Fractional Anisotropy Values In Patients Research Articles

Applicability of automated tractography during acute care stroke rehabilitation.

[Purpose] To assess the clinical applicability of a novel automated tractography tool named XTRACT during acute stroke rehabilitation. [Participants and Methods] Three patients with left hemisphere stroke were sampled. Diffusion tensor images were acquired on the second week, and automated tractography was then applied. Tractography images and fractional anisotropy (FA) values in the corticospinal tract (CST) and arcuate fasciculus (AF) were assessed in relation to hemiparesis and aphasia. [Results] Patient 1 was nearly asymptomatic; FA in the left CST was 0.610 and that in the AF was 0.509. Patient 2 had severe hemiparesis and mild motor aphasia. Tractography images of the CST and AF were blurred; FA in the left CST was 0.295 and that in the AF was 0.304. Patient 3 showed no hemiparesis or aphasia at initial assessment. Tractography image of the CST was intact but that of the AF was less clear; FA in the left CST was 0.586 and that in the AF was 0.338. Considering the less clear images of the AF and lower FA value in Patients 2 and 3, further examinations for aphasia were performed, which revealed agraphia. [Conclusion] Visualization and quantification of neural fibers using automated tractography promoted planning acute care rehabilitative treatment in patients with stroke.

Imaging Parameters of the Ipsilateral Medial Geniculate Body May Predict Prognosis of Patients with Idiopathic Unilateral Sudden Sensorineural Hearing Loss on the Basis of Diffusion Spectrum Imaging.

Idiopathic sudden sensorineural hearing loss is an acute unexplained onset of hearing loss. We examined the central auditory pathway abnormalities in patients with unilateral idiopathic sudden sensorineural hearing loss using diffusion spectrum imaging and the relationships between hearing recovery and diffusion spectrum imaging parameters. Forty-eight patients with unilateral idiopathic sudden sensorineural hearing loss with a duration of ≤2 weeks (range, 8.9 ± 4.3 days) and 20 healthy subjects underwent diffusion spectrum imaging tractography. Hearing levels were evaluated using a pure-tone average at initial presentation and 3-month follow-up. Clinical characteristics and MR imaging findings were assessed. Compared with healthy control subjects, the generalized fractional anisotropy values of patients decreased significantly in the bilateral posterior limbs of the internal capsule, with no differences between the ipsilateral and contralateral sides. The quantitative anisotropy values decreased in the Brodmann area 41, contralateral medial geniculate body, bilateral lateral lemniscus, anterior limb of internal capsule, middle temporal gyrus, and anterior corona radiata. Furthermore, at 3-month follow-up, 14 patients had <15 dB of hearing gain. Receiver operating characteristic curve analysis demonstrated that generalized fractional anisotropy in the ipsilateral medial geniculate body was related to prognosis (sensitivity = 64.7%; specificity = 85.7%; area under the curve = 0.796, 95% CI, 0.661-0.931; P < .01). Diffusion spectrum imaging can detect abnormalities of white matter microstructure along the central auditory pathway in patients with unilateral idiopathic sudden sensorineural hearing loss. The generalized fractional anisotropy value of the ipsilateral medial geniculate body may help to predict recovery outcomes.

Lateral Medullary Syndrome Following Injury of Lateral Vestibulospinal Tract: Diffusion Tensor Imaging Study

BackgroundUnilateral lesions of vestibular nucleus can cause lateral medullary syndrome. Little is known about injury of medial and lateral vestibulospinal tract (VST) after dorsolateral medullary infarct. We investigated injury of the lateral VST in patients with typical central vestibular disorder using diffusion tensor tractography (DTT). MethodsSeven patients with lateral medullary syndrome and ten control subjects were recruited. For the medial VST, we determined seed region of interest (ROI) as medial vestibular nuclei of pons and target ROI on posteromedial medulla. For the lateral VST, the seed ROI was placed on lateral vestibular nuclei of pons, and the target ROI on posterolateral medulla. Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. ResultReconstructed lateral VST on both sides had significantly lower FA values in patients than controls (p<0.05). Tract volume of lateral VST in affected side was significantly lower than unaffected side and control group (p<0.05). However, no DTI parameters of the medial VST differed between patients and controls (p>0.05). ConclusionInjury of the lateral VST was demonstrated in patients with lateral vestibular syndrome following dorsolateral medullary infarct. Analysis of the lateral VST using DTT would be helpful in evaluation of patients with lateral medullary syndrome.

