Fractional Diffusion Research Articles

Haar wavelet based numerical technique for the solutions of fractional advection diffusion equations

Haar wavelet based numerical technique for the solutions of fractional advection diffusion equations

Executive functioning, behavior, and white matter microstructure in the chronic phase after pediatric mild traumatic brain injury: results from the adolescent brain cognitive development study.

Mild traumatic brain injury (mTBI) is common in children. Long-term cognitive and behavioral outcomes as well as underlying structural brain alterations following pediatric mTBI have yet to be determined. In addition, the effect of age-at-injury on long-term outcomes is largely unknown. Children with a history of mTBI (n = 406; Mage = 10 years, SDage = 0.63 years) who participated in the Adolescent Brain Cognitive Development (ABCD) study were matched (1:2 ratio) with typically developing children (TDC; n = 812) and orthopedic injury (OI) controls (n = 812). Task-based executive functioning, parent-rated executive functioning and emotion-regulation, and self-reported impulsivity were assessed cross-sectionally. Regression models were used to examine the effect of mTBI on these domains. The effect of age-at-injury was assessed by comparing children with their first mTBI at either 0-3, 4-7, or 8-10 years to the respective matched TDC controls. Fractional anisotropy (FA) and mean diffusivity (MD), both MRI-based measures of white matter microstructure, were compared between children with mTBI and controls. Children with a history of mTBI displayed higher parent-rated executive dysfunction, higher impulsivity, and poorer self-regulation compared to both control groups. At closer investigation, these differences to TDC were only present in one respective age-at-injury group. No alterations were found in task-based executive functioning or white matter microstructure. Findings suggest that everyday executive function, impulsivity, and emotion-regulation are affected years after pediatric mTBI. Outcomes were specific to the age at which the injury occurred, suggesting that functioning is differently affected by pediatric mTBI during vulnerable periods. Groups did not differ in white matter microstructure.

Modelling of bifacial photovoltaic farms to evaluate the profitability of East/West vertical configuration

East/West (E/W) vertical bifacial photovoltaic (PV) modules can achieve higher profits than the conventional North/South (N/S) tilted configuration depending on the design choices and external conditions. In this study a model based on 2D view factor concept is developed to estimate the power generated by a large-scale bifacial PV farm, considering the non-uniformity of the incident irradiance and the spectral impact. A validation using measured data is performed, focusing on the non-uniformity of the rear irradiance. This model is used to compare the profitability between E/W vertical and N/S tilted PV farm configurations, considering higher prices during noon with respect to morning/evening periods. The results identify the ratio between these two price values as the key variable that influences the comparison between the PV farm configurations. Specifically, a sufficiently high price ratio ensures the higher profitability of E/W vertical modules, however, the exact value is dependent on the location and the design variables. In general, higher row-to-row distance and lower diffuse fraction enhance the profitability of the E/W vertical over the N/S tilted configuration. On the other hand, elevation of the modules, curtailment strategies and hybrid solutions have a minor influence.

Cognitive Impairment Is Related to Glymphatic System Dysfunction in Pediatric Multiple Sclerosis.

The aim of this study was to investigate whether, compared to pediatric healthy controls (HCs), the glymphatic system is impaired in pediatric multiple sclerosis (MS) patients according to their cognitive status, and to assess its association with clinical disability and MRI measures of brain structural damage. Sixty-five pediatric MS patients (females = 62%; median age = 15.5 [interquartile range, IQR = 14.5;17.0] years) and 23 age- and sex-matched HCs (females = 44%; median age = 14.1 [IQR = 11.8;16.2] years) underwent neurological, neuropsychological and 3.0 Tesla MRI assessment, including conventional and diffusion tensor imaging (DTI). We calculated the diffusion along the perivascular space (DTI-ALPS) index, a proxy of glymphatic function. Cognitive impairment (Co-I) was defined as impairment in at least 2 cognitive domains. No significant differences in DTI-ALPS index were found between HCs and cognitively preserved (Co-P) pediatric MS patients (estimated mean difference [EMD] = -0.002 [95% confidence interval = -0.069; 0.065], FDR-p = 0.956). Compared to HCs and Co-P patients, Co-I pediatric MS patients (n = 20) showed significantly lower DTI-ALPS index (EMD = -0.136 [95% confidence interval = -0.214; -0.058], FDR-p ≤ 0.004). In HCs, no associations were observed between DTI-ALPS index and normalized brain, cortical and thalamic volumes, and normal-appearing white matter (NAWM) fractional anisotropy (FA) and mean diffusivity (MD) (FDR-p ≥ 0.348). In pediatric MS patients, higher brain WM lesion volume (LV), higher NAWM MD, lower normalized thalamic volume, and lower NAWM FA were associated with lower DTI-ALPS index (FDR-p ≤ 0.016). Random Forest selected lower DTI-ALPS index (relative importance [RI] = 100%), higher brain WM LV (RI = 59.5%) NAWM MD (RI = 57.1%) and intelligence quotient (RI = 51.3%) as informative predictors of cognitive impairment (out-of-bag area under the curve = 0.762). Glymphatic system dysfunction occurs in pediatric MS, is associated with brain focal lesions, irreversible tissue loss accumulation and cognitive impairment. ANN NEUROL 2024;95:1080-1092.

