White matter microstructural alterations in Huntington’s disease: a systematic review of diffusion imaging findings
Brain Imaging and Behavior. 2026-04-13; 20(2):
DOI: 10.1007/s11682-026-01141-x
1. Brain Imaging Behav. 2026 Apr 13;20(2):73. doi: 10.1007/s11682-026-01141-x.
White matter microstructural alterations in Huntington’s disease: a systematic
review of diffusion imaging findings.
Salabat D(1)(2), KamaliZonouzi S(1)(3), Kiani I(1), Seyedmirzaei H(2)(4), Rezaei
S(5), Aarabi MH(6)(7).
Author information:
(1)School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran,
Iran.
(2)Interdisciplinary Neuroscience Research Program (INRP), Tehran University of
Medical Sciences, Tehran, Iran.
(3)Neuroimaging Network (NIN), Universal Scientific Education and Research
Network (USERN), Tehran, Iran.
(4)Sports Medicine Research Center, Tehran University of Medical Sciences
(TUMS), Tehran, Iran.
(5)Department of Nuclear Medicine, Medical School, Tabriz University of Medical
Sciences, Tabriz, Iran.
(6)Department of Neuroscience, University of Padova, via Giustiniani 2, Padova,
35131, Italy. .
(7)Institut des Maladies Neurodégénératives, IMN-UMR5293, Université de
Bordeaux, Bordeaux, France. .
Huntington’s Disease (HD) is characterized by neurodegeneration initially
targeting the striatum, before progressively affecting the white matter and
cortex. Diffusion Tensor Imaging (DTI) could provide critical insights into
microstructural changes in HD patients, unraveling pathophysiological mechanisms
linked with this disease and the clinical symptoms. This study systematically
reviews the literature on HD-associated microstructural changes identified by
means of DTI, and further investigates correlations of DTI metrics with disease
progression, motor deficits, cognitive performance, and genetic features. We
searched PubMed, Embase, and Scopus, with appropriate keywords for studies that
met our inclusion criteria. We identified 33 studies eligible for being
included. The reported microstructural alterations spanned across numerous brain
regions, and mostly included reduced fractional anisotropy (FA) and increased
mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD).
Reduced FA was observed across several brain regions, including the corpus
callosum, external and internal capsule, caudate, putamen, dorsal striatum,
thalamus, and corticospinal tracts. We reported an association between specific
diffusivity measures with both cognitive performance and clinical symptoms.
Motor deficits were linked with diffusivity alterations of the corpus callosum
and the corticospinal tract. DTI facilitates identification of HD-associated
brain abnormalities, potentially elucidating disease etiology and correlations
with clinical presentation. Additionally, targeting specific affected brain
regions could lead to innovative treatment strategies. Future research is
warranted to further elucidate DTI role in HD clinical practice, with the aim of
paving the way to new effective treatments and rehabilitation interventions.
DOI: 10.1007/s11682-026-01141-x
PMID: 41973187 [Indexed for MEDLINE]
Conflict of interest statement: Declarations. Ethical approval: Not applicable.
Consent for publication: This manuscript has been approved for publication by
all authors. Competing interests: The authors declare no competing interests.