title: Correlating Function and Imaging Measures of the Medial Longitudinal Fasciculus.
abstract: OBJECTIVE
  To test the validity of diffusion tensor imaging (DTI) measures of tissue injury by examining such measures in a white matter structure with well-defined function, the medial longitudinal fasciculus (MLF). Injury to the MLF underlies internuclear ophthalmoparesis (INO).
  
  
  METHODS
  40 MS patients with chronic INO and 15 healthy controls were examined under an IRB-approved protocol. Tissue integrity of the MLF was characterized by DTI parameters: longitudinal diffusivity (LD), transverse diffusivity (TD), mean diffusivity (MD) and fractional anisotropy (FA). Severity of INO was quantified by infrared oculography to measure versional disconjugacy index (VDI).
  
  
  RESULTS
  LD was significantly lower in patients than in controls in the medulla-pons region of the MLF (p < 0.03). FA was also lower in patients in the same region (p < 0.0004). LD of the medulla-pons region correlated with VDI (R = -0.28, p < 0.05) as did FA in the midbrain section (R = 0.31, p < 0.02).
  
  
  CONCLUSIONS
  This study demonstrates that DTI measures of brain tissue injury can detect injury to a functionally relevant white matter pathway, and that such measures correlate with clinically accepted evaluation indices for INO. The results validate DTI as a useful imaging measure of tissue integrity.
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Ken
authors.initials: K
authors.lastname: Sakaie
authors.affiliation: Advanced Imaging Research Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Masaya
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Gina
authors.initials: G
authors.lastname: Remington
authors.affiliation: Quantitative Health Sciences, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Amy
authors.initials: A
authors.lastname: Conger
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Darrel
authors.initials: D
authors.lastname: Conger
authors.affiliation: Advanced Imaging Research Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.|Philips Medical Systems, Cleveland, Ohio, United States of America.
authors.forename: Ivan
authors.initials: I
authors.lastname: Dimitrov
authors.affiliation: Imaging Institute, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Stephen
authors.initials: S
authors.lastname: Jones
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Ashley
authors.initials: A
authors.lastname: Frohman
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Teresa
authors.initials: T
authors.lastname: Frohman
authors.affiliation: Advanced Imaging Research Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Koji
authors.initials: K
authors.lastname: Sagiyama
authors.affiliation: Advanced Imaging Research Center, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Osamu
authors.initials: O
authors.lastname: Togao
authors.affiliation: Mellen Center, Cleveland Clinic, Cleveland, Ohio, United States of America.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Fox
authors.affiliation: Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, United States of America.
authors.forename: Elliot
authors.initials: E
authors.lastname: Frohman
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009886:Ophthalmoplegia / Q000473:pathology; D066127:White Matter / Q000473:pathology