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Background and purpose Temporal lobe epilepsy secondary to hippocampal sclerosis is related to epileptogenic networks rather than a focal epileptogenic source. Graph‐theoretical gray and white matter networks may help to identify alterations within these epileptogenic networks. Methods Twenty‐seven patients with hippocampal sclerosis and 14 controls underwent magnetic resonance imaging, including 3D‐T1, fluid‐attenuated inversion recovery, and diffusion tensor imaging. Subject‐specific structural gray and white matter network properties (normalized path length, clustering, and small‐worldness) were reconstructed. Group differences and differences between those with higher and lower seizure burden ( .05). Patients with lower seizure burden had significantly lower gray matter small‐worldness and normalized clustering compared to controls and those with higher seizure burden (all p, Temporal lobe epilepsy secondary to hippocampal sclerosis is related to abnormal epileptogenic networks, including multiple temporal and extra‐temporal structures, rather than a single focal epileptogenic source. This study aims to assess alterations within structural gray and white matter networks in patients with hippocampal sclerosis, through a graph theory analysis. In patients with hippocampal sclerosis, a more rigidly organized network (higher small‐worldness) was related to having more monthly seizures; also, patients with low seizure burden had significantly lower gray matter small‐worldness and normalized clustering compared to controls and those with high seizure burden.

Background and Objective: White matter lesions are non-static brain lesions that have a prevalence rate up to 98% in the elderly population. Because they may be associated with several brain diseases, it is important that they are detected as soon as possible. Magnetic Resonance Imaging (MRI) provides three-dimensional data with the possibility to detect and emphasize contrast differences in soft tissues, providing rich information about the human soft tissue anatomy. However, the amount of data provided for these images is far too much for manual analysis/interpretation, representing a difficult and time-consuming task for specialists. This work presents a computational methodology capable of detecting regions of white matter lesions of the brain in MRI of FLAIR modality. The techniques highlighted in this methodology are SLIC0 clustering for candidate segmentation and convolutional neural networks for candidate classification. Methods: The methodology proposed here consists of four steps: (1) images acquisition, (2) images preprocessing, (3) candidates segmentation and (4) candidates classification. Results: The methodology was applied on 91 magnetic resonance images provided by DASA, and achieved an accuracy of 98.73%, specificity of 98.77% and sensitivity of 78.79% with 0.005 of false positives, without any false positives reduction technique, in detection of white matter lesion regions. Conclusions: It is demonstrated the feasibility of the analysis of brain MRI using SLIC0 and convolutional neural network techniques to achieve success in detection of white matter lesions regions.

The purpose of this study was to examine the impact of age and education on the neural and behavioral correlates of verbal fluency. Forty-eight healthy adult participants were included: high-educated young and elderly, low-educated young and elderly. Participants performed semantic and phonemic and a control task during fMRI scanning. The phonemic fluency data showed an education effect across age groups. As for the semantic fluency data, there was an education effect only in young participants. The second-level fMRI results showed, in phonemic fluency, a main effect of age in the left posterior cingulate, superior temporal gyrus (STG) and right caudate, whereas the main effect of education involved activation in the right semantic fluency, there were a main effect of age in the left paracentral lobule and posterior cingulate, a main effect of education in the left claustrum and an interaction in the right claustrum and STG and the hippocampus bilaterally.

Background and purpose Cognitive dysfunction is common in multiple sclerosis (MS). The dorsal anterior insula (dAI) is a key hub of the salience network (SN) orchestrating access to critical cognitive brain regions. The aim of this study was to assess whole-brain dAI intrinsic functional connectivity (iFC) using resting-state functional MRI (rs-fMRI) in people with MS and healthy controls (HC) and test the relationship between cognitive reserve (CR) and dAI iFC in people with MS. Methods We studied 28 people with relapsing-remitting MS and 28 HC. CR index was quantified by combining premorbid IQ, leisure activities, and education level. For whole-brain iFC analyses, the bilateral dAI were used as seeds. Individual subject correlation maps were entered into general linear models for group comparison and to analyze the effect of CR index on dAI iFC, controlling for multiple comparisons. The correlation between CR index and iFC was assessed using a linear regression model. Results rs-fMRI analyses revealed a negative relationship between CR index and iFC within the left dAI and a left occipital cluster in people with MS including regions of the cuneus, superior occipital gyrus, and parieto-occipital sulcus. The regression analysis showed that people with MS and a higher CR index had a statistically significantly reduced iFC within the left dAI and the cluster. Conclusions CR is relevant to functional connectivity within one of the main nodes of the SN, the dAI, and occipital regions in MS. These results have implications for how CR may modulate the susceptibility to cognitive dysfunction in MS.

