title: Diffusion Tensor Imaging to Map Brain Microstructural Changes in CADASIL.
abstract: Diffusion tensor imaging (DTI) is sensitive to brain microstructural changes. The aims of this DTI study were to map voxelwise the spatial distribution of brain microstructural changes in patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) and to investigate any correlation between DTI-derived indices and extension of T2 hyperintensity.
  
  
  
  Eighteen patients with CADASIL and 18 age-, sex-, and education-level-matched healthy controls underwent magnetic resonance imaging at 3 T. Differences in DTI-derived indices (mean diffusivity [MD], fractional anisotropy [FA], axial [AD] and radial [RD] diffusivities, and mode of anisotropy [MO]) of brain white matter (WM) between CADASIL patients and healthy subjects were assessed through tract-based spatial statistics. Then, DTI-derived indices were correlated with the patient's score on the extended Fazekas visual scale of the T2 hyperintensity.
  
  
  
  When compared to healthy controls, CADASIL patients showed extensive symmetric areas of increased MD/RD and decreased AD/FA/MO that involved almost the entire hemispheric cerebral WM (internal and external capsule, WM of the temporal poles, superior and inferior longitudinal fasciculus, inferior frontal-occipital fasciculus, uncinate fasciculus, cingulum, forceps major and minor, corticospinal tracts, and thalamic radiations), thalami, and corpus callosum. Additional areas of increased RD were observed in pons, midbrain, cerebellar peduncles, and cerebellar WM. Only FA was negatively correlated with extended Fazekas visual score.
  
  
  
  Our results indicate that brain damage in CADASIL is associated with extensive microstructural changes implying impairment of intra- and inter-hemispheric cerebral, thalamocortical, and cerebrocerebellar connections. Severity of microstructural changes correlates with extension of T2 hyperintensity.
authors.affiliation: Neuroradiology Unit A. Meyer Children Hospital of Florence, Italy.|Department of Clinical and Experimental Biomedical Sciences, University of Florence, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Mascalchi
authors.affiliation: Department NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
authors.affiliation: Unit of Medical Physics, Pisa University Hospital "Azienda Ospedaliero-Universitaria Pisana", Pisa, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Giannelli
authors.affiliation: Department NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Valenti
authors.affiliation: Department of Clinical and Experimental Biomedical Sciences, University of Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Bianchi
authors.affiliation: Department NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pracucci
authors.affiliation: Department of Clinical and Experimental Biomedical Sciences, University of Florence, Italy.|Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Orsolini
authors.affiliation: Department of Clinical and Experimental Biomedical Sciences, University of Florence, Italy.|Medical Physics Section, Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.|School of Computer Science and Electronic Engineering, University of Essex, Colchester, UK.
authors.forename: Stefano
authors.initials: S
authors.lastname: Ciulli
authors.affiliation: Unit of Radiology, Versilia Hospital, Azienda USL 12 Viareggio, Lido di Camaiore (Lu), Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Tessa
authors.affiliation: Department NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Poggesi
authors.affiliation: Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pescini
authors.affiliation: Department NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.affiliation: Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi", University of Bologna, Cesena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Diciotti
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging*; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000473:pathology; D001931:Brain Mapping; D046589:CADASIL / Q000000981:diagnostic imaging* / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult
keywords: CADASIL; diffusion tensor imaging; small vessel disease; tract-based spatial statistics