The DOI matches its Crossref record; 191 of the 200 references it cites were found in a registry or an index.
White matter integrity, fiber count, and other fallacies: The do's and don'ts of diffusion MRI
Abstract
Diffusion-weighted MRI (DW-MRI) has been increasingly used in imaging neuroscience over the last decade. An early form of this technique, diffusion tensor imaging (DTI) was rapidly implemented by major MRI scanner companies as a scanner selling point. Due to the ease of use of such implementations, and the plausibility of some of their results, DTI was leapt on by imaging neuroscientists who saw it as a powerful and unique new tool for exploring the structural connectivity of human brain. However, DTI is a rather approximate technique, and its results have frequently been given implausible interpretations that have escaped proper critique and have appeared misleadingly in journals of high reputation. In order to encourage the use of improved DW-MRI methods, which have a better chance of characterizing the actual fiber structure of white matter, and to warn against the misuse and misinterpretation of DTI, we review the physics of DW-MRI, indicate currently preferred methodology, and explain the limits of interpretation of its results. We conclude with a list of 'Do's and Don'ts' which define good practice in this expanding area of imaging neuroscience.
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“We caution that the behaviour of the DTI indices in the human brain, which is characterized by a high density of crossing fibre that influence DTI measures (Jeurissen et al., 2013), is only partially understood and remains speculative (Jones et al., 2013).”
From White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease (2018) · cites this paper as Jones et al., 2013
In the citing paper
“DTI alterations may stem from a variety of tissue changes including altered crossing fibres, permeability of the axonal membrane, inflammation, or oedema (Jones et al., 2013).”
From White matter diffusion alterations precede symptom onset in autosomal dominant Alzheimer’s disease (2018) · cites this paper as Jones et al., 2013
In the citing paper
“However, DTI metrics are not specific to particular cellular or molecular processes.”
From Diffusion MRI reveals amyloid plaque–associated cellular signatures through spatial transcriptomic integration (2026) · cites this paper as [16]
In the citing paper
“This limitation is often expressed as the mantra “streamline count is not quantitative.””
From Quantitative mapping of the brain’s structural connectivity using diffusion MRI tractography: A review (2022) · cites this paper as Jones et al., 2013
In the citing paper
“However, because of the difference in resolution between the measured dMRI signal and actual axon dimensions (as described in Section 3.3: “Connection density biases”), many studies have emphasized that NOS does not provide a truly quantitative measure of connection strength (Jones, 2010; Jones et al., 2013; Sotiropoulos and Zalesky, 2019; Yeh et al., 2020).”
From Quantitative mapping of the brain’s structural connectivity using diffusion MRI tractography: A review (2022) · cites this paper as Jones et al., 2013
In the citing paper
“For example, many factors (e.g., cell death, edema, gliosis, inflammation, change in myelination, increase in connectivity of crossing fibers, increase in extracellular or intracellular water, etc.) may cause changes in FA (Assaf and Pasternak, 2008; Jones et al., 2013; Le Bihan and Johansen-Berg, 2012).”
From Quantitative mapping of the brain’s structural connectivity using diffusion MRI tractography: A review (2022) · cites this paper as Jones et al., 2013
In the citing paper
“However, these measures reflect a composite of axonal organization, myelin, extracellular water, fiber geometry, and cerebrovascular injury (Beck et al., 2021; Jones et al., 2013).”
From 40 Years of diffusion MRI in the brain: From history to emerging frontiers (2026) · cites this paper as Jones et al., 2013
In the citing paper
“This has led to considerable debate, since the inception of DTI, over the biological significance of these DTI-derived measures since WM integrity can be affected by many different parameters including axon packing density, axon caliber, myelination, microglia, inflammation, and tissue architecture (Mori and Zhang, 2006; Le Bihan and Johansen-Berg, 2012; Jones et al., 2013).”
From The role of myelination in measures of white matter integrity: Combination of diffusion tensor imaging and two-photon microscopy of CLARITY intact brains (2017) · cites this paper as Jones et al., 2013
In the citing paper
“higher values corresponding to higher diffusivity, which is often observed in damaged tissues (Jones et al., 2013)”
From Substance abuse and white matter: Findings, limitations, and future of diffusion tensor imaging research (2019) · cites this paper as Jones et al., 2013
In the citing paper
“Changes in FA signal one or many microstructural alterations, such as Wallerian degeneration (Pierpaoli et al., 2001; Thomalla et al., 2004) or decreased neuronal membrane permeability (Jones, KnöSche, & Turner, 2013).”
