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Progressive decline in fractional anisotropy on serial DTI examinations of the corpus callosum: a putative marker of disease activity and progression in SPMS

  • Diagnostic Neuroradiology
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Abstract

Introduction

Clinical trials of secondary progressive multiple sclerosis (SPMS) is lacking reliable biomarkers or outcome measures that reflect tissue injury incurred within a 1- to 2-year observation period. Diffusion tensor imaging (DTI) is sensitive in detecting acute brain tissue damage. We monitored SPMS patients over 12 months for diffusion changes within the corpus callosum (CC).

Methods

Bimonthly MRI examinations over a 1-year period were performed on 11 SPMS patients. The protocol included postcontrast T1-weighted images and DTI. Based on the appearance of T1 enhancing lesion(s) during the study period, the patients were divided into enhancing (five patients) and nonenhancing (six patients) groups. Fractional anisotropy (FA) and mean diffusivity (MD) of the genu, body, and splenium of the CC were measured and temporal changes in mean FA and MD were evaluated for each group as well as between groups. Immunology data from peripheral blood mononuclear cells were also collected on a monthly basis.

Results

The enhancing group showed significant, progressive decrease in FA in body (p = 0.012) and splenium (p = 0.033) of CC, and significantly higher lymphotoxin-β levels. No significant FA changes were seen in the nonenhancing group. Moreover, the FA decline in the enhancing group deviated significantly from the nonenhancing group, which remained essentially stable. Although MD increased slightly in both groups, there was no significant difference between the two groups.

Conclusion

Based on the MR and immunology findings, the results of our study suggest that DTI undergo more rapid and longitudinal changes in SPMS patients with inflammatory activity.

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Acknowledgments

We are very grateful to Bill Badger for his help with data collection. This work was supported by an Autoimmunity Center of Excellence grant (1 U 19 AI056390-01; Project 2) from the NIAID, NIH (to B.M. Segal) and a Dana Foundation research grant (to B.M. Segal)

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Imaging Sciences, University of Rochester Medical Center, Rochester, NY, USA

    Wei Tian, Tong Zhu, Jianhui Zhong, Xiang Liu & Sven Ekholm

  2. Department of Neurology, Holtom-Garrett Program in Neuroimmunology, University of Michigan, Ann Arbor, MI, USA

    Praveen Rao & Benjamin M. Segal

  3. Division of Diagnostic and Interventional Neuroradiology, University of Rochester Medical Center, 601 Elmwood Ave, Box 648, Rochester, NY, 14642-8638, USA

    Sven Ekholm

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  1. Wei Tian
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  2. Tong Zhu
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  3. Jianhui Zhong
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  4. Xiang Liu
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  5. Praveen Rao
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  6. Benjamin M. Segal
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  7. Sven Ekholm
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Correspondence to Sven Ekholm.

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Tian, W., Zhu, T., Zhong, J. et al. Progressive decline in fractional anisotropy on serial DTI examinations of the corpus callosum: a putative marker of disease activity and progression in SPMS. Neuroradiology 54, 287–297 (2012). https://doi.org/10.1007/s00234-011-0885-8

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  • DOI: https://doi.org/10.1007/s00234-011-0885-8

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