title: Diffusion tensor MRI alterations of subcortical deep gray matter in clinically isolated syndrome.
abstract: BACKGROUND
  Abnormalities in the gray matter (GM) of the brain parenchyma are present early in the course of multiple sclerosis.
  
  
  OBJECTIVE
  To quantify white matter (WM) and subcortical deep GM (SDGM) alterations in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging (DTI).
  
  
  METHODS
  45 CIS patients and 52 healthy controls (HC) were scanned on 3T MRI. Mean diffusivity (MD) and fractional anisotropy (FA) were calculated, in addition to the estimation of structural brain volume and lesion measurements.
  
  
  RESULTS
  FA was significantly lower in CIS patients in the whole brain (p<0.001), total SDGM (p<0.001), normal appearing (NA) GM (p=0.016), thalamus (p=0.029) putamen (p=0.036), caudate (p=0.041) and accumbens nuclei (p=0.041) compared to HC. No DTI MD or volumetric differences were detected in the brain parenchyma between CIS and HC groups. Normalized lateral ventricular volume was higher in CIS patients compared to HC (p=0.033). A significant association was detected between the increased T2 lesion number and volume and decreased FA of the NAWM (p=0.036), but not with FA of NAGM or SDGM structures.
  
  
  CONCLUSIONS
  Diffuse DTI alterations of GM structures, not associated with lesion formation, are present in CIS patients.
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; Department GF Ingrassia, Section of Neurosciences, University of Catania, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cappellani
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Niels
authors.initials: N
authors.lastname: Bergsland
authors.affiliation: The Jacobs Neurological Institute, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY, USA.
authors.forename: Bianca
authors.initials: B
authors.lastname: Weinstock-Guttman
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Cheryl
authors.initials: C
authors.lastname: Kennedy
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Carl
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Deepa P
authors.initials: DP
authors.lastname: Ramasamy
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Jesper
authors.initials: J
authors.lastname: Hagemeier
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Dwyer
authors.affiliation: Department GF Ingrassia, Section of Neurosciences, University of Catania, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Patti
authors.affiliation: Buffalo Neuroimaging Analysis Center, Department of Neurology, State University of New York, Buffalo, NY, USA; The Jacobs Neurological Institute, Department of Neurology, University at Buffalo, State University of New York, Buffalo, NY, USA. Electronic address: rzivadinov@bnac.net.
authors.forename: Robert
authors.initials: R
authors.lastname: Zivadinov
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology*; D016022:Case-Control Studies; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D056784:Leukoencephalopathies / Q000175:diagnosis* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications*; D009413:Nerve Fibers, Myelinated / Q000473:pathology*
keywords: Clinically isolated syndrome; Diffusion tensor imaging; Fractional anisotropy; Lesions; Normal appearing white matter; Subcortical deep gray matter