Microstructural Brain Changes in Buerger's Disease and Smokers: A Case- Control Study Using Diffusion Tensor Imaging

Aim: Thromboangiitis Obliterans (TAO), or Buerger's disease, affects peripheral vessels and is linked to smoking. This study using diffusion tensor imaging tractography (DTI) examines brain function changes in TAO patients compared to healthy smokers and non-smokers, aiming to reveal neurological implications beyond the known peripheral effects. Methods: The case-control study involved 50 participants aged 27-56 in northeastern Iran, including TAO patients, healthy smokers, and non-smoking controls. MRI scans with DTI were conducted to assess 21 brain tracts for fractional anisotropy (FA) and apparent diffusion coefficient (ADC). Results: Significant differences in brain tract integrity were observed among the groups. TAO patients showed lower FA values of the minor forceps compared to healthy smokers, while smokers had higher FA values than non-smoking controls. ADC values were notably higher in TAO patients across several tracts, including the minor forceps, the major forceps, corticospinal tracts, fornix tracts, and arcuate fasciculus, compared to both healthy smokers and controls. Conclusion: The study highlights distinct brain tract alterations in TAO patients and suggests potential neurological consequences associated with the disease and smoking habits. DTI proves valuable in understanding microstructural brain changes and could serve as a diagnostic tool for evaluating smoking-related neurologic complications, providing insights into TAO's impact beyond peripheral vessels.