Sliding mode control for the stabilization of fractional heat equations subject to boundary uncertainty

By adopting the sliding mode control (SMC) and the generalized Lyapunov method, the boundary feedback stabilization issue is studied for the fractional diffusion system subject to boundary control matched disturbance. The classical sliding surface and the fractional integral sliding function are constructed and sliding mode controllers are designed respectively to realize the Mittag-Leffler (M-L) stabilization of the considered system. The controller based on the newly-introduced fractional integral sliding function not only helps to relax the constraints on the disturbance but also realizes the same stabilization effect as that of the classical one. The well-posedness result of the solution is also obtained for discontinuous fractional heat equations. Besides, a numerical experiment validates the theoretical outcomes.

Reduced cross-scanner variability using vendor-agnostic sequences for single-shell diffusion MRI.

To reduce the inter-scanner variability of diffusion MRI (dMRI) measures between scanners from different vendors by developing a vendor-neutral dMRI pulse sequence using the open-source vendor-agnostic Pulseq platform. We implemented a standard EPI based dMRI sequence in Pulseq. We tested it on two clinical scanners from different vendors (Siemens Prisma and GE Premier), systematically evaluating and comparing the within- and inter-scanner variability across the vendors, using both the vendor-provided and Pulseq dMRI sequences. Assessments covered both a diffusion phantom and three human subjects, using standard error (SE) and Lin's concordance correlation to measure the repeatability and reproducibility of standard DTI metrics including fractional anisotropy (FA) and mean diffusivity (MD). Identical dMRI sequences were executed on both scanners using Pulseq. On the phantom, the Pulseq sequence showed more than a 2.5× reduction in SE (variability) across Siemens and GE scanners. Furthermore, Pulseq sequences exhibited markedly reduced SE in-vivo, maintaining scan-rescan repeatability while delivering lower variability in FA and MD (more than 50% reduction in cortical/subcortical regions) compared to vendor-provided sequences. The Pulseq diffusion sequence reduces the cross-scanner variability for both phantom and in-vivo data, which will benefit multi-center neuroimaging studies and improve the reproducibility of neuroimaging studies.

Microstructural abnormality of white matter tracts in rheumatoid arthritis

BackgroundStructural and functional brain imaging studies have reported abnormalities of gray matter morphology and functional activities in patients with rheumatoid arthritis (RA). However, it is largely unknown whether patients with RA show alterations of white matter microstructural organization. ObjectivesTo automatically identify alteration of white matter microstructure in patients with RA and further examine how this alteration associates with clinical characteristics. MethodsThis single-institutional prospective study included 66 participants (33 patients with RA [52 ± 9 years, 29 women] and 33 sex/age-matched healthy controls [53 ± 12 years, 27 women]), who underwent diffusion MRI scan from January 2021 to December 2021. The white matter microstructure was assessed using fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity. Voxelwise analyses were conducted on white matter skeleton using an automated, observer-independent tract-based spatial statistics analysis. The relationship between white matter microstructural alterations and clinical and neuropsychological variables was evaluated using correlation analysis. ResultsCompared with healthy controls, patients with RA exhibited lower fractional anisotropy in several major white matter tracts (threshold-free cluster enhancement at P < 0.05 for multiple comparison correction, permutation test), involving the forceps minor, bilateral inferior fronto-occipital fasciculus, bilateral anterior thalamic radiation, and bilateral uncinate fasciculus. Lower fractional anisotropy values in the patients with RA were significantly associated with pain-related assessments, including tender joint count (r = -0.43, P = 0.015), Clinical Disease Activity Index score (r = -0.36, P = 0.049), pain severity rated through visual analogue scale (r = -0.45, P = 0.012), and Simplified Disease Activity Index score (r = -0.36, P = 0.045). No significant group difference was found in mean diffusivity, axial diffusivity, and radial diffusivity. ConclusionsWe report the first anatomical evidence for aberrant microstructure organization of several major white matter tracts and its associations with pain processing in patients with rheumatoid arthritis.

