A Comparison Study Of Diffusion Tensor Imaging Features Of Brain Deep Nuclei And Cervical Spinal Cord In Patients With Mutiple Sclerosis And Neuromyelitis Optica

PART1QUANTITATIVE RESEARCH OF BRAIN DEEPNUCLEI IN PATIENTS WITH MULTIPLE SCLEROSISAND NEUROMYELITIS OPTICA USING DIFFUSIONTENSOR IMAGINGObjective: To explore the changes of brain deep nuclei in patientswith multiple sclerosis (MS) and neuromyelitis optica (NMO) usingdiffusion tensor imaging (DTI) and to analyze the correlations betweenDTI indexes and clinical Expanded Disability Status Scale (EDSS).Methods:30patients with MS (MS group), NMO (NMO group) andhealthy volunteers (control group) were imaged using DTI on a3.0Teslascanner, respectively. DTI of brain deep nuclei from all participants weremeasured, including mean diffusivity (MD) and fractional anisotropy (FA),and the correlations between the DTI results and EDSS scores wereassessed. One-way ANOVA, Dunnett-t test, Spearman correlation analysis, and Paired Sample T tests were used for statistics.Results:(1) Compared with the control group: MD values of boththalamus and substantia nigra were increased (t was0.239and0.667,respectively. P <0.05), and FA of both globus pallidus and dentate nucleuswere decreased (t was-0.057and-0.052, respectively. P <0.05) for MSgroup; MD values of red nucleus were increased (t=0.576, P=0.008) forNMO group. For MS group and NMO group, however, there weresignificant differences for FA of putamen (t=-0.034，P=0.034).(2)Univariate correlations between DTI measures and the average EDSSscores were assessed: MD values of both thalamus and substantia nigrashowed positive correlations with EDSS scores (r was0.26and0.329, andP was0.045and0.01, respectively), and FA had no correlations with EDSSscores.Conclusions: There were gray matter damage in patients with MS andNMO. Putamen can provide a potentially value of distinguishing MS andNMO, and its FA values may be useful quantitative biomarkers formonitoring the evolution of MS and NMO. PART2QUANTITATIVE STUDY OF THE CERVICALSPINAL CORD DAMAGE IN PATIENTS WITHMULTIPLE SCLEROSIS AND NEUROMYELITISOPTICA USING DIFFUSION TENSOR IMAGINGObjective: To explore the changes of the cervical spinal cord inPatients with multiple sclerosis (MS) and neuromyelitis optica (NMO)using diffusion tensor imaging (DTI) and to analyze the correlations withclinical disability scores.Methods: Thirty patients with MS (MS group),28patients with NMO(NMO group) and20healthy volunteers were imaged using DTI on a3.0Tesla scanner. DTI indices of cervical spinal cord from all participants weremeasured, including mean diffusivity (MD) and fractional anisotropy (FA),and the correlations between the DTI metrics and the Expanded DisabilityStatus Scale (EDSS) scores were assessed. One-way ANOVA, Dunnett-t testand Spearman correlation analysis were used for statistics.Results:(1) The values of MD among three groups were different atC3level for left lateral and dorsal columns, C4level for the central graysubstance and dorsal columns, and C5-C6level for all structures. Therewere significant differences among them (F between4.006and36.814,P<0.05). The values of FA were significantly different at all levels (Fbetween5.561and98.128, P<0.01).(2) Compared with the control group, the values of MD were increased and FA were decreased for both MS andNMO groups, there were significant differences among them (t between-0.32and3.138, P<0.05). In MS and NMO groups, there were nosignificant differences for MD (t between-1.183and0.069, P>0.05), whilethe FA at C4-C6levels (including the central gray substance, dorsalcolumns, right lateral columns and left lateral columns) for NMO groupwere0.57±0.09,0.56±0.11,0.54±0.10,0.57±0.09,0.55±0.11、0.52±0.13、0.55±0.11、0.54±0.13,0.54±0.10、0.54±0.11、0.53±0.13,0.52±0.11；and for MS group were0.67±0.10,0.68±0.10,0.68±0.10,0.70±0.12,0.68±0.11,0.69±0.10,0.68±0.11,0.69±0.12,0.67±0.14,0.68±0.15,0.69±0.14,0.69±0.16, therewere significant differences between two groups (t between-0.011and0.169, P<0.05).(3) Univariate correlations between DTI measures and theaverage EDSS scores were assessed. The results showed MD at all levelssignificant positive correlations with disability scores (r between0.324and0.541, P<0.05), and FA significant negative correlations with disabilityscores (r between-0.632and-0.294, P<0.05), except C4level for lateralcolumns and C2level.Conclusions: DTI metrics are sensitive to cervical spinal cord damagein demyelinating diseases, providing an important value of distinguishingMS and NMO, and can be potentially useful quantitative biomarkers formonitoring the evolution of demyelinating diseases.