{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:30:28Z","timestamp":1786649428077,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,11]]},"abstract":"\n Background and Objectives:<\/jats:title>\n Wilson\u2019s disease (WD) is a rare autosomal recessive disorder due to abnormal hepatic copper transport, leading to copper accumulation in the liver, brain, and other tissues. Although conventional magnetic resonance imaging (MRI) features are valuable for diagnosis, the role of diffusion-weighted imaging (DWI) remains underexplored in WD. The study aims to assess the prevalence and clinical correlates of diffusion restriction on MRI in WD.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n \n A single-center, retrospective study was conducted. Clinicodemographic and MRI findings of patients diagnosed with WD based on a modified Leipzig score cut-off of 4 were analyzed. Characteristics of patients with diffusion restriction (WD\n DR+<\/jats:sub>\n ) and without diffusion restriction (WD\n DR-<\/jats:sub>\n ) were compared using statistical tests.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Of 91 patients with WD, 17 (18.7%) demonstrated MRI diffusion restriction. WD\n DR+<\/jats:sub>\n were noted to have a lower median age at symptom onset (14 [9\u201317] versus 15 [14\u201323] years;\n P<\/jats:italic>\n = 0.020) and presentation (15 [13\u201320] years versus 19 [15\u201325.5] years;\n P<\/jats:italic>\n = 0.022) compared to WD\n DR-<\/jats:sub>\n . WD\n DR+<\/jats:sub>\n had a higher modified Leipzig score compared to WD\n DR-<\/jats:sub>\n (5 [4\u20135] versus 7 [5\u20138];\n P<\/jats:italic>\n \u2264 0.001). They also had significantly higher Global Assessment Scale (GAS) for WD (32.5 [30\u201337]) compared to WD\n DR-<\/jats:sub>\n (19 [13\u201322]) (\n P<\/jats:italic>\n < 0.001). WD\n DR+<\/jats:sub>\n had significantly higher proportions of patients with dysphagia (10\/17, 58.8% versus 6\/74, 8.1%;\n P<\/jats:italic>\n < 0.001) and portal hypertension (8\/17, 47.1% versus 6\/74, 8.1%;\n P<\/jats:italic>\n < 0.001). WD\n DR+<\/jats:sub>\n also experienced significantly higher rates of early neurological deterioration (END) (23.5% versus 6.6%,\n P<\/jats:italic>\n = 0.04).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Diffusion restriction may hence serve as a pointer toward more severe neurological and hepatic involvement in WD, indicating the need for close supervision in this group of patients.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/aian.aian_483_25","type":"journal-article","created":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T17:00:14Z","timestamp":1756486814000},"page":"855-862","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Diffusion Restriction in Wilson\u2019s Disease: A Radiological Pointer Toward Clinically Severe Disease"],"prefix":"10.4103","volume":"28","author":[{"given":"Divyani","family":"Garg","sequence":"first","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shariq Ahmad","family":"Shah","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayush","family":"Agarwal","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divya M","family":"Radhakrishnan","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roopa","family":"Rajan","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achal Kumar","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Department of Neurology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ajay","family":"Garg","sequence":"additional","affiliation":[{"name":"Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"R1-20251222","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1038\/s41572-018-0018-3","article-title":"Wilson disease","volume":"4","author":"Cz\u0142onkowska","year":"2018","journal-title":"Nat Rev Dis Primers"},{"key":"R2-20251222","doi-asserted-by":"crossref","first-page":"727","DOI":"10.3390\/brainsci14070727","article-title":"Brain magnetic resonance imaging in Wilson\u2019s disease-significance and practical aspects-A narrative review","volume":"14","author":"Litwin","year":"2024","journal-title":"Brain Sci"},{"key":"R3-20251222","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1034\/j.1600-0676.2003.00824.x","article-title":"Diagnosis and phenotypic classification of Wilson disease","volume":"23","author":"Ferenci","year":"2003","journal-title":"Liver Int"},{"key":"R4-20251222","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1016\/j.jceh.2018.08.009","article-title":"Wilson\u2019s Disease: Clinical Practice Guidelines of the Indian National Association for Study of the Liver, the Indian Society of Pediatric Gastroenterology, Hepatology and Nutrition, and the Movement Disorders Society of India","volume":"9","author":"Nagral","year":"2019","journal-title":"J Clin Exp Hepatol"},{"key":"R5-20251222","doi-asserted-by":"crossref","first-page":"994","DOI":"10.1002\/mds.28018","article-title":"Semiquantitative scale for assessing brain MRI abnormalities in Wilson disease: A validation study","volume":"35","author":"Dusek","year":"2020","journal-title":"Mov Disord"},{"key":"R6-20251222","doi-asserted-by":"crossref","first-page":"4405","DOI":"10.1007\/s10072-022-06001-2","article-title":"Brain magnetic resonance imaging and severity of neurological disease in Wilson\u2019s disease-the neuroradiological correlations","volume":"43","author":"R\u0119dzia-Ogrodnik","year":"2022","journal-title":"Neurol Sci"},{"key":"R7-20251222","doi-asserted-by":"crossref","first-page":"917","DOI":"10.1007\/s13760-022-02091-z","article-title":"Serum neurofilament light chain and initial severity of neurological disease predict the early neurological deterioration in Wilson\u2019s disease","volume":"123","author":"Ziemssen","year":"2023","journal-title":"Acta Neurol Belg"},{"key":"R8-20251222","first-page":"1086","article-title":"[Study of diffusion weighted magnetic resonance imaging in Wilson\u2019s 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