Decreased Value of Highly Accurate Fractional Anisotropy Using 3-Tesla ZOOM Diffusion Tensor Imaging After Decompressive Surgery in Patients with Cervical Spondylotic Myelopathy: Aligned Fibers Effect

BackgroundDiffusion tensor imaging (DTI) is widely used; however, most of the prior studies have resulted in presurgical decreased fractional anisotropy (FA) values in patients with cervical spondylotic myelopathy (CSM). We used ZOOM DTI and could acquire highly accurate FA values during perioperative periods, which indicated different insights than preceding studies. The objective of this study was to assess the perioperative FA change in patients with CSM and determine the prognostic factor.MethodsTwenty-eight patients with CSM and healthy control subjects were enrolled in this study. Twenty patients (71%) had intracordal high intensity before surgery. All patients underwent decompressive surgery. ZOOM DTI and the Japanese Orthopaedic Association (JOA) assessment were performed before and after surgery. The region of interest was manually contoured to omit the surrounding cerebrospinal fluid. The axial plane of the most stenotic cervical level was assessed.ResultsFA values before surgery and at 1 week after surgery, and FA values at 1 week after surgery and at 6 months after surgery differed significantly as determined. The FA values of patients with intracordal high intensity significantly decreased after surgery and significantly increased from 1 week to 6 months, whereas those of patients without intracordal high intensity did not significantly change. JOA scores at 6 months after surgery (13.1) improved significantly compared with JOA scores before surgery (10.8). Only FA values at 1 week after surgery had a significant positive relationship with JOA scores presurgery and at 6 months after surgery.ConclusionsThe presurgical FA value in patients with CSM did not differ from that of normal control subjects, but significantly decreased after surgery, and significantly increased 6 months after surgery. We concluded that the postsurgical FA value approximates the proper state of the damaged cord and the presurgical FA value includes a masked effect as an aligned fiber effect because of compression by degenerative construction. Only the FA value at 1 week had a significant positive relationship with the JOA score presugery and at 6 months, which established that the postsurgical FA value may be a more accurate prognostic factor than the presurgical FA value.

Analysis of radiological parameters associated with decreased fractional anisotropy values on diffusion tensor imaging in patients with lumbar spinal stenosis

Previous studies have indicated that decreased fractional anisotropy (FA) values on diffusion tensor imaging (DTI) are well correlated with the symptoms of nerve root compression. The aim of our study is to determine primary radiological parameters associated with decreased FA values in patients with lumbar spinal stenosis involving single L5 nerve root. Patients confirmed with single L5 nerve root compression by transforaminal nerve root blocks were included in this study. FA values of L5 nerve roots on both symptomatic and asymptomatic side were obtained. Conventional radiological parameters, such as disc height, degenerative scoliosis, dural sac cross-sectional area (DSCSA), foraminal height (FH), hypertrophic facet joint degeneration (HFJD), sagittal rotation (SR), sedimentation sign, sagittal translation and traction spur were measured. Correlation and regression analyses were performed between the radiological parameters and FA values of the symptomatic L5 nerve roots. A predictive regression equation was established. Twenty-one patients were included in this study. FA values were significantly lower at the symptomatic side comparing to the asymptomatic side (0.263 ± 0.069 vs. 0.334 ± 0.080, P = 0.038). DSCSA, FH, HFJD, and SR were significantly correlated with the decreased FA values, with r = 0.518, 0.443, 0.472 and - 0.910, respectively (P < 0.05). DSCSA and SR were found to be the primary radiological parameters related to the decreased FA values, and the regression equation is FA = - 0.012 × SR + 0.002 × DSCSA. DSCSA and SR were primary contributors to decreased FA values in LSS patients involving single L5 nerve root, indicating that central canal decompression and segmental stability should be the first considerations in preoperative planning of these patients. These slides can be retrieved under Electronic Supplementary Material.

