We present an optimized processing pipeline for longitudinal DTI data analysis in spinocerebellar ataxia type 1 (SCA1) patients, a rare neurodegenerative disease. Tract-based spatial statistics (TBSS) analysis was used to investigate longitudinal changes in white matter (WM) integrity in patients. While no significant changes in WM integrity were observed using the standard TBSS analysis pipeline, TBSS with advanced spatial normalization with DTITK tool showed significant longitudinal alterations in WM integrity. This result suggests that the use of advanced spatial normalization must be considered for longitudinal group studies of DTI data, especially when small to moderate disease effects are expected.
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