Cell transplantation offers a promising approach in many neurological disorders. Neural stem (NS) cells are potential candidates for cell therapy. The ability to track the grafted cells in the host tissue will refine this therapy. Superparamagnetic iron oxide nanoparticles (SPION) have been suggested as a feasible method, but there is no consensus about its safety. Here we investigated the feasibility of label NS cells with SPION and track by MRI after transplantation into mouse striatum with SPION cells and its therapeutic effects by grafting the cells into mouse striatum. We demonstrated that SPION-labeled NS cells display normal patterns of cellular processes including proliferation, migration, differentiation and neurosphere formation. Transmission electron microscopy reveals SPION in the cytoplasm of the cells, which was confirmed by microanalysis. Neurons and astrocytes generated from SPION-labeled NS cells were able to carry nanoparticles after 7 days under differentiation. SPION-labeled NS cells transplanted into striatum of mice were detected by magnetic resonance imaging (MRI) and microscopy 51 days later. In agreement with others reports, we demonstrated that NS cells are able to incorporate SPION in vitro without altering the stemness, and can survive and be tracked by MRI after they have been grafted into mice striatum.

The aim of this study was to evaluate white matter (WM) integrity in vivo in patients with unilateral mesial temporal sclerosis (MTS).Diffusion tensor imaging (DTI) findings from patients with left-sided MTS (L-MTS; N = 14) and right-sided MTS (R-MTS; N = 13), all taking antiepileptic medication, were compared with those from gender- and age-matched controls; DTI was performed along 30 noncollinear directions in a 1.5-T scanner. Tract-based spatial statistics (TBSS) analysis was performed by creating a WM skeleton; 5000-permutation-based inference (threshold, p 0.05) was used to identify fractional anisotropy (FA) abnormalities. Mean (MD), radial (RD), and axial diffusivities (AD) were projected onto the mean FA skeleton.Compared with the control groups, patients with MTS had decreased FA affecting widespread WM tracts as well as extensive areas with increased RD, bilaterally and independent of the disease side. Areas with decreased FA and increased RD overlapped substantially. There were no significant differences in DTI parameters between L-MTS and R-MTS patients.Diffusion tensor imaging abnormalities were observed within and beyond the temporal lobe in patients with MTS. Patients with R- and L-MTS had extensive bilateral abnormalities in comparison to controls. These findings suggest that MTS pathobiology involves diffuse dysfunction of WM tracts, even in areas with no direct connections to the hippocampus.

Purpose Cognitive dysfunction is common in neuropsychiatric systemic lupus erythematosus (SLE). Memory is a commonly affected cognitive domain. Clinically, however, it is difficult to detect memory deficits. The objective of this study is to evaluate whether normal controls and SLE patients with and without memory deficit differ in terms of white-matter integrity. Methods Twenty SLE patients with memory deficit were compared to 47 SLE patients without memory deficit and 22 sex-, age-, and education-matched control individuals. Diffusion tensor imaging (DTI) was performed in a 1.5-Tesla scanner. For tract-based spatial statistics analysis, a white-matter skeleton was created. A permutation-based inference with 5000 permutations with a threshold of p Results Compared to controls, SLE patients with and without memory deficit had decreased FA in: bilateral anterior thalamic radiation, inferior fronto-occipital fasciculus, superior longitudinal fasciculus, uncinate fasciculus, corticospinal tract, genu, and body of the corpus callosum. SLE patients with and without memory deficit also presented increased MD and RD values compared to controls in these areas. Comparison between SLE patients with and without memory deficit did not present significant differences in DTI parameters. Conclusion DTI can detect extensive abnormalities in the normal-appearing white matter of SLE patients with and without memory deficit, compared to controls. However, there was no difference, in terms of white-matter integrity, between the groups of SLE patients.

Central nervous system (CNS) malformations play a role in all fetal malformations. Ultrasonography (US) is the best screening method for identifying fetal CNS malformations. A good echographic study depends on several factors, such as positioning, fetal mobility and growth, the volume of amniotic fluid, the position of the placenta, the maternal wall, the quality of the apparatus, and the sonographer’s experience. Although US is the modality of choice for routine prenatal follow-up because of its low cost, wide availability, safety, good sensitivity, and real-time capability, magnetic resonance imaging (MRI) is promising for the morphological evaluation of fetuses that otherwise would not be appropriately evaluated using US. The aim of this article is to present correlations of fetal MRI findings with US findings for the major CNS malformations.

