Quantitative evaluation of callosal abnormalities in relapsing-remitting multiple sclerosis using diffusion tensor imaging: A systemic review and meta-analysis

Abstract

Background: Although the changes of diffusion tensor imaging (DTI) in corpus callosum (CC) in patients with relapsing-remitting multiple sclerosis (RRMS) has been reported, the results are controversial. We aimed to determine the damage to the CC in patients with RRMS using DTI.

Material and methods: A systematic search of English databases (PubMed, Embase, Cochrane Library, and Scopus) was performed. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) values of DTI were compared between RRMS patients and healthy controls (HC) using Stata 12.0.

Results: A total of 461 patients and 365 HC from 15 studies were included. Compared with HC, the FA values of the whole CC (SMD -1.894, P < 0.001), genu (SMD -0.830, P < 0.001) and splenium (SMD -1.431, P < 0.001) of CC were significantly reduced in patients with RRMS. Moreover, the MD values of the whole CC (SMD 1.213, P < 0.001), genu (SMD 0.657, P < 0.001) and splenium (SMD 0.830, P < 0.001) of CC were significantly increased in patients with RRMS. Additionally, the AD values (SMD 0.635, P < 0.001) and RD values (SMD 1.480, P < 0.001) were significantly increased in the whole CC in patients with RRMS. The meta-regression analysis revealed that the male ratio showed a significant effect on the FA reduction in the splenium CC in RRMS patients.

Conclusions: These results indicated that DTI parameters were potential biomarkers with increased sensitivity for detecting pathological damage in the CC in patients with RRMS.

Keywords: Corpus callosum; Diffusion tensor imaging; Meta-analysis; Multiple sclerosis; Systemic review.