Reproducibility of corticospinal diffusion tensor tractography in normal subjects and hemiparetic stroke patients.

PURPOSE The reproducibility of corticospinal diffusion tensor tractography (DTT) for a guideline is important before longitudinal monitoring of the therapy effects in stroke patients. This study aimed to establish the reproducibility of corticospinal DTT indices in healthy subjects and chronic hemiparetic stroke patients. MATERIALS AND METHODS Written informed consents were obtained from 10 healthy subjects (mean age 25.8 ± 6.8 years), who underwent two scans in one session plus the third scan one week later, and from 15 patients (mean age 47.5 ± 9.1 years, 6-60 months after the onset of stroke, NIHSS scores between 9 and 20) who were scanned thrice on separate days within one month. Diffusion-tensor imaging was performed at 3T with 25 diffusion directions. Corticospinal tracts were reconstructed using fiber assignment by continuous tracking without and with motion/eddy-current corrections. Intra- and inter-rater as well as intra- and inter-session variations of the DTT derived indices (fiber number, apparent diffusion coefficient (ADC), and fractional anisotropy (FA)) were assessed. RESULTS Intra-session and inter-session coefficients of variations (CVs) are small for FA (1.13-2.09%) and ADC (0.45-1.64%), but much larger for fiber number (8.05-22.4%). Inter-session CVs in the stroke side of patients (22.4%) are higher than those in the normal sides (18.0%) and in the normal subjects (14.7%). Motion/eddy-current correction improved inter-session reproducibility only for the fiber number of the infarcted corticospinal tract (CV reduced from 22.4% to 14.1%). CONCLUSION The fiber number derived from corticospinal DTT shows substantially lower precision than ADC and FA, with infarcted tracts showing lower reproducibility than the healthy tissues.

[1]  Sung Hyun Kim,et al.  Fiber tracking by diffusion tensor imaging in corticospinal tract stroke: Topographical correlation with clinical symptoms , 2005, NeuroImage.

[2]  Paul A. Viola,et al.  Multi-modal volume registration by maximization of mutual information , 1996, Medical Image Anal..

[3]  Bin Chen,et al.  Correction for direction-dependent distortions in diffusion tensor imaging using matched magnetic field maps , 2006, NeuroImage.

[4]  David Bonekamp,et al.  Diffusion tensor imaging in children and adolescents: Reproducibility, hemispheric, and age-related differences , 2007, NeuroImage.

[5]  Gareth J. Barker,et al.  From diffusion tractography to quantitative white matter tract measures: a reproducibility study , 2003, NeuroImage.

[6]  A. Kirton,et al.  Quantified Corticospinal Tract Diffusion Restriction Predicts Neonatal Stroke Outcome , 2007, Stroke.

[7]  R. A. Davidoff.  The pyramidal tract. , 1990, Neurology.

[8]  Jerry L. Prince,et al.  Effects of diffusion weighting schemes on the reproducibility of DTI-derived fractional anisotropy, mean diffusivity, and principal eigenvector measurements at 1.5T , 2007, NeuroImage.

[9]  Manabu Kinoshita,et al.  Fiber-tracking does not accurately estimate size of fiber bundle in pathological condition: initial neurosurgical experience using neuronavigation and subcortical white matter stimulation , 2005, NeuroImage.

[10]  P. Basser,et al.  Comprehensive approach for correction of motion and distortion in diffusion‐weighted MRI , 2004, Magnetic resonance in medicine.

[11]  D. York.  Review of descending motor pathways involved with transcranial stimulation. , 1987, Neurosurgery.

[12]  D. Reich,et al.  Quantitative characterization of the corticospinal tract at 3T. , 2006, AJNR. American journal of neuroradiology.

[13]  Ken E Sakaie,et al.  Quantitative assessment of motion correction for high angular resolution diffusion imaging. , 2010, Magnetic resonance imaging.

[14]  Chunshui Yu,et al.  A longitudinal diffusion tensor imaging study on Wallerian degeneration of corticospinal tract after motor pathway stroke , 2009, NeuroImage.

[15]  Susumu Mori,et al.  Fiber tracking: principles and strategies – a technical review , 2002, NMR in biomedicine.

[16]  Susumu Mori,et al.  Introduction to Diffusion Tensor Imaging , 2007 .

[17]  Michael E. Moseley,et al.  Longitudinal changes in white matter following ischemic stroke: A three-year follow-up study , 2006, Neurobiology of Aging.

[18]  P. V. van Zijl,et al.  Three‐dimensional tracking of axonal projections in the brain by magnetic resonance imaging , 1999, Annals of neurology.

[19]  A. Canedo.  PRIMARY MOTOR CORTEX INFLUENCES ON THE DESCENDING AND ASCENDING SYSTEMS , 1997, Progress in Neurobiology.

[20]  V. Wedeen,et al.  Reduction of eddy‐current‐induced distortion in diffusion MRI using a twice‐refocused spin echo , 2003, Magnetic resonance in medicine.

[21]  M Nakagawa,et al.  MR tractography for the evaluation of functional recovery from lenticulostriate infarcts , 2005, Neurology.

[22]  P. V. van Zijl,et al.  Analysis of noise effects on DTI‐based tractography using the brute‐force and multi‐ROI approach , 2004, Magnetic resonance in medicine.

[23]  Randy L. Gollub,et al.  Reproducibility of quantitative tractography methods applied to cerebral white matter , 2007, NeuroImage.

[24]  Timothy Edward John Behrens,et al.  Between session reproducibility and between subject variability of diffusion MR and tractography measures , 2006, NeuroImage.

[25]  M. Raichle,et al.  Tracking neuronal fiber pathways in the living human brain. , 1999, Proceedings of the National Academy of Sciences of the United States of America.

[26]  J M Bland,et al.  Statistical methods for assessing agreement between two methods of clinical measurement , 1986 .

[27]  Walter H Backes,et al.  Assessing and minimizing the effects of noise and motion in clinical DTI at 3 T , 2009, Human brain mapping.