Diffusion tensor imaging within the healthy cervical spinal cord: Within- participants reliability and measurement error

BackgroundDiffusion tensor imaging (DTI) is a promising technique for the visualization of the cervical spinal cord (CSC) in vivo. It provides information about the tissue structure of axonal white matter, and it is thought to be more sensitive than other MR imaging techniques for the evaluation of damage to tracts in the spinal cord. AimThe purpose of this study was to determine the within-participants reliability and error magnitude of measurements of DTI metrics in healthy human CSC. MethodsA total of twenty healthy controls (10 male, mean age: 33.9 ± 3.5 years, 10 females, mean age: 47.5 ± 14.4 years), with no family history of any neurological disorders or a contraindication to MRI scanning were recruited over a period of two months. Each participant was scanned twice with an MRI 3 T scanner using standard DTI sequences. Spinal Cord Toolbox (SCT) software was used for image post-processing. Data were first corrected for motion artefact, then segmented, registered to a template, and then the DTI metrics were computed. The within-participants coefficients of variation (CV%), the single and average within-participants intraclass correlation coefficients (ICC) and Bland-Altman plots for WM, VC, DC and LC fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) were determined for the cervical spinal cord (between the 2nd and 5th cervical vertebrae). ResultsDTI metrics showed poor to excellent within-participants reliability for both single and average ICC and moderate to high reproducibility for CV%, all variation dependent on the location of the ROI. The BA plots showed good within-participants agreement between the scan-rescan values. ConclusionResults from this reliability study demonstrate that clinical trials using the DTI technique are feasible and that DTI, in particular regions of the cord is suitable for use for the monitoring of degenerative WM changes.

Structural disconnectivity in postoperative delirium: A perioperative two-center cohort study in older patients.

Structural disconnectivity was found to precede dementia. Global white matter abnormalities might also be associated with postoperative delirium (POD). We recruited older patients (≥65 years) without dementia that were scheduled for major surgery. Diffusion kurtosis imaging metrics were obtained preoperatively, after 3 and 12 months postoperatively. We calculated fractional anisotropy (FA), mean diffusivity (MD), mean kurtosis (MK), and free water (FW). A structured and validated delirium assessment was performed twice daily. Of 325 patients, 53 patients developed POD (16.3%). Preoperative global MD (standardized beta 0.27 [95% confidence interval [CI] 0.21-0.32] p<0.001) was higher in patients with POD. Preoperative global MK (-0.07 [95% CI -0.11 to (-0.04)] p<0.001) and FA (0.07 [95% CI -0.10 to (-0.04)] p<0.001) were lower. When correcting for baseline diffusion, postoperative MD was lower after 3 months (0.05 [95% CI -0.08 to (-0.03)] p<0.001; n = 183) and higher after 12 months (0.28 [95% CI 0.20-0.35] p<0.001; n = 45) among patients with POD. Preoperative structural disconnectivity was associated with POD. POD might lead to white matter depletion 3 and 12 months after surgery.

Midpoint splitting methods for nonlinear space fractional diffusion equations

We propose a midpoint splitting method to solve nonlinear space fractional diffusion equations. We first discretize the equation in space using the weighted and shifted Grünwald difference (WSGD) operators. Then, we obtain the fully discrete scheme of the equation using the midpoint splitting method, which can alleviate computational costs and mitigate instability issues that may arise. We establish the stability result of the fully discrete scheme under certain conditions. Finally, we demonstrate its feasibility and efficiency through numerical examples.

An $$\alpha $$-robust analysis of finite element method for space-time fractional diffusion equation

An $$\alpha $$-robust analysis of finite element method for space-time fractional diffusion equation

Numerical solution of two-dimensional fractional differential equations using Laplace transform with residual power series method

Abstract One of the efficient and reliable methods for resolving fractional order linear as well as non-linear differential equations is the Laplace transform with residual power series method. This approach is used in the current research to obtain the numerical solutions of the two-dimensional fractional differential equations, namely, the temporal fractional order diffusion equation and the fractional biological population equation. The unknown coefficients of the series solutions to these equations are determined using the proposed approach. The difference between exact and analytical-numerical solutions is presented for these equations in the form of errors. The advantage of the suggested method over alternative approaches is that it requires less computation to solve these two-dimensional differential equations of time-fractional order.