From Substance abuse and white matter: Findings, limitations, and future of diffusion tensor imaging research (2019) · cites this paper as Jones, KnöSche, & Turner, 2013
In the citing paper
“Moreover, diffusion-weighted imaging has many limitations and sources of error at each step of the analysis pipeline that must be considered when interpreting results236, 237.”
From Imaging structural and functional brain development in early childhood (2018) · cites this paper as [237]
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“…motion is modeled within a voxel using a three-dimensional ellipsoidal tensor, and by solving for diffusion features, a series of quantitative DTI maps can be obtained, such as Fractional Anisotropy (FA), Mean Diffusivity (MD), Color FA, Axial Diffusivity (AD), and Radial Diffusivity (RD) [3].”
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“FA values, as a microstructural marker of WM, reflect the degree of organization of nerve fibers within WM. 35 Decreased FA values typically indicate damage or degeneration of nerve fibers within WM tracts, which may lead to reduced efficiency in neural signal transmission and subsequently affect the communication and…”
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“Although DTI can be acquired and has been widely used to study brain WM, its capacity to capture the microstructure was limited (Jones et al., 2013).”
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InfluentialModular community structure of the face network supports face recognition
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“, stressing that the DTI values are just a marker, not a direct measure, of SC [60].”
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“Notably, decreased FA can be attributable to altered microstructural properties, including myelination, axon density, thickness, membrane permeability, and fiber coherence (Jones et al., 2013).”
BackgroundWard, I. L., Raven, E. P., de la Rosa, S., Jones, D. K., Teufel, C., & Hagen, E. V. D. (2023) · Human Brain Mapping · doi:10.1002/hbm.26211 · Cited by 3
Self-citationFunctional MRI but not white matter fibre dissection identifies language dominance
Busaidi, A. A., Gangemi, E., Wastling, S. J., Berg, A. S. V. D., Mancini, L., & Yousry, T. A. (2023) · European Radiology · doi:10.1007/s00330-023-09838-z · Cited by 4
“We chose volume and HMOA as metrics as they are less affected by tract morphology compared with FA [53, 52–56], and their values are less ambiguous than the number of streamlines and relative fiber density (RFD) [54].”
MethodInfluentialLanders, M. J. F., Rutten, G.-J. M., Baene, W. D., Gehring, K., Sitskoorn, M. M., & Butterbrod, E. (2023) · Cortex · doi:10.1016/j.cortex.2023.05.019 · Cited by 4
Role of deep brain stimulation (DBS) in addiction disorders
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“[53] e relationship between substance abuse and white matter microstructure varies across different substances:”
BackgroundIdentification and Connectomic Profiling of Concussion Using Bayesian Machine Learning
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“First-order statistics (i.e., mean, standard deviation) of cognitive scores were calculated for injured participants and HCs in SPSS version 28.”
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“This can lead to false negatives, if we do not correctly map existing tracts and, for example, tracking may stop prematurely; or false positives , if we map tracts that do not exist and tracking may switch to an unrelated neighboring tract [7, 15, 16].”
Network Modeling of Epilepsy Using Structural and Functional MRI
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“It is worth saying that tractography results should be interpreted with care (Jones et al., 2013).”
BackgroundDiffusion tensor MR microscopy of tissues with low diffusional anisotropy
Bajd, F., Mattea, C., Stapf, S., et al. (2016) · Radiology and Oncology · doi:10.1515/raon-2016-0018 · Cited by 4
A Bayesian approach to fiber orientation estimation guided by volumetric tract segmentation
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“Instead, the connectivity patterns provide a qualitative evaluation of connectivity (Jones et al., 2013).”
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A structural motor network correlates with motor function and not impairment post stroke
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The robust and independent nature of structural STS asymmetries
Bain, J. S., Filo, S., & Mezer, A. (2019) · Brain Structure and Function · doi:10.1007/s00429-019-01952-3 · Cited by 4
Inward versus reward: white matter pathways in extraversion
Leshem, R., Paoletti, P., Piervincenzi, C., Carducci, F., Mallio, C. A., Errante, Y., Quattrocchi, C. C., & Ben‐Soussan, T. D. (2019) · Personality Neuroscience · doi:10.1017/pen.2019.6 · Cited by 4
“The relationship between AD and RD (degree of anisotropy) can be expressed by FA (Jones et al., 2013).”
