title: Tensor and non-tensor tractography for the assessment of the corticospinal tract of children with motor disorders: a comparative study.
abstract: BACKGROUND
  Non-invasive measures of corticospinal tract (CST) integrity may help to guide clinical interventions, particularly in children and young people (CAYP) with motor disorders. We compared diffusion tensor imaging (DTI) metrics extracted from the CST generated by tensor and non-tensor based tractography algorithms.
  
  
  METHODS
  For a group of 25 CAYP undergoing clinical evaluation, the CST was reconstructed using (1) deterministic tensor-based tractography algorithm, (2) probabilistic tensor-based, and (3) constrained spherical deconvolution (CSD)-derived tractography algorithms.
  
  
  RESULTS
  Choice of tractography algorithm significantly altered the results of tracking. Larger tracts were consistently defined with CSD, with differences in FA but not MD values for tracts to the pre- or post-central gyrus. Differences between deterministic and probabilistic tensor-based algorithms were minimal. Non-tensor reconstructed tracts appeared to be more anatomically representative. Examining metrics along the tract, difference in FA values appeared to be greatest in voxels with predominantly single-fibre orientations. Less pronounced differences were seen outwith of these regions.
  
  
  CONCLUSIONS
  With an increasing interest in the applications of tractography analysis at all stages of movement disorder surgery, it is important that clinicians remain alert to the consequences of choice of tractography algorithm on subsequently generated tracts, including differences in volumes, anatomical reconstruction, and DTI metrics, the latter of which will have global as well as more regional effects. Tract-wide analysis of DTI based metrics is of limited utility, and a more segmental approach to analysis may be appropriate, particularly if disruption to a focal region of a white matter pathway is anticipated.
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College, London, UK.|Department of Neurology and Stroke, and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.
authors.forename: Maria-Ioanna
authors.initials: MI
authors.lastname: Stefanou
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College, London, UK. daniel.lumsden@gstt.nhs.uk.|Complex Motor Disorder Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminister Bridge Road, London, SE1 7EH, UK. daniel.lumsden@gstt.nhs.uk.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Lumsden
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College, London, UK.|Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Ashmore
authors.affiliation: Functional Neurosurgery, Department of Neurosurgery, King's College Hospital, King's College Hospital NHS Foundation Trust, London, UK.|Clinical Neurosciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
authors.forename: Keyoumars
authors.initials: K
authors.lastname: Ashkan
authors.affiliation: Complex Motor Disorder Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, Westminister Bridge Road, London, SE1 7EH, UK.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Lin
authors.affiliation: Division of Imaging Sciences and Biomedical Engineering, King's College, London, UK.|Medical Physics, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Charles-Edwards
mesh_terms: D000293:Adolescent; D000465:Algorithms; D002648:Child; D002675:Child, Preschool; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009069:Movement Disorders / Q000000981:diagnostic imaging* / Q000473:pathology*; D011712:Pyramidal Tracts / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: DTI; Diffusion; Motor disease; Paediatric