The cognitive relevance of non-lesional damage to cortical networks in people with multiple sclerosis.

Cognitive impairment, a common and debilitating symptom in people with multiple sclerosis (MS), is especially related to cortical damage. However, the impact of regional cortical damage remains poorly understood. Our aim was to evaluate structural (network) integrity in lesional and non-lesional cortex in people with MS, and its relationship with cognitive dysfunction. In this cross-sectional study, 176 people with MS and 48 healthy controls underwent MRI, including double inversion recovery and diffusion-weighted scans, and neuropsychological assessment. Cortical integrity was assessed based on fractional anisotropy (FA) and mean diffusivity (MD) within 212 regions split into lesional or non-lesional cortex, and grouped into seven cortical networks. Integrity was compared between people with MS and controls, and across cognitive groups: cognitively-impaired (CI; ≥ two domains at Z ≤ -2 below controls), mildly CI (≥ two at -2 < Z ≤ -1.5), or cognitively-preserved (CP). Cortical lesions were observed in 87.5% of people with MS, mainly in ventral attention network, followed by limbic and default mode networks. Compared to controls, in non-lesional cortex, MD was increased in people with MS, but mean FA did not differ. Within the same individual, MD and FA were increased in lesional compared to non-lesional cortex. CI-MS exhibited higher MD than CP-MS in non-lesional cortex of default mode, frontoparietal and sensorimotor networks, of which the default mode network could best explain cognitive performance. Diffusion differences in lesional cortex were more severe than in non-lesional cortex. However, while most people with MS had cortical lesions, diffusion differences in CI-MS were more prominent in non-lesional cortex than lesional cortex, especially within default mode, frontoparietal and sensorimotor networks.

Exact Solutions for a Class of Variable Coefficients Fractional Differential Equations Using Mellin Transform and the Invariant Subspace Method

AbstractIn this paper, we propose a class of variable coefficients fractional ordinary differential equations (FODEs). Using Mellin transform (MT), we have transformed this class into a functional equation which can’t be solved in general. So, we have selected many special cases of this functional equation that can be solved exactly. After solving these special cases of the functional equation and using the inverse MT, we obtained some exact solutions for the proposed class. The obtained solutions are given in the form of $$H$$ H -function and the Wright function. The results, as special cases, contain some special forms given in the literature. Also, the invariant subspace method (ISM) is utilized for solving a class of nonlinear fractional diffusion equations with variable coefficients. The solutions of this class of nonlinear fractional diffusion equations depend upon the solutions of the proposed class of FODEs.

Diffusion tractography of kidney by high angular resolution diffusion imaging

Diffusion magnetic resonance imaging (MRI) has been utilized to probe the renal microstructures but investigating the three-dimensional (3D) tubular network still presents significant challenges due to the complicated architecture of kidney. This study aims to assess whether high angular resolution diffusion imaging (HARDI) could improve the reconstruction of 3D tubular architectures. Kidneys from both mice and rats were imaged using 3D diffusion-weighted pulse sequences at 9.4 T. Five healthy mouse kidneys were scanned at an isotropic spatial resolution of 40 μm, with a b value of 1500 s/mm2 across 46 diffusion encoding directions. The study employed diffusion tensor imaging (DTI) and generalized Q-sampling imaging (GQI) to examine the tubular orientation distributions and tractography, validated by conventional histology. Fractional anisotropy (FA) and mean diffusivity (MD) were quantified and compared among the inner medullar (IM), outer medullar (OM), and cortex (CO) at different angular resolutions. FA values, estimated with 6 diffusion-weighted images (DWIs), were significantly overestimated by 49.9% (p < 0.001) in IM, 179.4% (p < 0.001) in OM, and 225.5% (p < 0.001) in CO, compared to using 46 DWIs. In contrast, MD exhibited less variations to angular resolution variations (3.4% in IM, 4.2% in OM, and 4.6% in CO). Both DTI and GQI at high angular resolution successfully traced renal tubular structures throughout the kidney, with GQI demonstrating superior performance in generating more continuous tracts. Furthermore, disrupted renal tubule structures were observed in a chronic kidney disease (CKD) rat model. HARDI, especially when combined with the GQI approach, holds promise in tracking complicated 3D tubule architectures and may serve as a potent tool for kidney disease research.