BackgroundVinçon-Leite, A., Saitovitch, A., Lemaître, H., Rechtman, E., Fillon, L., Grévent, D., Calmon, R., Brunelle, F., Boddaert, N., & Zilbovicius, M. (2020) · Scientific Reports · doi:10.1038/s41598-020-63273-4 · Cited by 4
Magnetic resonance imaging in Huntington's disease
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Molecular and connectomic vulnerability shape cross-disorder cortical abnormalitiesPreprint
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“Second, despite the fact that structural connectomes were reconstructed from high resolution diffusion spectrum imaging, diffusion tractography is still prone to false-positives and false-negatives [58, 68, 132].”
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Human white matter myelination rate slows down at birthPreprint
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“Instead, they reflect various changes to the white matter including the diameter, spacing, and orientation of fibers along with myelination (29).”
BackgroundMetric comparison of connectome-based lesion-symptom mapping in post-stroke aphasia
Ding, J., Thye, M. D., Edmondson-Stait, A. J., Szaflarski, J. P., & Mirman, D. (2024) · Brain Communications · doi:10.1093/braincomms/fcae313 · Cited by 4
“17,18 However, practical limitations, such as cost and clinical constraints, mean that often DWI data are not collected and only low-resolution structural MRI or CT images are available.”
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“One approach to increase specificity is to employ increasingly more sophisticated biophysical models ( Novikov, Kiselev, et al., 2018; Olesen et al., 2022; Palombo et al., 2020), which often rely on fragile assumptions ( Jelescu et al., 2020; Jones et al., 2013; Lampinen et al., 2023).”
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“…organization; (2) mean diffusivity (MD), the average amount of water diffusion independent of directionality in each voxel; (3) axial diffusivity (AD), water diffusivity along the tract; and (4) radial diffusivity (RD), water diffusivity perpendicular to the tract (Jones et al., 2013).”
Fiber orientation‐dependent T1 angular features in human white matter at 1.5 T, 3 T, and 7 T
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“35,36 To minimize this issue, the FA cutoff was set at 0.5, above which the crossing fiber issue is less prominent.”
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“13 To overcome some of these issues, a multi-shell diffusion MRI technique called neurite orientation dispersion and density imaging (NODDI) has been introduced.”
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Motor learning induces myelin-related white matter changes revealed by MRI-based in vivo histology
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“This acquisition provides suf fi cient diffusion weighting to probe water pools exhibiting restricted diffusion (e.g., within neurites) while reducing signal contributions from faster diffusing extracellular water compartments 12,15 .”
White matter predictors of cerebellar tDCS treatment effects in aphasia rehabilitation
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“While experimenting, it is crucial to bear in mind that cleaner tracts, more fi ber crossings, a higher streamline count, or longer streamlines do not inherently equate to more accurate results or “ higher connectivity ” (46).”
Background
Metadata
- Authors
- Jones, D. K., Knösche, T. R., & Turner, R.
- Affiliations
- Cardiff University (GB)
- Max Planck Institute for Human Cognitive and Brain Sciences (DE)
- Corresponding author
- Jones, Derek K.
- Venue
- NeuroImage
- Publisher
- Elsevier BV
- Published
- 2013-06
- Volume
- 73
- Pages
- 239-254
- ISSN
- 1053-8119 (ISSN-L)
- OpenAlex
- W2117987496
- Semantic Scholar
- 18c1f13bf2af5a9efb0126b7bd4683fa1b786532
- Cited by
- 2,402
- References
- 200
- Citations by year
- 2026: 140 · 2025: 134 · 2024: 121 · 2023: 150 · 2022: 183 · 2021: 225 · 2020: 209 · 2019: 203 · 2018: 189 · 2017: 201 · 2016: 213 · 2015: 182 · 2014: 135 · 2013: 105
- FWCI
- 92.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- NeuroImage (publishedVersion)
- PubMed (publishedVersion)
- MPG.PuRe (Max Planck Society) (submittedVersion)
- Funders
- Wellcome Trust (096646/Z/11/Z)
- Topics
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced Neuroimaging Techniques and Applications
- Life Sciences › Neuroscience › Cognitive Neuroscience › Functional Brain Connectivity Studies
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Advanced MRI Techniques and Applications
- Keywords
- diffusion-weighted imaging, diffusion tensor imaging, white matter integrity, fiber count, structural connectivity
- MeSH terms
- Brain, Brain Mapping, Cell Count, Data Interpretation, Statistical, Humans, Image Processing, Computer-Assisted, Nerve Fibers, Neural Pathways, Models, Statistical, Diffusion Magnetic Resonance Imaging, Diffusion Tensor Imaging, Signal-To-Noise Ratio
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