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000165324 0247_ $$2doi$$a10.1016/j.nicl.2022.103213
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000165324 037__ $$aDZNE-2022-01602
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000165324 1001_ $$0P:(DE-2719)9000938$$aLindig, Tobias$$b0$$udzne
000165324 245__ $$aDetection of spinal long fiber tract degeneration in HSP: Improved diffusion tensor imaging.
000165324 260__ $$a[Amsterdam u.a.]$$bElsevier$$c2022
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000165324 520__ $$aSpinal diffusion tensor imaging (sDTI) is still a challenging technique for selectively evaluating anatomical areas like the pyramidal tracts (PT), dorsal columns (DC), and anterior horns (AH) in clinical routine and for reliably quantifying white matter anisotropy and diffusivity. In neurodegenerative diseases, the value of sDTI is promising but not yet well understood. The objective of this prospective, single-center study was to evaluate the long fiber tract degeneration within the spinal cord in normal aging (n = 125) and to prove its applicability in pathologic conditions as in patients with molecular genetically confirmed hereditary spastic paraplegias (HSP; n = 40), a prototypical disease of the first motor neuron and in some genetic variants with affection of the dorsal columns. An optimized monopolar Stejskal-Tanner sequence for high-resolution, axial sDTI of the cervical spinal cord at 3.0 T with advanced standardized evaluation methods was developed for a robust DTI value estimation of PT, DC, and AH in both groups. After sDTI measurement at C2, an automatic motion correction and an advanced semi-automatic ROI-based, standardized evaluation of white matter anisotropy and diffusivity was performed to obtain regional diffusivity measures for PT, DC, and AH. Reliable and stable sDTI values were acquired in a healthy population without significant decline between age 20 and 65. Reference values for PT, DC, and AH for fractional anisotropy (FA), mean diffusivity (MD), and radial diffusivity (RD) were established. In HSP patients, the decline of the long spinal fiber tracts could be demonstrated by diffusivity abnormalities in the pyramidal tracts with significantly reduced PTFA (p < 0.001), elevated PTRD (p = 0.002) and reduced PTMD (p = 0.003) compared to healthy controls. Furthermore, FA was significantly reduced in DCFA (p < 0.001) with no differences in AH. In a genetically homogeneous subgroup of SPG4 patients (n = 12) with affection of the dorsal columns, DCRD significantly correlated with the overall disease severity as measured by the Spastic Paraplegia Rating Scale (SPRS) (r = - 0.713, p = 0.009). With the most extensive sDTI study in vivo to date, we showed that axial sDTI combined with motion correction and advanced data post-processing strategies enables robust measurements and is ready to use, allowing recognition and quantification of disease- and age-related changes of the PT, DC, and AH. These results may also encourage the usage of sDTI in other neurodegenerative diseases with spinal cord involvement to explore its capability as selective biomarkers.
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000165324 650_7 $$2Other$$aFractional anisotropy
000165324 650_7 $$2Other$$aHereditary spastic paraplegia
000165324 650_7 $$2Other$$aPyramidal degeneration
000165324 650_7 $$2Other$$aRadial diffusivity
000165324 650_7 $$2Other$$aSpinal diffusion tensor imaging
000165324 650_2 $$2MeSH$$aAnimals
000165324 650_2 $$2MeSH$$aHumans
000165324 650_2 $$2MeSH$$aYoung Adult
000165324 650_2 $$2MeSH$$aAdult
000165324 650_2 $$2MeSH$$aMiddle Aged
000165324 650_2 $$2MeSH$$aAged
000165324 650_2 $$2MeSH$$aDiffusion Tensor Imaging: methods
000165324 650_2 $$2MeSH$$aProspective Studies
000165324 650_2 $$2MeSH$$aWhite Matter: diagnostic imaging
000165324 650_2 $$2MeSH$$aWhite Matter: pathology
000165324 650_2 $$2MeSH$$aAnisotropy
000165324 650_2 $$2MeSH$$aPyramidal Tracts: diagnostic imaging
000165324 7001_ $$aRuff, Christer$$b1
000165324 7001_ $$0P:(DE-2719)2811827$$aRattay, Tim W$$b2$$udzne
000165324 7001_ $$aKönig, Stephan$$b3
000165324 7001_ $$0P:(DE-2719)2810795$$aSchöls, Ludger$$b4$$udzne
000165324 7001_ $$0P:(DE-2719)2812018$$aSchüle, Rebecca$$b5$$udzne
000165324 7001_ $$aNägele, Thomas$$b6
000165324 7001_ $$aErnemann, Ulrike$$b7
000165324 7001_ $$aKlose, Uwe$$b8
000165324 7001_ $$0P:(DE-2719)9001506$$aBender, Benjamin$$b9$$udzne
000165324 773__ $$0PERI:(DE-600)2701571-3$$a10.1016/j.nicl.2022.103213$$gVol. 36, p. 103213 -$$p103213$$tNeuroImage: Clinical$$v36$$x2213-1582$$y2022
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