Reduced Field-of-View Diffusion Tensor Imaging of the Spinal Cord Shows Motor Dysfunction of the Lower Extremities in Patients With Cervical Compression Myelopathy.

A cross-sectional study. The aim of this study was to quantify spinal cord dysfunction at the tract level in patients with cervical compressive myelopathy (CCM) using reduced field-of-view (rFOV) diffusion tensor imaging (DTI). Although magnetic resonance imaging (MRI) is the standard used for radiological evaluation of CCM, information acquired by MRI does not necessarily reflect the severity of spinal cord disorder. There is a growing interest in developing imaging methods to quantify spinal cord dysfunction. To acquire high-resolution DTI, a new scheme using rFOV has been proposed. We enrolled 10 healthy volunteers and 20 patients with CCM in this study. The participants were studied using a 3.0-T MRI system. For DTI acquisitions, diffusion-weighted spin-echo rFOV single-shot echo-planar imaging was used. Regions-of-interest (ROI) for the lateral column (LC) and posterior column (PC) tracts were determined on the basis of a map of fractional anisotropy (FA) of the spinal cord and FA values were measured. The FA of patients with CCM was compared with that of healthy controls and correlated with Japanese Orthopaedic Association (JOA) score. In LC and PC tracts, FA values in patients with CCM were significantly lower than in healthy volunteers. Total JOA scores correlated moderately with FA in LC and PC tracts. JOA subscores for motor dysfunction of the lower extremities correlated strongly with FA in LC and PC tracts. It is feasible to evaluate the cervical spinal cord at the tract level using rFOV DTI. Although FA values at the maximum compression level were not well correlated with total JOA scores, they were strongly correlated with JOA subscores for motor dysfunction of the lower extremities. Our findings suggest that FA reflects white matter dysfunction below the maximum compression level and FA can be used as an imaging biomarker of spinal cord dysfunction. 4.

Application of diffusion tensor imaging in prognosis evaluation in patients with moderate and severe diffuse axonal injury

Objective To investigate the application of diffusion tensor imaging (DTI) in evaluating prognosis of patients with moderate and severe diffuse axonal injury (DAI). Methods A prospective cohort study was made on 35 patients with moderate and severe DAI, who were enrolled from June 2013 to December 2015 as study group. There were 21 males and 14 females, with age of (55.1±11.6) years. The Glasgow coma scale (GCS) was (8.2±2.9)points on admission. Moderate DAI was seen in 20 patients and severe DAI in 15 patients. Other 15 healthy volunteers were selected as control group. Fractional anisotropy (FA) was measured by DTI in three areas of interests as follows: the corpus callosum, thalamus, and brainstem areas. Glasgow outcome scale (GOS) was adopted to assess the prognosis of DAI patients at 6 months after the injury. The FA values of the three areas between study group and control group as well as FA values of patients when they were admitted to hospital and 6 months after injury were measured. In this way, the relationship between the FA values of different areas of interests in DAI patients on admission and the prognosis 6 months after injury was analyzed. Results The FA values of the corpus callosum, thalamus and brainstem area in study group were all lower than those in control group (P<0.05). Further, FA values of the corpus callosum, thalamus, brainstem area in severe DAI patients were lower than those of moderate DAI patients (P<0.05). FA values of the corpus callosum, thalamus, brain stem areas in DAI patients at 6 months after injury were lower than those of corresponding areas when DAI patients were admitted to hospital (P<0.05). FA values of the corpus callosum, thalamus and brain stem on admission were significantly positively correlated with GOS at 6 months after injury (P<0.05). Conclusions Lower FA values of the corpus callosum, thalamus and brainstem area in patients with moderate and severe DAI are associated with more severe injury and worse prognosis. DTI scans can be used as a valuable tool to evaluate the prognosis of DAI patients. Key words: Diffuse axonal injury; Diffusion tensor imaging; Prognosis

Association between the scores of the Japanese version of the Brief Assessment of Cognition in Schizophrenia and whole-brain structure in patients with chronic schizophrenia: A voxel-based morphometry and diffusion tensor imaging study.

