Voxel-based analysis combined with tract-based spatial statistics for assessing white matter microstructural alterations in primary dysmenorrhea
JIANG Mao
WEI Wei
FAN Lihua
MA Xiaotong
TIAN Xin
ZHOU Feng
YANG Ziyuan
ZHENG Yunsong
Abstract：Objective To investigate the characteristics of white matter microstructure alterations in patients with primary dysmenorrhea(PDM)using voxel-based analysis(VBA)and tract-based spatial statistics(TBSS)derived from diffusion tensor imaging(DTI).Methods We retrospectively analyzed 37 female PDM patients(PDM group)and 40 age-matched healthy female controls(HC group)who were recruited from the student population of Shaanxi University of Chinese Medicine from January to December 2022.Whole-brain DTI scans were acquired,TBSS were used to assess microstructural integrity,and VBA was applied to compare whole-brain white matter differences in fractional anisotropy(FA),axial diffusivity(AD),mean diffusivity(MD),and radial diffusivity(RD)between groups.Subsequently,correlations between these alterations and clinical data were analyzed within the PDM group.Results The TBSS analysis showed no statistically significant differences in white matter microstructure between the two groups across all comparisons.VBA revealed significant white matter microstructural alterations between the HC and PDM groups across all four DTI parameters(FA,AD,MD,and RD).Relative to the HC group,PDM patients demonstrated significantly lower FA in the right inferior fronto-occipital fasciculus(peak t=2.96)and higher FA in the fornix(column and body of fornix,peak t=-2.52)(GRF corrected);For AD,the PDM group exhibited decreased values in the fornix(column and body of fornix,peak t=2.74)and increased values in the left corticospinal tract(peak t=-4.34)(GRF corrected);For MD,the PDM group exhibited decreases in the fornix(column and body of fornix,peak t=3.31)and increases in the left cerebral peduncle(peak t=-4.33)(GRF corrected);For RD,the PDM group exhibited a decrease in the fornix(column and body of fornix,peak t=3.53)and an increase in the right superior corona radiata(peak t=-3.75)(GRF corrected).Correlation analysis failed to establish any significant associations between the VBA-derived white alterations and clinical scores(P>0.05).Conclusion Our study provides complementary evidence for white matter microstructural alterations in PDM through the combined use of VBA and TBSS.VBA served as an unbiased,whole-brain exploratory tool,revealing significant alterations outside pre-defined networks.TBSS,by circumventing registration and smoothing issues via its skeleton-based approach,offered enhanced sensitivity for major tracts.The convergence of findings from VBA,alongside the methodological rigor of TBSS,reinforces the validity of our primary results and underscores the utility of this dual-menthod approach in neuroimaging research.
Keywords：primary dysmenorrheadiffusion tensor imagingbrain white matter microstructuremagnetic resonance imaging
Publication Date：2026-01-20
Online Publishing Date：2026-02-04(First online date of this platform, not the publication date of the document)
Pages：12( 56-67 )