Altered diffusion tensor in multiple sclerosis normal-appearing brain tissue: Cortical diffusion changes seem related to clinical deterioration

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To investigate normal-appearing white (NAWM) and cortical gray (NAGM) matter separately in multiple sclerosis (MS) in vivo using diffusion tensor imaging (DTI). Materials and Methods: In 64 MS patients (12 primary progressive [PP], 38 relapsing remitting [RR], 14 secondary progressive [SP]) and 20 healthy controls, whole-brain apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were acquired. A stimulated echo acquisition mode (STEAM) DTI sequence was used with minimal geometrical distortion in comparison to echo-planar imaging (EPI). NAWM and NAGM were identified using conventional magnetic resonance (MR) images, allowing a cautious assessment of FA in cortex. Results: Histogram analyses showed significant global FA decreases and ADC increases in MS NAWM compared to control WM. MS cortical NAGM had no significant global ADC increase, but FA was decreased significantly. In regional analyses, nearly all NAWM regions-of-interest (ROIs) had significantly increased ADC compared to controls, but FA was not changed. In nearly all cortical NAGM ROIs, ADC was significantly increased and FA significantly reduced. In multiple linear regression analyses in RR/SPMS patients, NAGM-ADC histogram peak height was associated more strongly with clinical disability than T2 lesion load. Conclusion: Tissue damage occurs in both NAWM and cortical NAGM. The cortical damage appears to have more clinical impact than T2 lesions.

Original languageEnglish
Pages (from-to)628-636
Number of pages9
JournalJournal of Magnetic Resonance Imaging
Volume23
Issue number5
DOIs
Publication statusPublished - 1 May 2006

Cite this

@article{50a7fd9f31984a4ba47ff64f2662de16,
title = "Altered diffusion tensor in multiple sclerosis normal-appearing brain tissue: Cortical diffusion changes seem related to clinical deterioration",
abstract = "Purpose: To investigate normal-appearing white (NAWM) and cortical gray (NAGM) matter separately in multiple sclerosis (MS) in vivo using diffusion tensor imaging (DTI). Materials and Methods: In 64 MS patients (12 primary progressive [PP], 38 relapsing remitting [RR], 14 secondary progressive [SP]) and 20 healthy controls, whole-brain apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were acquired. A stimulated echo acquisition mode (STEAM) DTI sequence was used with minimal geometrical distortion in comparison to echo-planar imaging (EPI). NAWM and NAGM were identified using conventional magnetic resonance (MR) images, allowing a cautious assessment of FA in cortex. Results: Histogram analyses showed significant global FA decreases and ADC increases in MS NAWM compared to control WM. MS cortical NAGM had no significant global ADC increase, but FA was decreased significantly. In regional analyses, nearly all NAWM regions-of-interest (ROIs) had significantly increased ADC compared to controls, but FA was not changed. In nearly all cortical NAGM ROIs, ADC was significantly increased and FA significantly reduced. In multiple linear regression analyses in RR/SPMS patients, NAGM-ADC histogram peak height was associated more strongly with clinical disability than T2 lesion load. Conclusion: Tissue damage occurs in both NAWM and cortical NAGM. The cortical damage appears to have more clinical impact than T2 lesions.",
keywords = "Axonal damage, Diffusion, Multiple sclerosis, Myelin, Normal-appearing brain tissue, Water",
author = "Hugo Vrenken and Pouwels, {Petra J W} and Geurts, {Jeroen J G} and Knol, {Dirk L.} and Polman, {Chris H.} and Frederik Barkhof and Castelijns, {Jonas A.}",
year = "2006",
month = "5",
day = "1",
doi = "10.1002/jmri.20564",
language = "English",
volume = "23",
pages = "628--636",
journal = "Journal of magnetic resonance imaging : JMRI",
issn = "1053-1807",
number = "5",

}

TY - JOUR

T1 - Altered diffusion tensor in multiple sclerosis normal-appearing brain tissue

T2 - Cortical diffusion changes seem related to clinical deterioration

AU - Vrenken, Hugo

AU - Pouwels, Petra J W

AU - Geurts, Jeroen J G

AU - Knol, Dirk L.

AU - Polman, Chris H.

AU - Barkhof, Frederik

AU - Castelijns, Jonas A.

PY - 2006/5/1

Y1 - 2006/5/1

N2 - Purpose: To investigate normal-appearing white (NAWM) and cortical gray (NAGM) matter separately in multiple sclerosis (MS) in vivo using diffusion tensor imaging (DTI). Materials and Methods: In 64 MS patients (12 primary progressive [PP], 38 relapsing remitting [RR], 14 secondary progressive [SP]) and 20 healthy controls, whole-brain apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were acquired. A stimulated echo acquisition mode (STEAM) DTI sequence was used with minimal geometrical distortion in comparison to echo-planar imaging (EPI). NAWM and NAGM were identified using conventional magnetic resonance (MR) images, allowing a cautious assessment of FA in cortex. Results: Histogram analyses showed significant global FA decreases and ADC increases in MS NAWM compared to control WM. MS cortical NAGM had no significant global ADC increase, but FA was decreased significantly. In regional analyses, nearly all NAWM regions-of-interest (ROIs) had significantly increased ADC compared to controls, but FA was not changed. In nearly all cortical NAGM ROIs, ADC was significantly increased and FA significantly reduced. In multiple linear regression analyses in RR/SPMS patients, NAGM-ADC histogram peak height was associated more strongly with clinical disability than T2 lesion load. Conclusion: Tissue damage occurs in both NAWM and cortical NAGM. The cortical damage appears to have more clinical impact than T2 lesions.

AB - Purpose: To investigate normal-appearing white (NAWM) and cortical gray (NAGM) matter separately in multiple sclerosis (MS) in vivo using diffusion tensor imaging (DTI). Materials and Methods: In 64 MS patients (12 primary progressive [PP], 38 relapsing remitting [RR], 14 secondary progressive [SP]) and 20 healthy controls, whole-brain apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps were acquired. A stimulated echo acquisition mode (STEAM) DTI sequence was used with minimal geometrical distortion in comparison to echo-planar imaging (EPI). NAWM and NAGM were identified using conventional magnetic resonance (MR) images, allowing a cautious assessment of FA in cortex. Results: Histogram analyses showed significant global FA decreases and ADC increases in MS NAWM compared to control WM. MS cortical NAGM had no significant global ADC increase, but FA was decreased significantly. In regional analyses, nearly all NAWM regions-of-interest (ROIs) had significantly increased ADC compared to controls, but FA was not changed. In nearly all cortical NAGM ROIs, ADC was significantly increased and FA significantly reduced. In multiple linear regression analyses in RR/SPMS patients, NAGM-ADC histogram peak height was associated more strongly with clinical disability than T2 lesion load. Conclusion: Tissue damage occurs in both NAWM and cortical NAGM. The cortical damage appears to have more clinical impact than T2 lesions.

KW - Axonal damage

KW - Diffusion

KW - Multiple sclerosis

KW - Myelin

KW - Normal-appearing brain tissue

KW - Water

UR - http://www.scopus.com/inward/record.url?scp=33646183346&partnerID=8YFLogxK

U2 - 10.1002/jmri.20564

DO - 10.1002/jmri.20564

M3 - Article

VL - 23

SP - 628

EP - 636

JO - Journal of magnetic resonance imaging : JMRI

JF - Journal of magnetic resonance imaging : JMRI

SN - 1053-1807

IS - 5

ER -