The Brief Assessment of Cognition in Schizophrenia (BACS) is a concise tool designed to evaluate cognitive deficits in schizophrenia. We examined the possible association between BACS scores and whole-brain structure, as observed using magnetic resonance imaging with a relatively large sample. The study sample comprised 116 patients with schizophrenia (mean age, 39.3 ± 11.1 years; 66 men) and 118 healthy controls (HC; mean age, 40.0 ± 13.6 years; 58 men) who completed the Japanese version of the BACS (BACS-J). All participants were of Japanese ethnicity. The magnetic resonance imaging volume and diffusion tensor imaging data were processed with voxel-based morphometry and tract-based spatial statistics, respectively. There were significant reductions in the regional gray matter volumes and white matter fractional anisotropy values in patients with schizophrenia compared to HC. For the gray matter areas, the working memory score had a significant positive correlation with the anterior cingulate and medial frontal cortices volumes in the patients. For the white matter areas, the motor speed score had a significant positive correlation with fractional anisotropy values in the corpus callosum, internal capsule, superior corona radiata, and superior longitudinal fasciculus in the patients. However, there was no significant correlation among either the gray or white matter areas in the HC. Our results suggest that among the BACS-J measures, the working memory and motor speed scores are associated with several structural alterations in the brains of patients with schizophrenia.

Cerebral Microstructural Alterations after Radiation Therapy in High-Grade Glioma: A Diffusion Tensor Imaging-Based Study.

To investigate radiation therapy-induced microstructural damage of white matter in patients with high-grade glioma by diffusion tensor imaging (DTI). DTI was performed in 18 patients with high-grade glioma (WHO grades III and IV) and 13 healthy controls. DTI images were cross-sectionally aligned for the calculation of baseline fractional anisotropy (FA). Interhemispheric FA values in patients with high-grade glioma before or without brain radiation therapy were compared with the interhemispheric FA values in patients after radiation therapy and in healthy controls. In a subgroup without any clinical or diagnostic evidence of tumor progression, serial DTI data (5-11 scans) before and after radiation therapy were collected and longitudinal interhemispheric FA changes were assessed and compared to longitudinal data from the control group.In addition, interhemispheric axial, mean, and radial diffusivity was assessed. Global interhemispheric FA reductions could be detected cross-sectionally in patients after radiation therapy; these were significantly different from global interhemispheric FA differences both in patients without radiation and in healthy controls. Longitudinal scans in patients with radiation therapy confirmed these findings and revealed progressive microstructural white matter damage after partial brain radiotherapy. The additional DTI metrics axial diffusion, mean diffusivity, and radial diffusion confirmed interhemispheric differences in patients without or before radiation therapy, which were lower than the differences in patients after radiation therapy, although not reaching significance. Interhemispheric global FA differences could potentially serve as a biological marker for irradiation-induced microstructural white matter damage.

Cerebral Reorganization after Hemispherectomy: A DTI Study.

Hemispherectomy is a neurosurgical procedure to treat children with intractable seizures. Postsurgical improvement of cognitive and behavioral functions is observed in children after hemispherectomy suggesting plastic reorganization of the brain. Our aim was to characterize changes in DTI scalars in WM tracts of the remaining hemisphere in children after hemispherectomy, assess the associations between WM DTI scalars and age at the operation and time since the operation, and evaluate the changes in GM fractional anisotropy values in patients compared with controls. Patients with congenital or acquired neurologic diseases who required hemispherectomy and had high-quality postsurgical DTI data available were included in this study. Atlas- and voxel-based analyses of DTI raw data of the remaining hemisphere were performed. Fractional anisotropy and mean, axial, and radial diffusivity values were calculated for WM and GM regions. A linear regression model was used for correlation between DTI scalars and age at and time since the operation. Nineteen patients after hemispherectomy and 21 controls were included. In patients, a decrease in fractional anisotropy and axial diffusivity values and an increase in mean diffusivity and radial diffusivity values of WM regions were observed compared with controls (P < .05, corrected for multiple comparisons). In patients with acquired pathologies, time since the operation had a significant positive correlation with white matter fractional anisotropy values. In all patients, an increase in cortical GM fractional anisotropy values was found compared with controls (P < .05). Changes in DTI metrics likely reflect Wallerian and/or transneuronal degeneration of the WM tracts within the remaining hemisphere. In patients with acquired pathologies, postsurgical fractional anisotropy values correlated positively with elapsed time since the operation, suggesting a higher ability to recover compared with patients with congenital pathologies leading to hemispherectomy.

