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Background: Several studies have identified changes in the spinal cord DTI measurements in patients with multiple sclerosis (MS). However, correlations between changes in DTI parameters in normal appearing cervical spine and neurological findings have not been clearly established., Objectives: To determine whether diffusion tensor imaging (DTI) measurements such as fractional anisotropy (FA) and apparent diffusion coefficient (ADC) are sufficiently sensitive in detecting microstructure alterations in normal-appearing spinal cords in patients with MS and whether they reflect these patients' clinical disability., Material and Methods: Fifteen patients diagnosed with relapsing-remitting MS (RRMS) with normal-appearing cervical spinal cords on plain MRI and 11 asymptomatic volunteers were enrolled in the study. Overall, 75 cervical spinal segments were analyzed. The regions of interest were drawn from the entire spinal cord cross-section and in the normal-appearing white matter tracts: the superior and inferior cerebellar peduncles and the posterior limbs of the internal capsules. Neurological deficit and the level of disability were evaluated using the Expanded Disability Status Scale (EDSS), the timed 25-foot walk test (T25FW) and the 9-hole peg test (9HPT) for manual dexterity., Results: A significant difference (p < 0.05) in FA values between patients with MS and the control group was found at levels C2 (p = 0.047) and C3 (p = 0.023). No significant changes in ADC values were found. There was correlation between FA and ADC values in selected white matter tracts and at particular spinal cord levels. We also observed significant correlations between diffusion tensor imaging parameters and manual dexterity., Conclusions: Our preliminary results may suggest that the spinal cord's structural loss is the dominant factor in the inflammatory/demyelinating component in patients with MS. Diffusion tensor imaging changes in the spinal cord correlate with brain DTI changes. Manual functioning seems to be more affected than walking.

Aims: The objectives of the study were to assess the usefulness of measurements of apparent diffusion coefficient (ADC) in normal appearing white and grey matter (NAWM, NAGM) in differential diagnosis between patients with hyperintense demyelinating plaques in the course of multiple sclerosis (MS) and other conditions presenting white matter hyperintensities (WMHs), as well as to evaluate the relationship between clinical data and ADC values in MS patients., Material and Methods: The study comprised 66 patients with MS before treatment, 66 patients with WMHs and 64 control subjects (control group, CG), who underwent MRI (magnetic resonance imaging) examination including diffusion weighted imaging (DWI) with a 1.5 T MR unit. ADC measurements were obtained from NAWM of the cerebellum, pons as well as frontal, fronto-parietal and temporal regions bilaterally, and from NAGM of thalami and heads of caudate nuclei, using round region of interest (ROI) sized 200mm 2 ., Results: The mean ADC values in frontal, fronto-parietal and temporal NAWM were significantly higher in the MS group than in subjects with WMHs and CG (p < .001), whereas the mean ADC value in pons was higher in MS than in CG (p < .05). In the MS group we observed a positive correlation between the Expanded Disability Status Scale (EDSS) and lesion load, between duration of the disease and mean ADC values and between lesion load and mean ADC values., Conclusion: Our results suggest that ADC measurements may support the differential diagnosis between MS and other conditions associated with white matter hyperintensities. The most significant changes were observed in temporal white matter regions., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Background: The aim of the study was to assess microstructural changes within strategic brain regions in multiple sclerosis (MS) patients, using diffusion tensor imaging (DTI), with regard to various aspects of disability., Material and Methods: The study comprised 50 patients with relapsing-remitting MS (37 women, 13 men, mean age 36.4 yrs) and 27 age- and sex-matched controls. Using DTI, fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained within corpus callosum (CC), both thalami (TH) and middle cerebellar peduncles (MCP). Disability was assessed using Expanded Disability Status Scale (EDSS), MS Functional Composite (MSFC), Symbol Digit Modalities Test (SDMT) and Fatigue Severity Scale (FSS). DTI indices were compared between the patients and controls and in the MS group - referred to disability measures., Results: Significant decrease in FA and increase in ADC within CC and both TH were found in MS patients compared to the controls. DTI indices within CC and TH correlated significantly with SDMT score, and within TH and MCP - with MSFC manual dexterity measure., Conclusions: Changes in DTI measures in normal appearing white and grey matter in the MS patients indicate subtle alterations of the tissue integrity. An occult damage to the strategic brain regions may contribute to various aspects of disability due to MS., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Primary lateral sclerosis (PLS) is one of the forms of motor neuron disease (MND), affecting only upper motor neurons. The diagnosis of PLS should be made on different diagnostic criteria, for example, Pringle or Gordon, but it is usually a diagnosis of exclusion. There are no characteristic findings in standard laboratory and electrophysiological assessment. We present details of a 31-year-old woman who had suffered from progressive paraparesis with right-side predominance. Conventional MRI of brain and spinal cord and diffusion tensor imaging (DTI) studies showed Hyperintense lesions in the upper part of the cervical spinal cord at the level C1 in lateral funicules, in the medulla oblongata at the pyramidal decussation and in the midbrain. Brain DTI revealed changes along the corticospinal tracts on fractional anisotropy (FA) maps. MRI of the thoracic spinal cord showed in T2-weighted images hyperintensive regions in the course of the lateral corticospinal tracts. This aided in PLS recognition.

Aim: Holmes tremor (HT) is a combination of rest, postural and action tremor. A parallel dysfunction of cerebello-thalamic and nigrostriatal pathways seems necessary to produce this kind of tremor. We present the clinical and neuroimaging study verifying that hypothesis., Material and Methods: A total of 10 patients: five male, five female, fulfilling consensus criteria were included. Demographic, clinical and neuroimaging data (MRI = 9; CT = 1, SPECT with the use of 123-I-FP CIT: DaTSCAN in six patients to assess the presynaptic dopaminergic nigrostriatal system involvement, indices of asymmetry for ligand uptake for each striatum were calculated) were analyzed., Results: Hemorrhage was the most frequent etiology and thalamus - the most commonly involved structure. Contrary to the previous reports, the visual assessment did not reveal remarkable interhemispheric differences of DaTSCAN uptake. Quantitative measurements showed only minimal differences., Conclusions: It is open to debate whether nigrostriatal pathway damage is crucial for the phenomenology of HT. Alternative hypothesis is presented that HT represents the heterogeneous spectrum of tremors with similar phenomenology, but different pathophysiology., (Copyright © 2010 The Authors. Journal compilation © 2010 Blackwell Munksgaard.)

A rare coexistence of multiple intracranial neoplasms of mesodermal origin with asymptomatic syringomyelia is reported. The clinical findings were documented by NMR and CT results. The histological examination of the tumours removed surgically is included.