Brain microstructure charts in controls and multiple sclerosis patients using clinical diffusion MRI

Motivation: Currently, brain charts index gray matter brain volume from T1-weighted MRI, whose sensitivity is limited to millimeter resolution, thereby unable to probe early signs of aging and pathology at the cellular level. Goal(s): To introduce normative data for diffusion MRI (dMRI) and apply it to multiple sclerosis (MS) patients to evaluate sensitivity and accuracy. Approach: We created normative data using diffusion tensor, diffusion kurtosis, and standard model imaging metrics in white matter. Then, assessed MS subjects by comparing to these normative data. Results: dMRI metrics from MS patients deviate from normative data, suggesting brain charts may be used to benchmark brain health. Impact: This study is the first step to achieve a brain-age framework from clinically feasible dMRI scans that provides meaningful insight into microstructural processes underlying brain aging and disease– possibly enabling quantitative assessment of treatment response to future disease-modifying therapies.