Alteration of the optic radiations using diffusion-tensor MRI in patients with retinitis pigmentosa

PurposeTo evaluate alteration of the optic radiation (OR) in patients with retinitis pigmentosa (RP) using fractional anisotropy (FA) measured by diffusion tensor MRI.MethodsWe performed MRI and evaluated alteration of the...

A comparative study of cervical cord diffusion tensor imaging between multiple sclerosis and neuromyelitis optica patients

Objective To assess the diffusion changes of normal appearing spinal cord (NASC) in MRI examination in patients with neuromyelitis optica (NMO) and multiple sclerosis (MS). Methods Axial diffusion tensor imaging (DTI) of cervical cord was performed in 10 patients with NMO, 14 patients with MS and 13 sex- and age-matched healthy controls. Mean diffusivity (MD) and fractional anisotropy (FA) were measured in the C 2-5 level of spinal cord. Regions of interest (ROIs) were placed in the anterior, lateral, posterior funiculi of spinal cord, and the central gray matter of spinal cord. Results Compared with healthy controls, the values of FA in anterior, lateral and posterior funiculi of spinal cord were significantly decreased ( P < 0.05, for all) and MD in left lateral funiculus, posterior funiculus and gray matter were significantly increased ( P ≤ 0.05, for all) in NMO group, and the FA values of right lateral and posterior funiculi in MS group were significantly decreased ( P < 0.05, for all). Compared with MS group, FA value in patients with NMO was significantly decreased in lateral funiculus, and MD value in left lateral and right posterior funiculi were significantly increased ( P < 0.05, for all). Conclusions NASC diffusion abnormalities were found both in patients with NMO and MS. The difference of DTI indicators between NMO and MS patients may offer important information in the early diagnosis and differential diagnosis of NMO and MS. doi: 10.3969/j.issn.1672-6731.2014.10.007

Study of diffusion tensor imaging in subcortical ischemic vascular cognitive impairment

Objective Using diffusion tensor imaging (DTI) to explore the microstructure changes of white matter in subcortical ischemic vascular cognitive impairment (SIVCI) and its correlation with cognitive function. Methods Forty-nine patients with subcortical ischemic cerebrovascular diseases were collected. By using Clinical Dementia Rating Scale (CDR), they were classified into 10 cases of vascular dementia (VaD group), 20 cases of vascular cognitive impairment-no dementia (VCIND group) and 19 cases of normal cognitive function (control group). Conventional MRI and DTI were performed in all cases. Based on the DTI data, voxel-based analysis was used to assess the whole brain region. Correlation analysis was applied to illustrate the relationship between DTI parameters and cognitive scale in VaD patients. Results Compared with the control group, fractional anisotropy (FA) values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes, right temporal lobe and bilateral orbitofrontal lobes ( P = 0.000, for all), and FA values of patients in VCIND group decreased in right inferior frontal gyrus, right hippocampus and bilateral precuneus ( P = 0.000, for all). Compared with VCIND group, FA values of patients in VaD group decreased in medial prefrontal cortex, anterior cingulate, corpus callosum, bilateral parietal lobes and right temporal lobe ( P = 0.000, for all). Compared with the control group, mean diffusivity (MD) values in VaD group increased in medial prefrontal cortex, corpus callosum, bilateral parietal lobes, bilateral temporal lobes and anterior cingulate ( P = 0.000, for all), while in VCIND group increased in bilateral precuneus and right hippocampus ( P = 0.000, for all). Compared with VCIND group, MD values in VaD group increased in right medial prefrontal cortex, anterior cingulate cortex, corpus callosum stem, bilateral parietal lobes and bilateral temporal lobes ( P = 0.000, for all). The correlation analysis showed that the FA value of medial prefrontal lobe in VaD group was negatively correlated with the time to finish Trail Making Test A (TMT-A; r = - 0.782, P = 0.007), and MD value of bilateral inferior frontal gyrus was positively correlated with the time to complete TMT-A ( r = 0.877, P = 0.001). Conclusions DTI was more sensitive on the white matter microstructure change of SIVCI patients than conventional MRI. It can reflect patient's early cognitive functional changes. Microstructrual change in medial prefrontal white matter is an important factor which may influence the executive functions of patients with SIVCI. doi: 10.3969/j.issn.1672-6731.2014.04.009

