ORIGINAL RESEARCH article
Front. Neurol.
Sec. Neuro-Ophthalmology
Volume 16 - 2025 | doi: 10.3389/fneur.2025.1598510
This article is part of the Research TopicExploring Neuro-Ophthalmology Through Modern ImagingView all articles
White Matter Structural Changes in the Visual Pathway of Thyroidassociated ophthalmopathy patients: A Free Water and Multi-shell Diffusion Imaging Study
Provisionally accepted
- 1Second Xiangya Hospital, Central South University, Changsha, China
- 2Second Affiliated Hospital, Xinjiang Medical University, Urumqi, China
- 3Fifth Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang Uyghur Region, China
- 4Shaoxing People's Hospital, Shaoxing, Zhejiang Province, China
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Background Compared to single-shell diffusion tensor imaging (DTI), Free Water (FW) and neurite orientation dispersion and density imaging (NODDI) offer a more comprehensive evaluation of microstructural alterations in cerebral white matter (WM), particularly in detecting crossing fibers. However, research utilizing multi-shell diffusion imaging to investigate thyroid-associated ophthalmopathy (TAO) remains limited.This study employs FW and NODDI to investigate microstructural changes in the white matter of the visual pathways in patients with TAO.Methods Multi-shell diffusion magnetic resonance imaging (dMRI) scans were performed on 45 patients with TAO and 31 age-and sex-matched healthy controls(HC). Tract-based spatial statistics (TBSS) analysis was conducted using eight FW and NODDI-derived metrics to identify group differences in white matter microstructure. Furthermore, correlations between these microstructural changes and clinical measures were examined.Results TBSS analysis revealed that, compared to HC, patients with TAO exhibited lower free-water corrected fractional anisotropy (fwFA) and free-water corrected axial diffusivity (fwAD), while free-water corrected mean diffusivity (fwMD), free-water corrected radial diffusivity (fwRD), and orientation dispersion index (ODI) were significantly increased (P < 0.05, FWE). Notably, ODI demonstrated the highest area under the curve (AUC) among these metrics. Furthermore, fwFA, fwAD, fwMD, fwRD, and ODI showed significant correlations with the Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), and the Graves' Orbitopathy Quality of Life Questionnaire (GO-QOL2) scores.This study suggests that abnormalities in the white matter microstructure of TAO patients can be detected through the complementary use of FW and NODDI metrics, and it is revealed that these changes may have an impact on mental health.
Keywords: Thyroid-associated ophthalmopathy, free water-diffusion tensor imaging, Neurite orientation dispersion and density imaging, tract-based spatial statistics, dMRI (diffusion magnetic resonance imaging)
Received: 23 Mar 2025; Accepted: 19 Jun 2025.
Copyright: © 2025 Liu, Tong, Yao, Lu, Ma, Hao, Liu and Huang. 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) or licensor 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:
Jun Liu, Second Xiangya Hospital, Central South University, Changsha, China
Boding Tong, Second Xiangya Hospital, Central South University, Changsha, China
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