Searching for the neurite density with diffusion MRI: Challenges for biophysical modeling

In vivo mapping of the neurite density with diffusion MRI (dMRI) is a high but challenging aim. First, it is unknown whether all neurites exhibit completely anisotropic ('stick-like') diffusion. Second, the 'density' of tissue components may be confounded by non-diffusion properties such as T2 relaxation. Third, the domain of validity for the estimated parameters to serve as indices of neurite density is incompletely explored. We investigated these challenges by acquiring data with 'b-tensor encoding' and multiple echo times in both healthy brain and white matter lesions. Results showed that microscopic anisotropy from b-tensor data is associated with myelinated axons but not with dendrites. Furthermore, b-tensor and multi-echo data showed that unbiased density estimates in white matter lesions require data-driven estimates of compartment-specific T2 times. Finally, the 'stick' fractions of different biophysical models could generally not serve as neurite density indices across the healthy brain and white matter lesions, where outcomes of comparisons depended on the choice of constraints. In particular, constraining compartment-specific T2 times was ambiguous in the healthy brain and had a large impact on estimated values. In summary, estimating neurite density may require accounting for different diffusion and/or T2 properties between axons and dendrites. Constrained 'index' parameters could be valid within limited domains that should be delineated by future studies.