3T magnetic resonance diffusion tensor imaging in chronic kidney disease

To investigate the relationship of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values with renal function on 3T diffusion tensor imaging (DTI) in chronic kidney disease. Twenty healthy volunteers and 29 patients with CKD underwent DTI. The relationship among ADC, FA, and renal function was analyzed. Cortical and medullary ADC and FA values of patients with chronic kidney disease were lower than those of healthy volunteers (P = 0.000). Both the renal ADC and FA values correlated inversely with serum creatinine and blood urea nitrogen (P < 0.05). DTI is a feasible and non-invasive means to reflect the severity of renal function damaged.

Postoperative Increase in Cerebral White Matter Fractional Anisotropy on Diffusion Tensor Magnetic Resonance Imaging Is Associated With Cognitive Improvement After Uncomplicated Carotid Endarterectomy

Carotid endarterectomy (CEA) might improve cognitive function. Fractional anisotropy (FA) values in the cerebral white matter derived from diffusion tensor magnetic resonance imaging (DTI) correlate with cognitive function in patients with various central nervous system diseases. To use tract-based spatial statistics to determine whether postoperative changes of FA values in the cerebral white matter derived from DTI are associated with cognitive improvement after uncomplicated CEA. In 80 patients undergoing CEA for ipsilateral internal carotid artery stenosis (≥70%), FA values in the cerebral white matter were derived from DTI before and 1 month after surgery and were analyzed by using tract-based spatial statistics. Neuropsychological testing, consisting of the Wechsler Adult Intelligence Scale Revised, the Wechsler Memory Scale and the Rey-Osterreith Complex Figure test, was also performed preoperatively and after the first postoperative month. Based on the neuropsychological assessments, 11 (14%) patients were defined as having postoperatively improved cognition. The difference between the 2 mean FA values (postoperative values minus preoperative values) in the cerebral hemisphere ipsilateral to surgery was significantly associated with postoperative cognitive improvement (95% confidence intervals, 2.632-9.877; P = .008). White matter FA values in patients with postoperative cognitive improvement were significantly increased after surgery in the whole ipsilateral cerebral hemisphere, in the contralateral anterior cerebral artery territory, and in the watershed zone between the contralateral anterior and middle cerebral arteries. Postoperative increase in cerebral white matter FA on DTI is associated with cognitive improvement after uncomplicated CEA.

Elevated diffusion anisotropy in gray matter and the degree of brain compression

For several decades, clinicians have predicted intraparenchymal brain pressure or brain tissue compression indirectly based on the degree of distortion of the midline structures (midline shift) and ventricle wall (ventriculomegaly) observed on conventional MRI. However, this method has several limitations. Diffusion tensor imaging (DTI) is a novel MRI technique that can provide information about the microstructural properties of compressed tissue. In this study, the authors evaluated whether DTI can precisely define the degree of tissue compression in patients with chronic subdural hematoma (CSDH). The study sample consisted of 18 patients (mean age 71 years, 10 men and 8 women) with unilateral CSDH and 12 age-matched volunteers. Diffusion tensor imaging results were acquired before and after the surgical irrigation in the CSDH group. Subdural pressure during the operation was also measured. Fractional anisotropy (FA) values were evaluated at several locations, including the gray matter. The FA values of the gray matter, especially in the caudate nucleus and putamen, were increased in the patients with CSDH compared with the control group. The change in FA data before and after surgery (ΔFA) correlated with the degree of tissue compression evaluated by measurement of the subdural pressure. Furthermore, the increased FA values in patients with CSDH decreased after surgery. These findings indicate that FA values of the gray matter, especially in the caudate nucleus and putamen, may be important markers of tissue compression. The assessment of FA values of the gray matter will result in a new, less-invasive diagnostic technique to evaluate the degree of brain compression.

