pulse sequence of the upper arm level. Calculations of quantitative DTI parameters including fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) for median nerve lesion and non-lesion fascicles as well as ulnar and radial nerve were obtained. DTI values were compared to each other and to a previously published dataset of 58 healthy controls using one-way Analysis of Variance with Bonferroni correction and p-values <.05 were considered significant. Receiver operating characteristic (ROC) curves were performed to assess diagnostic accuracy.ResultsFA of median nerve lesion fascicles was decreased compared to median nerve non-lesion fascicles, ulnar nerve and radial nerve while MD, RD, and AD was increased (p < .001 for all parameters). Compared to median nerve values of healthy controls, lesion fascicles showed a significant decrease in FA while MD, RD, and AD was increased (p < .001 for all parameters). FA of median nerve non-lesion fascicles showed a weak significant decrease compared to healthy controls (p < .01) while there was no difference in MD, RD, and AD. ROC analyses revealed an excellent diagnostic accuracy of FA, MD and RD in the discrimination of median nerve lesion and non-lesion fascicles in AINS patients as well as in the discrimination of lesion fascicles and normative median nerve values of healthy controls.ConclusionBy applying this functional MR Neurography technique in patients with AINS, this proof of principle study demonstrates that diffusion tensor imaging is feasible to quantify structural nerve injury at the anatomical level of individual fascicles.

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Peripheral nerve diffusion tensor imaging (DTI): normal values and demographic determinants in a cohort of 60 healthy individuals

Cited by 59 publications

References 40 publications

Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta-analysis of normative values

Diffusion tensor imaging of the roots of the brachial plexus: a systematic review and meta-analysis of normative values

Diffusion tensor MRI of the healthy brachial plexus

Diffusion tensor imaging in anterior interosseous nerve syndrome – functional MR Neurography on a fascicular level

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