Purpose Despite antiretroviral therapy, approximately half of individuals with human immunodeficiency virus (HIV) will develop HIV-associated neurocognitive disorder (HAND). Efficiency of brain networks is of great importance for cognitive functioning, since functional networks may reorganize or compensate to preserve normal cognition. This study aims to compare efficiency of the posterior cingulate cortex (PCC) between patients with and without HAND and controls. We hypothesize HAND negative (HAND–) patients will show higher PCC efficiency than HAND positive (HAND+) patients. Methods A total of 10 HAND + patients were compared with 9 HAND– patients and 17 gender-, age-, and education-matched controls. Resting-state functional MRI was acquired with a 3 Tesla scanner. Local efficiency, a measure of network functioning, was investigated for PCC. Network differences among HAND + , HAND– patients and controls were tested as well as correlations between network parameters and cognitive test performance in different domains. Results HAND– patients showed significantly increased PCC efficiency compared with healthy controls ( p = 0.015). No differences were observed between HAND + patients and either controls ( p = 0.327) or HAND– patients ( p = 0.152). In HAND– patients, PCC efficiency was positively related with cognitive performance in the attention/working memory domain ( p = 0.003). Conversely, in HAND + patients, PCC efficiency was negatively correlated with performance in the abstraction/executive domain ( p = 0.002). Conclusion HAND– patients showed a higher level of PCC efficiency compared with healthy subjects, and PCC efficiency was positively related to cognitive performance. These results support the functional reorganization hypothesis, that increased PCC efficiency is a compensation technique to maintain cognitive functioning.

PURPOSE: To develop a deep learning model for detecting brain abnormalities on MR images. MATERIALS AND METHODS: In this retrospective study, a deep learning approach using T2-weighted fluid-attenuated inversion recovery images was developed to classify brain MRI findings as “likely normal” or “likely abnormal.” A convolutional neural network model was trained on a large, heterogeneous dataset collected from two different continents and covering a broad panel of pathologic conditions, including neoplasms, hemorrhages, infarcts, and others. Three datasets were used. Dataset A consisted of 2839 patients, dataset B consisted of 6442 patients, and dataset C consisted of 1489 patients and was only used for testing. Datasets A and B were split into training, validation, and test sets. A total of three models were trained: model A (using only dataset A), model B (using only dataset B), and model A + B (using training datasets from A and B). All three models were tested on subsets from dataset A, dataset B, and dataset C separately. The evaluation was performed by using annotations based on the images, as well as labels based on the radiology reports. RESULTS: Model A trained on dataset A from one institution and tested on dataset C from another institution reached an F1 score of 0.72 (95% CI: 0.70, 0.74) and an area under the receiver operating characteristic curve of 0.78 (95% CI: 0.75, 0.80) when compared with findings from the radiology reports. CONCLUSION: The model shows relatively good performance for differentiating between likely normal and likely abnormal brain examination findings by using data from different institutions. Keywords: MR-Imaging, Head/Neck, Computer Applications-General (Informatics), Convolutional Neural Network (CNN), Deep Learning Algorithms, Machine Learning Algorithms © RSNA, 2021 Supplemental material is available for this article.

Although infection with the Zika virus was first recognized in 1942, it received little attention until 2007, when a true pandemic spread throughout Africa, Asia, and the Americas. Since then, numerous forms of central nervous system involvement have been described, mainly malformations related to congenital infection. Although the neuroimaging findings in congenital Zika syndrome are not pathognomonic, many are quite suggestive of the diagnosis, and radiologists should be prepared to interpret such findings accordingly. The objective of this article is to review the computed tomography and magnetic resonance imaging findings in congenital Zika syndrome. Resumo A infecção pelo vírus Zika, apesar de conhecida desde 1942, apresentou destaque somente a partir de 2007, quando uma verdadeira pandemia se espalhou pela África, Ásia e Américas. Durante este período, numerosas formas de acometimento do sistema nervoso central têm sido descritas, principalmente as malformações relacionadas a infecção congênita. Apesar de os achados de neuroimagem na síndrome congênita pelo vírus Zika não serem patognomônicos, muitos são bastante sugestivos, devendo o radiologista estar preparado para saber interpretar e sugerir o diagnóstico. O objetivo deste artigo é revisar os achados de tomografia computadorizada e ressonância magnética da síndrome congênita pelo vírus Zika.

