Abstract
Objectives
To evaluate the diffusion kurtosis and susceptibility change in the U-fiber region of patients with relapsing–remitting multiple sclerosis (pwRRMS) and their correlations with cognitive status and degeneration.
Materials and methods
Mean kurtosis (MK), axial kurtosis (AK), radial kurtosis (RK), kurtosis fractional anisotropy (KFA), and the mean relative quantitative susceptibility mapping (mrQSM) values in the U-fiber region were compared between 49 pwRRMS and 48 healthy controls (HCs). The U-fiber were divided into upper and deeper groups based on the location. The whole brain volume, gray and white matter volume, and cortical thickness were obtained. The correlations between the mrQSM values, DKI-derived metrics in the U-fiber region and clinical scale scores, brain morphologic parameters were further investigated.
Results
The decreased MK, AK, RK, KFA, and increased mrQSM values in U-fiber lesions (p < 0.001, FDR corrected), decreased RK, KFA, and increased mrQSM values in U-fiber non-lesions (p = 0.034, p < 0.001, p < 0.001, FDR corrected) were found in pwRRMS. There were differences in DKI-derived metrics and susceptibility values between the upper U-fiber region and the deeper one for U-fiber non-lesion areas of pwRRMS and HCs (p < 0.05), but not for U-fiber lesions in DKI-derived metrics. The DKI-derived metrics and susceptibility values were widely related with cognitive tests and brain atrophy.
Conclusion
RRMS patients show abnormal diffusion kurtosis and susceptibility characteristics in the U-fiber region, and these underlying tissue abnormalities are correlated with cognitive deficits and degeneration.
Clinical relevance statement
The macroscopic and microscopic tissue damages of U-fiber help to identify cognitive impairment and brain atrophy in multiple sclerosis and provide underlying pathophysiological mechanism.
Key Points
• Diffusion kurtosis and susceptibility changes are present in the U-fiber region of multiple sclerosis.
• There are gradients in diffusion kurtosis and susceptibility characteristics in the U-fiber region.
• Tissue damages in the U-fiber region are correlated with cognitive impairment and brain atrophy.
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Abbreviations
- AK:
-
Axial kurtosis
- DKI:
-
Diffusion kurtosis imaging
- DST:
-
Digit Span Test
- DTI:
-
Diffusion tensor imaging
- DWM:
-
Deep white matter
- EDSS:
-
Expanded Disability Status Scale
- FLAIR:
-
Fluid-attenuated inversion recovery
- FSS:
-
Fatigue Severity Scale
- HAMD:
-
Hamilton Depression
- HCs:
-
Healthy controls
- KFA:
-
Kurtosis fractional anisotropy
- MK:
-
Mean kurtosis
- MoCA:
-
Montreal Cognitive Assessment
- MPRAGE:
-
Magnetization prepared rapid gradient echo
- MRI:
-
Magnetic resonance imaging
- mrQSM:
-
Mean relative quantitative susceptibility mapping
- MS:
-
Multiple sclerosis
- NAWM:
-
Normal-appearing white matter
- Non-UFLs:
-
U-fiber non-lesions
- pwRRMS:
-
Patients with relapsing–remitting multiple sclerosis
- QSM:
-
Quantitative susceptibility mapping
- RK:
-
Radial kurtosis
- RRMS:
-
Relapsing-remitting MS
- SDMT:
-
Symbol Digit Modalities Test
- SWM:
-
Superficial white matter
- UFLs:
-
U-fiber lesions
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Funding
This study received grants from the Key Project of Technological Innovation and Application Development of Chongqing Science and Technology Bureau (CSTC2021 jscx-gksb-N0008).
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The scientific guarantor of this publication is Yongmei Li.
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Luo, D., Peng, Y., Zhu, Q. et al. U-fiber diffusion kurtosis and susceptibility characteristics in relapsing–remitting multiple sclerosis may be related to cognitive deficits and neurodegeneration. Eur Radiol 34, 1422–1433 (2024). https://doi.org/10.1007/s00330-023-10114-3
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DOI: https://doi.org/10.1007/s00330-023-10114-3