title: Influence of cigarette smoking on white matter in patients with clinically isolated syndrome as detected by diffusion tensor imaging.
abstract: OBJECTIVE
  Cigarette smoking has been associated with increased occurrence of multiple sclerosis (MS), as well as clinical disability and disease progression in MS. We aimed to assess the effects of smoking on the white matter (WM) in patients with clinically isolated syndrome (CIS) using diffusion tensor imaging.
  
  
  METHODS
  Smoker patients with CIS (n=16), smoker healthy controls (n=13), nonsmoker patients with CIS (n=17) and nonsmoker healthy controls (n=14) were included. Thirteen regions-of-interest including nonenhancing T1 hypointense lesion and perilesional WM, and 11 normal-appearing white matter (NAWM) regions were drawn on color-coded fractional anisotropy (FA) maps. Lesion load was determined in terms of number and volume of WM hyperintensities.
  
  
  RESULTS
  A tendency towards greater lesion load was found in smoker patients. T1 hypointense lesions and perilesional WM had reduced FA and increased mean diffusivity to a similar degree in smoker and nonsmoker CIS patients. Compared with healthy smokers, smoker CIS patients had more extensive NAWM changes shown by increased mean diffusivity. There was no relationship between diffusion metrics and clinical disability scores, duration of the disease and degree of smoking exposure.
  
  
  CONCLUSIONS
  Smoker patients showed a tendency towards having greater number of WM lesions and displayed significantly more extensive NAWM abnormalities.
authors.affiliation: Department of Radiology, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey. karlioguz@yahoo.com.
authors.forename: Gamze
authors.initials: G
authors.lastname: Durhan
authors.forename: Sevda
authors.initials: S
authors.lastname: Diker
authors.forename: Arzu Ceylan
authors.initials: AC
authors.lastname: Has
authors.forename: Jale
authors.initials: J
authors.lastname: Karakaya
authors.forename: Asli
authors.initials: A
authors.lastname: Tuncer Kurne
authors.forename: Kader Karli
authors.initials: KK
authors.lastname: Oguz
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D003711:Demyelinating Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D056324:Diffusion Tensor Imaging / Q000379:methods*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects* / Q000473:pathology*; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult