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Objectives: To investigate diffusional changes in multiple sclerosis (MS) plaques and non-Gaussian behavior of water diffusion by using diffusional kurtosis imaging (DKI). Methods: 31 MS patients and 21 controls underwent MRI on a 3T scanner. Mean kurtosis (MK) parametric maps were computed. Region of interest (ROI) was delineated as white matter (WM) in controls and MS plaques and WM in patients. Results: There was no significance of WM kurtosis and skewness parameters among MS group and control group patients p=0.213 and p=0.390, respectively. In MS patients, kurtosis, skewness, maximum intensity, minimum intensity, and median intensity values of WM, Plaque 1, Plaque 2, and Plague 3 were significantly higher at p<0.0001 for all. Conclusions: DKI may provide more extensive characterization of lesions and WM and may be a sensitive indicator of tissue damage and microstructural change in patients with MS in addition to conventional diffusional evaluations.

Background and Introduction: Botulinum neurotoxin (BoNT) is a potent biological toxin extracted from Clostridium Botulinum bacteria. BoNT injection is mainly used for medical purposes; it is frequently used for cosmetic purposes as well. The hypothesis that frequent application of this treatment modality may also affect the central nervous system constitutes the subject of our study. Objective: We aimed to demonstrate the possible central effects of BoNT in hemifacial spasm patients. Methods and Materials: Diffusion tensor imaging was used for this study. Patients were divided into two groups, and the measured values for each determined bilateral neuroanatomic region were compared within the relevant group. Results: Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were found to be closer to the pathological values in the right motor cortex and in the left internal capsule areas of the patients who were injected with BoNT into the left side, in the left motor cortex area of the patients who were injected with BoNT into the right side. No significant changes were detected in other regions. Conclusion: Botulinum neurotoxin administration in patients with hemifacial spasms may cause some changes in the central nervous system as well as peripheral effects. In the case of similar studies supporting pathological changes, BoNT treatment modalities or appropriate indications may be reviewed, and regulation on excessive cosmetic use may be in question.

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