Empirical assessment of the assumptions of ComBat with diffusion tensor imaging.

Diffusion tensor imaging (DTI) is a magnetic resonance imaging technique that provides unique information about white matter microstructure in the brain but is susceptible to confounding effects introduced by scanner or acquisition differences. ComBat is a leading approach for addressing these site biases. However, despite its frequent use for harmonization, ComBat's robustness toward site dissimilarities and overall cohort size have not yet been evaluated in terms of DTI. As a baseline, we match participants from two sites to create a "silver standard" that simulates a cohort for multi-site harmonization. Across sites, we harmonize mean fractional anisotropy and mean diffusivity, calculated using participant DTI data, for the regions of interest defined by the JHU EVE-Type III atlas. We bootstrap 10 iterations at 19 levels of total sample size, 10 levels of sample size imbalance between sites, and 6 levels of mean age difference between sites to quantify (i), the linear regression coefficient of the relationship between FA and age; (ii), the ComBat-estimated site-shift; and (iii), the ComBat-estimated site-scaling. We characterize the reliability of ComBat by evaluating the root mean squared error in these three metrics and examine if there is a correlation between the reliability of ComBat and a violation of assumptions. ComBat remains well behaved for when and when the mean age difference is less than 4 years. The assumptions of the ComBat model regarding the normality of residual distributions are not violated as the model becomes unstable. Prior to harmonization of DTI data with ComBat, the input cohort should be examined for size and covariate distributions of each site. Direct assessment of residual distributions is less informative on stability than bootstrap analysis. We caution use ComBat of in situations that do not conform to the above thresholds.

Helicobacter pylori, persistent infection burden and structural brain imaging markers.

Persistent infections, whether viral, bacterial or parasitic, including Helicobacter pylori infection, have been implicated in non-communicable diseases, including dementia and other neurodegenerative diseases. In this cross-sectional study, data on 635 cognitively normal participants from the UK Biobank study (2006-21, age range: 40-70 years) were used to examine whether H. pylori seropositivity (e.g. presence of antibodies), serointensities of five H. pylori antigens and a measure of total persistent infection burden were associated with selected brain volumetric structural MRI (total, white, grey matter, frontal grey matter (left/right), white matter hyperintensity as percent intracranial volume and bi-lateral sub-cortical volumes) and diffusion-weighted MRI measures (global and tract-specific bi-lateral fractional anisotropy and mean diffusivity), after an average 9-10 years of lag time. Persistent infection burden was calculated as a cumulative score of seropositivity for over 20 different pathogens. Multivariable-adjusted linear regression analyses were conducted, whereby selected potential confounders (all measures) and intracranial volume (sub-cortical volumes) were adjusted, with stratification by Alzheimer's disease polygenic risk score tertile when exposures were H. pylori antigen serointensities. Type I error was adjusted to 0.007. We report little evidence of an association between H. pylori seropositivity and persistent infection burden with various volumetric outcomes (P > 0.007, from multivariable regression models), unlike previously reported in past research. However, H. pylori antigen serointensities, particularly immunoglobulin G against the vacuolating cytotoxin A, GroEL and outer membrane protein antigens, were associated with poorer tract-specific white matter integrity (P < 0.007), with outer membrane protein serointensity linked to worse outcomes in cognition-related tracts such as the external capsule, the anterior limb of the internal capsule and the cingulum, specifically at low Alzheimer's disease polygenic risk. Vacuolating cytotoxin A serointensity was associated with greater white matter hyperintensity volume among individuals with mid-level Alzheimer's disease polygenic risk, while among individuals with the highest Alzheimer's disease polygenic risk, the urease serointensity was consistently associated with reduced bi-lateral caudate volumes and the vacuolating cytotoxin A serointensity was linked to reduced right putamen volume (P < 0.007). Outer membrane protein and urease were associated with larger sub-cortical volumes (e.g. left putamen and right nucleus accumbens) at middle Alzheimer's disease polygenic risk levels (P < 0.007). Our results shed light on the relationship between H. pylori seropositivity, H. pylori antigen levels and persistent infection burden with brain volumetric structural measures. These data are important given the links between infectious agents and neurodegenerative diseases, including Alzheimer's disease, and can be used for the development of drugs and preventive interventions that would reduce the burden of those diseases.