The objective of this study was to evaluate the cortical thickness and the volume of deep gray matter structures, measured from 3D T1-weighted gradient echo imaging, and white matter integrity, by diffusion tensor imaging (DTI) in patients with typical absence epilepsy (AE). Patients (n = 19) with typical childhood AE and juvenile AE, currently taking antiepileptic medication, were compared with control subjects (n = 19), matched for gender and age. 3D T1 magnetization-prepared rapid gradient echo-weighted imaging and DTI along 30 noncolinear directions were performed using a 1.5-T MR scanner. FreeSurfer was used to perform cortical volumetric reconstruction and segmentation of deep gray matter structures. For tract-based spatial statistics analysis of DTI, a white matter skeleton was created, along with a permutation-based inference with 5000 permutations. A threshold of p

Purpose To determine whether systemic lupus erythematosus (SLE) affecting subcortical white matter volumes, deep gray matter volumes, and cortical thickness differ between groups of SLE patients with psychiatric (P-SLE), neurological (N-SLE), or nonneuropsychiatric (non-NPSLE) presentations. Materials and methods Sixty-seven participants were divided into three groups (P-SLE [n = 19], N-SLE [n = 12], and non-NPSLE [n = 36]) and examined with a 1.5T MRI scanner. The images were segmented in FreeSurfer software into volumetric and cortical thickness measures using T1 3D magnetization prepared rapid gradient echo-weighted imaging. For comparative analyses of volume, multivariate analyses of covariance (MANCOVA) were applied followed by Bonferroni post-hoc tests, with age as a covariate. For cortical thickness analyses, the groups were compared with the Query Design Estimate Contrast tool adjusted for age. Results Globus pallidus volumes in both left (P ≤ 0.01) and right (P ≤ 0.05) hemispheres were larger in the N-SLE group than in the non-NPSLE group, and the left GP volume was greater in the N-SLE group than in the P-SLE group (P ≤ 0.05) (MANCOVA, post-hoc Bonferroni). The P-SLE group presented with thinning of cortical areas relative to the N-SLE (predominantly in the left parietal and right frontal and parietal regions) (P ≤ 0.05) and non-NPSLE (predominantly in parietal and occipital regions) (P ≤ 0.05) groups, whereas the N-SLE group presented with thickening of cortical areas (mostly right frontal and left parietal regions) relative to the non-NPSLE (P ≤ 0.05) and P-SLE groups. Conclusion N-SLE patients had greater local volumes and cortical thicknesses than the other two groups, whereas P-SLE patients presented with decreased volumes and cortical thinning. These findings provide evidence of distinct neuroanatomical abnormalities in neurological versus psychiatric manifestations of SLE. Level of evidence 2 Technical Efficacy: Stage 3 J. MAGN. RESON. IMAGING 2017;46:150-158.

Objetivo Realizar estudo piloto para investigar a associacao entre memoria de trabalho e espessura cortical em criancas com transtorno de defict de atencao e hiperatividade (TDAH). Metodos Dezessete criancas com TDAH, entre 7 e 10 anos, e dezesseis criancas saudaveis foram submetidas a ressonância magnetica para afericao de espessura cortical. Os dados foram correlacionados com desempenho da memoria de trabalho usando a ordem inversa do subteste Digitos da Escala de Inteligencia Wechsler para Criancas. Resultados Prejuizos na memoria de trabalho, evidenciado pela menor pontuacao na ordem inversa do subteste Digitos, foram observados em pacientes com TDAH, em comparacao com criancas saudaveis. Observou-se correlacao direta entre memoria de trabalho e espessura do lobo temporal medio a esquerda (coeficiente de correlacao de Spearman: 0,499; p < 0,005). Conclusoes Nossos dados sugerem, pela primeira vez, uma correlacao entre memoria de trabalho, avaliada atraves da pontuacao na ordem inversa do subteste Digitos, e espessura do cortex temporal medial a esquerda.