Poster #49 NEUROANATOMICAL ALTERATIONS IN REGIONS MEDIATING LANGUAGE IN YOUNG ADULTS AT HIGH RISK FOR INHERITANCE OF SCHIZOPHRENIA (GHR)

Poster #49 NEUROANATOMICAL ALTERATIONS IN REGIONS MEDIATING LANGUAGE IN YOUNG ADULTS AT HIGH RISK FOR INHERITANCE OF SCHIZOPHRENIA (GHR)

A comparative analysis of cognitive profiles and white-matter alterations using voxel-based diffusion tensor imaging between patients with Parkinson's disease dementia and dementia with Lewy bodies

BackgroundDespite clinical and neuropsychological similarities between Parkinson's disease dementia (PDD) and dementia with Lewy bodies (DLB), recent studies have demonstrated that structural and pathological changes are more severe in DLB...

Anatomical brain connectivity and positive symptoms of schizophrenia: A diffusion tensor imaging study

Structural brain changes in schizophrenia are well documented in the neuroimaging literature. The classical morphometric analyses of magnetic resonance imaging (MRI) data have recently been supplemented by diffusion tensor imaging (DTI), which mainly assesses changes in white matter (WM). DTI increasingly provides evidence for abnormal anatomical connectivity in schizophrenia, most often using fractional anisotropy (FA) as an indicator of the integrity of WM tracts. To better understand the clinical significance of such anatomical changes, we studied FA values in a whole-brain analysis comparing paranoid schizophrenic patients with a history of auditory hallucinations and matched healthy controls. The relationship of WM changes to psychopathology was assessed by correlating FA values with PANSS scores (positive symptoms and severity of auditory hallucinations) and with illness duration. Schizophrenic patients showed FA reductions indicating WM integrity disturbance in the prefrontal regions, external capsule, pyramidal tract, occipitofrontal fasciculus, superior and inferior longitudinal fasciculi, and corpus callosum. The arcuate fasciculus was the only tract which showed increased FA values in patients. Increased FA values in this region correlated with increased severity of auditory hallucinations and length of illness. Our results suggest that local changes in anatomical integrity of WM tracts in schizophrenia may be related to patients' clinical presentation.

Diffusion Tensor Imaging in Idiopathic Acute Transverse Myelitis

Our study was based on our hypotheses that in idiopathic acute transverse myelitis (ATM), fractional anisotropy (FA) values would be abnormal not only in the T2-hyperintense lesion but also in the surrounding normal-appearing spinal cord and that the abnormal FA values in the spinal cord could be related to clinical outcome. Sagittal diffusion tensor imaging (DTI) was performed in 10 patients with idiopathic ATM (four men, six women; mean age, 45 years; age range, 20-66 years) and 10 sex- and age-matched normal volunteers. FA measurements were made in the spinal cord at three levels: lesion, proximal normal-appearing spinal cord, and distal normal-appearing spinal cord. The grade of FA decrease (mild, less than 10% decrease [(FA normal - FA pt) x 100 / FA normal]; moderate, 10-20%; severe, more than 20%) was related to the clinical outcome, which was determined by a neurologist using Paine's scale of normal, good, fair, or poor. Mean FA values in patients were significantly lower than those in normal volunteers in lesions (0.5328 vs 0.7125, p = 0.002) and distal normal-appearing spinal cord (0.6676 vs 0.7720, p = 0.0137). All three patients with a mild FA decrease or increase in distal normal-appearing spinal cord showed a normal or good outcome, but all three patients with a severe FA decrease in distal normal-appearing spinal cord showed a fair outcome, among the eight patients to whom steroid treatment was given. FA values in lesions and in distal normal-appearing spinal cord significantly decreased in patients with idiopathic ATM, and FA decrease in distal normal-appearing spinal cord might be related to clinical outcome.