Histologic tau lesions and magnetic resonance imaging biomarkers differ across two progressive supranuclear palsy variants.

Progressive supranuclear palsy is a neurodegenerative disease characterized by the deposition of four-repeat tau in neuronal and glial lesions in the brainstem, cerebellar, subcortical and cortical brain regions. There are varying clinical presentations of progressive supranuclear palsy with different neuroimaging signatures, presumed to be due to different topographical distributions and burden of tau. The classic Richardson syndrome presentation is considered a subcortical variant, whilst progressive supranuclear palsy with predominant speech and language impairment is considered a cortical variant, although the pathological underpinnings of these variants are unclear. In this case-control study, we aimed to determine whether patterns of regional tau pathology differed between these variants and whether tau burden correlated with neuroimaging. Thirty-three neuropathologically confirmed progressive supranuclear palsy patients with either the Richardson syndrome (n = 17) or speech/language (n = 16) variant and ante-mortem magnetic resonance imaging were included. Tau lesion burden was semi-quantitatively graded in cerebellar, brainstem, subcortical and cortical regions and combined to form neuronal and glial tau scores. Regional magnetic resonance imaging volumes were converted to Z-scores using 33 age- and sex-matched controls. Diffusion tensor imaging metrics, including fractional anisotropy and mean diffusivity, were calculated. Tau burden and neuroimaging metrics were compared between groups and correlated using linear regression models. Neuronal and glial tau burden were higher in motor and superior frontal cortices in the speech/language variant. In the subcortical and brainstem regions, only the glial tau burden differed, with a higher burden in globus pallidus, subthalamic nucleus, substantia nigra and red nucleus in Richardson's syndrome. No differences were observed in the cerebellar dentate and striatum. Greater volume loss was observed in the motor cortex in the speech/language variant and in the subthalamic nucleus, red nucleus and midbrain in Richardson's syndrome. Fractional anisotropy was lower in the midbrain and superior cerebellar peduncle in Richardson's syndrome. Mean diffusivity was greater in the superior frontal cortex in the speech/language variant and midbrain in Richardson's syndrome. Neuronal tau burden showed associations with volume loss, lower fractional anisotropy and higher mean diffusivity in the superior frontal cortex, although these findings did not survive correction for multiple comparisons. Results suggest that a shift in the distribution of tau, particularly neuronal tau, within the progressive supranuclear palsy network of regions is driving different clinical presentations in progressive supranuclear palsy. The possibility of different disease epicentres in these clinical variants has potential implications for the use of imaging biomarkers in progressive supranuclear palsy.

Existence of solutions to a nonlinear fractional diffusion equation with exponential growth

In this paper, we study a Cauchy problem for a space–time fractional diffusion equation with exponential nonlinearity. Based on the standard Lp-Lq estimates of strongly continuous semigroup generated by fractional Laplace operator, we investigate the existence of global solutions for initial data with small norm in Orlicz space exp Lp(Rd) and a time weighted Lr(Rd) space. In the framework of the Hölder interpolation inequality, we also discuss the existence of local solutions without the Orlicz space.

Exploring subtypes of multiple sclerosis through unsupervised machine learning of automated fiber quantification.

This study aimed to subtype multiple sclerosis (MS) patients using unsupervised machine learning on white matter (WM) fiber tracts and investigate the implications for cognitive function and disability outcomes. We utilized the automated fiber quantification (AFQ) method to extract 18 WM fiber tracts from the imaging data of 103 MS patients in total. Unsupervised machine learning techniques were applied to conduct cluster analysis and identify distinct subtypes. Clinical and diffusion tensor imaging (DTI) metrics were compared among the subtypes, and survival analysis was conducted to examine disability progression and cognitive impairment. The clustering analysis revealed three distinct subtypes with variations in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). Significant differences were observed in clinical and DTI metrics among the subtypes. Subtype 3 showed the fastest disability progression and cognitive decline, while Subtype 2 exhibited a slower rate, and Subtype 1 fell in between. Subtyping MS based on WM fiber tracts using unsupervised machine learning identified distinct subtypes with significant cognitive and disability differences. WM abnormalities may serve as biomarkers for predicting disease outcomes, enabling personalized treatment strategies and prognostic predictions for MS patients.