title: Diffusion tensor imaging (DTI) and its clinical correlates in drug naïve Wilson's disease.
abstract: The purpose is to evaluate white matter (WM) abnormalities in Wilson's disease (WD) using the technique of diffusion tensor imaging (DTI). The prospective case-control study comprised of 15 drug-naïve patients with WD and 15 controls. The phenotype of subjects was evaluated. The DTI/conventional MRI was acquired (3T MRI): Fractional anisotropy (FA) and mean diffusivity (MD) values were extracted from regions of interest placed in pons, midbrain, bilateral frontal and occipital cerebral white matter, bilateral internal capsules (IC), middle cerebellar peduncles (MCP) and corpus callosum (CC). Six patients showed lobar WM signal changes on T(2)-Weighted (T2W)/Fluid attenuation inversion recovery (FLAIR) images while remaining had normal appearing WM. MD was significantly increased in the lobar WM, bilateral IC and midbrain of WD patients. FA was decreased in the frontal and occipital WM, bilateral IC, midbrain and pons. Normal-appearing white matter on FLAIR images showed significantly increased MD and decreased FA values in both frontal and occipital lobar WM and IC compared with those in controls. Correlation of clinical scores and DTI metrics revealed positive correlation between neurological symptom score (NSS) and MD of anterior limb of right internal capsule, Chu stage and MD of frontal and occipital WM. Negative correlation was observed between the Modified Schwab and England Activities of Daily Living (MSEADL) score and MD of bilateral frontal and occipital WM and IC. This is the probably the first study to reveal widespread alterations in WM by DTI metrics in drug naïve WD. DTI analysis revealed lobar WM abnormalities which is less frequently noted on conventional MRI and suggests widespread WM abnormalities in WD. It may be valuable in assessing the true extent of involvement and therefore the severity of the illness.
authors: Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Bangalore, 560 029, Karnataka, India.
authors: Rakesh
authors: R
authors: Jadav
authors: Jitender
authors: J
authors: Saini
authors: Sanjib
authors: S
authors: Sinha
authors: Bhavanishankara
authors: B
authors: Bagepally
authors: S
authors: S
authors: Rao
authors: Arun B
authors: AB
authors: Taly
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D001921:Brain / Q000473:pathology; D016022:Case-Control Studies; D002648:Child; D003430:Cross-Sectional Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006527:Hepatolenticular Degeneration / Q000473:pathology* / Q000503:physiopathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D011446:Prospective Studies; D012744:Sex Ratio; D055815:Young Adult
references: Rinsho Shinkeigaku. 1993 Oct;33(10):1086-9
references: 8293612
references: AJNR Am J Neuroradiol. 2005 May;26(5):1066-71
references: 15891161
references: Neurology. 2006 Feb 14;66(3):384-9
references: 16476937
references: Metab Brain Dis. 2009 Sep;24(3):463-8
references: 19707862
references: J Clin Neurosci. 2008 Apr;15(4):409-17
references: 18242093
references: J Magn Reson Imaging. 2008 May;27(5):1061-8
references: 18425846
references: Neuroradiology. 2006 Sep;48(9):613-21
references: 16752136
references: Gastroenterology. 2003 Dec;125(6):1868-77
references: 14724838
references: J Neurol Sci. 2010 Apr 15;291(1-2):44-51
references: 20116809
references: Neurol India. 2010 Sep-Oct;58(5):708-13
references: 21045492
references: Lancet. 2007 Feb 3;369(9559):397-408
references: 17276780
references: J Neurol. 2004 Nov;251(11):1413-4
references: 15592743
references: J Neurol Sci. 1996 Mar;136(1-2):129-39
references: 8815159
references: Neuroradiology. 1994;36(2):97-100
references: 8183467
references: Brain. 1986 Jun;109 ( Pt 3):491-507
references: 3719287
references: Arch Neurol. 1987 Apr;44(4):365-70
references: 3827691
references: Brain. 2010 Feb;133(Pt 2):529-39
references: 19914928
references: Clin Auton Res. 2002 Jun;12(3):185-9
references: 12269551
references: Mov Disord. 2002 Sep;17(5):1077-83
references: 12360563
references: Semin Neurol. 1999;19(3):261-70
references: 12194382
references: Br J Radiol. 2007 Sep;80(957):744-9
references: 17709362
references: Brain. 1981 Mar;104(Pt 1):79-95
references: 7470846
references: AJNR Am J Neuroradiol. 2003 May;24(5):965-7
references: 12748103
references: Comput Med Imaging Graph. 2003;27(1):17-21
references: 12573885