BACKGROUND AND PURPOSE The purpose of this study was to investigate differences in brain cortical thickness of systemic lupus erythematosus (SLE) patients with and without episodic memory impairment and healthy controls. METHODS We studied 51 patients divided in 2 groups (SLE with episodic memory deficit, n = 17; SLE without episodic memory deficit, n = 34) by the Rey Auditory Verbal Learning Test and 34 healthy controls. Groups were paired based on sex, age, education, Mini-Mental State Examination score, and accumulation of disease burden. Cortical thickness from magnetic resonance imaging scans was determined using the FreeSurfer software package. RESULTS SLE patients with episodic memory deficits presented reduced cortical thickness in the left supramarginal cortex and superior temporal gyrus when compared to the control group and in the right superior frontal, caudal, and rostral middle frontal and precentral gyri when compared to the SLE group without episodic memory impairment considering time since diagnosis of SLE as covaried. There were no significant differences in the cortical thickness between the SLE without episodic memory and control groups. CONCLUSIONS Different memory-related cortical regions thinning were found in the episodic memory deficit group when individually compared to the groups of patients without memory impairment and healthy controls.

Neurocysticercosis (NCC) is an endemic disease and important public health problem in some areas of the World and epilepsy is the most common neurological manifestation. Multiple intracranial lesions, commonly calcified, are seen on cranial computed tomography (CT) in the chronic phase of the disease and considered one of the diagnostic criteria of the diagnosis. Magnetic resonance imaging (MRI) is the test that better depicts the different stages of the intracranial cysts but does not show clearly calcified lesions. Cerebral cavernous malformations (CCM), also known as cerebral cavernomas, are frequent vascular malformations of the brain, better demonstrated by MRI and have also epilepsy as the main form of clinical presentation. When occurring in the familial form, cerebral cavernomas typically present with multiple lesions throughout the brain and, very often, with foci of calcifications in the lesions when submitted to the CT imaging. In the countries, and geographic areas, where NCC is established as an endemic health problem and neuroimaging screening is done by CT scan, it will be important to consider the differential diagnosis between the two diseases due to the differences in adequate management. RESUMO A neurocisticercose (NCC) é um importante problema endêmico de saúde pública em algumas áreas do mundo, sendo epilepsia sua manifestação clínica mais comum. Múltiplas lesões intracranianas, geralmente com calcificações visualizadas em tomografia computorizada de crânio, são interpretadas como um dos critérios diagnósticos na fase crônica da doença. A ressonância magnética é o melhor teste de imagem para identificar a doença em diferentes estágios de sua forma cística mas apresenta limitações para demonstrar lesões calcificadas. Malformações cavernosas cerebrais, ou cavernomas, são malformações vasculares comuns ao sistema nervoso e epilepsia é também a sua forma mais frequente de apresentação. Na sua forma familiar cavernomas apresentam-se tipicamente com múltiplas lesões encefálicas e, frequentemente, com focos de calcificações na TC. Em alguns países, e determinadas regiões geográficas, onde neurocisticercose é endêmica, a neuroimagem mais usada para diagnóstico é a TC de crânio. Nesse contexto torna-se importante estabelecer bases para o diagnóstico diferencial entre as duas doenças, devido às diferentes formas de acompanhamento e tratamento adequado.

Purpose To evaluate whether human immunodeficiency virus (HIV)-positive patients with and without executive functions deficits and healthy control subjects differ on cortical thickness and subcortical brain structures volume in vivo. Methods In total, 34 HIV-positive patients with executive functions deficits were compared with 13 HIV-positive patients without executive functions deficits and 19 gender-, age-, and education-matched control subjects. Executive functions impairments were classified by performance on the Wisconsin card sorting test. T1 3-dimensional magnetization prepared rapid gradient echo-weighted imaging was performed using a 1.5 Tesla (magnetic resonance) MR scanner. FreeSurfer software was used to perform cortical reconstruction and volumetric segmentation of subcortical gray matter structures. Results HIV-positive patients with executive functions deficits had smaller volumes in the right and left caudate compared with the HIV-positive patients without executive functions deficits and control groups. In addition, HIV-positive patients with executive functions deficits had smaller volumes in their left accumbens, right putamen, and globus pallidum compared with the control group. No significant differences in cortical thickness were observed between the groups. Conclusion HIV-positive patients with executive functions deficits have reduced volumes of several subcortical structures, primarily in the caudate nucleus.

