TY  - JOUR
AU  - Lindig, Tobias
AU  - Ruff, Christer
AU  - Rattay, Tim W
AU  - König, Stephan
AU  - Schöls, Ludger
AU  - Schüle, Rebecca
AU  - Nägele, Thomas
AU  - Ernemann, Ulrike
AU  - Klose, Uwe
AU  - Bender, Benjamin
TI  - Detection of spinal long fiber tract degeneration in HSP: Improved diffusion tensor imaging.
JO  - NeuroImage: Clinical
VL  - 36
SN  - 2213-1582
CY  - [Amsterdam u.a.]
PB  - Elsevier
M1  - DZNE-2022-01602
SP  - 103213
PY  - 2022
AB  - Spinal 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.
KW  - Animals
KW  - Humans
KW  - Young Adult
KW  - Adult
KW  - Middle Aged
KW  - Aged
KW  - Diffusion Tensor Imaging: methods
KW  - Prospective Studies
KW  - White Matter: diagnostic imaging
KW  - White Matter: pathology
KW  - Anisotropy
KW  - Pyramidal Tracts: diagnostic imaging
KW  - Fractional anisotropy (Other)
KW  - Hereditary spastic paraplegia (Other)
KW  - Pyramidal degeneration (Other)
KW  - Radial diffusivity (Other)
KW  - Spinal diffusion tensor imaging (Other)
LB  - PUB:(DE-HGF)16
C2  - pmc:PMC9668628
C6  - pmid:36270162
DO  - DOI:10.1016/j.nicl.2022.103213
UR  - https://pub.dzne.de/record/165324
ER  -