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Front. Neurosci. | doi: 10.3389/fnins.2018.00247

Comparison of Multi-Tensor Diffusion Models’ Performance for White Matter Integrity Estimation in Chronic Stroke

 Olena G. Filatova1, 2, Lucas J. van Vliet2,  Alfred C. Schouten1, 3,  Gert Kwakkel4, Frans C. van der Helm1 and Frans M. Vos2, 5*
  • 1Department of Biomechanical Engineering, Delft University of Technology, Netherlands
  • 2Department of Imaging Physics, Delft University of Technology, Netherlands
  • 3Institute for Biomedical Technology and Technical Medicine, University of Twente, Netherlands
  • 4Department of Rehabilitation Medicine, Medical Center, VU University Amsterdam, Netherlands
  • 5Department of Radiology, Academic Medical Center (AMC), Netherlands

Better insight into white matter (WM) alterations after stroke onset could help to understand the underlying recovery mechanisms and improve future interventions. MR diffusion imaging enables to assess such changes. Our goal was to investigate the relation of WM diffusion characteristics derived from diffusion models of increasing complexity with the motor function of the upper limb. Moreover, we aimed to evaluate the variation of such characteristics across different WM structures of chronic stroke patients in comparison to healthy subjects. Subjects were scanned with a two b-value diffusion-weighted MRI protocol to exploit multiple diffusion models: single tensor, single tensor with isotropic compartment, bi-tensor model, bi-tensor with isotropic compartment. From each model we derived the mean tract fractional anisotropy (FA), mean (MD), radial (RD) and axial (AD) diffusivities outside the lesion site based on a WM tracts atlas. Asymmetry of these measures was correlated with the Fugl-Meyer upper extremity assessment (FMA) score and compared between patient and control groups. Eighteen chronic stroke patients and eight age-matched healthy individuals participated in the study. Significant correlation of the outcome measures with the clinical scores of stroke recovery was found. The lowest correlation of the corticospinal tract FAasymmetry and FMA was with the single tensor model (r=-0.3, p=0.2) whereas the other models reported results in the range of r=-0.79÷-0.81 and p=4E-5÷8E-5. The corticospinal tract and superior longitudinal fasciculus showed most alterations in our patient group relative to controls. Multiple compartment models yielded superior correlation of the diffusion measures and FMA compared to the single tensor model.

Keywords: diffusion MRI, Stroke, Diffusion Tensor Imaging/methods, rehabilitation outcomes, Motor performance, anatomic lateralization

Received: 05 Oct 2017; Accepted: 29 Mar 2018.

Edited by:

Maxime Descoteaux, Université de Sherbrooke, Canada

Reviewed by:

Ofer Pasternak, Harvard Medical School, United States
Mariem Boukadi, Institut Universitaire De Gériatrie De Montréal, Canada  

Copyright: © 2018 Filatova, van Vliet, Schouten, Kwakkel, van der Helm and Vos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Frans M. Vos, Delft University of Technology, Department of Imaging Physics, Delft, Netherlands,