Cell transplantation offers a promising approach in many neurological disorders. Neural stem (NS) cells are potential candidates for cell therapy. The ability to track the grafted cells in the host tissue will refine this therapy. Superparamagnetic iron oxide nanoparticles (SPION) have been suggested as a feasible method, but there is no consensus about its safety. Here we investigated the feasibility of label NS cells with SPION and track by MRI after transplantation into mouse striatum with SPION cells and its therapeutic effects by grafting the cells into mouse striatum. We demonstrated that SPION-labeled NS cells display normal patterns of cellular processes including proliferation, migration, differentiation and neurosphere formation. Transmission electron microscopy reveals SPION in the cytoplasm of the cells, which was confirmed by microanalysis. Neurons and astrocytes generated from SPION-labeled NS cells were able to carry nanoparticles after 7 days under differentiation. SPION-labeled NS cells transplanted into striatum of mice were detected by magnetic resonance imaging (MRI) and microscopy 51 days later. In agreement with others reports, we demonstrated that NS cells are able to incorporate SPION in vitro without altering the stemness, and can survive and be tracked by MRI after they have been grafted into mice striatum.

Objective The main goal of this study was to correlate migraine improvement, after prophylactic therapy, with cortical thickness changes. Methods Cortical thickness maps were obtained with magnetic resonance imaging (MRI) from 19 patients with migraine before (first scan) and after (second scan) prophylactic treatment, and these were compared with controls using the FreeSurfer MRI tool. Cortical changes were correlated with the headache index (HI). Results Anincrease incortical thickness was found in the right cuneus and precuneus, somatosensory and superior parietal cortices in both patient scans, compared with the controls. No changes were observed in the left hemisphere. Following correction for multiple comparisons, no areas changed from the first to the second scan. Regression analysis showed a significant negative correlation between the HI improvement and cortical thickness changes in the left posterior cingulate, a region involved with nociception and, possibly, the development of chronic pain. Conclusion There were changes in cortical thickness in patients with migraine relative to controls in areas involved with vision and pain processing. Left posterior cingulate cortical changes correlated with headache frequency and intensity. RESUMO Objetivos Correlacionar a melhora de pacientes enxaquecosos após tratamento preventivo com alterações na espessura do córtex cerebral. Métodos Espessura cortical foi determinada a partir de imagens de ressonância magnética (RM)em 19 pacientes com enxaqueca, antes (1ᵃ RM) e após (2ᵃ RM) o tratamento profilático, e comparada com controles, usando o programa FreeSurfer. Mudanças corticais foram correlacionadas com o índice de cefaleia (HI). Resultados O hemisfério direito apresentou aumento da espessura no córtex do cúneus e pré-cúneus, parietal superior e somatossensitivo na primeira RM e na segunda RM, em comparação aos controles. Após correção para comparações múltiplas, nenhuma região cortical se mostrou estatisticamente diferente entre a primeira e a segunda RM. A regressão mostrou correlação (negativa) significativa entre melhora do HI e mudanças na espessura cortical do cíngulo posterior esquerdo. Conclusão Existem alterações de espessura cortical em pacientes com enxaqueca em relação a controles em áreas envolvidas com processamento visual e com a dor. As alterações corticais no cíngulo posterior esquerdo variaram de acordo com a frequência e intensidade das crises.

Introduction: Friedreich's ataxia (FRDA) is the most common hereditary ataxia and thinning of the cervical spinal cord is a consistent observation in Magnetic resonance imaging (MRI), although neuropathological examination in FRDA reveals neuronal loss in gray matter (GM) nuclei and degeneration of white matter (WM) tracts in the spinal cord, brainstem and cerebellum. Using diffusion-tensor (DTI) imaging and tract-based spatial statistics (TBSS) we tested the hypothesis that WM damage in FRDA is more extensive than previously described and probably involves normal-appearing WM. Methods: This transversal study included 21 genetically confirmed FRDA patients and seventeen healthy controls that underwent structural MRI of the brain on a 1.5 T scanner. We quantify the severity of ataxia using SARA scale. DTI was performed and diffusion data were analyzed using FMRIB's Diffusion Toolbox in FSL 4.1 in order to identify Fractional anisotropy (FA) decreases in specific brain regions and also the mean, radial and axial diffusivities (MD, RD, AD). Results: The greatest decreases in FA were in the left superior cerebellar peduncle, left posterior thalamic radiation, major forceps, left inferior fronto-occipital fasciculus and corpus callosum and had a significance level of p < 0.01. No significant correlation between FA, AD, MD and RD values and the clinical findings, SARA scores and genetic expansion was found. Conclusion: DTI and TBSS techniques clearly demonstrate the extensive cerebral and cerebellar involvement in FRDA, partially explaining the clinical phenotype of the disease. Further studies are needed with larger samples to correlate clinical, genetic findings and ataxia scores.