Validating Neurite EXchange Imaging (NEXI) using diffusion Monte Carlo simulations in realistic numerical gray matter substrates

NEXI is a gray matter (GM) microstructural model designed to probe brain tissue microstructure in vivo using diffusion MRI. NEXI describes GM as two exchanging Gaussian compartments - neurites, modeled as randomly oriented, infinitely long sticks, and the extracellular space - allowing the estimation of biophysically interpretable parameters related to neurite microstructure and intercompartmental exchange. While modeling cell processes as sticks and each compartment as Gaussian are common assumptions for brain biophysical models of diffusion, neurite structural irregularities and the presence of somas, particularly in GM, may violate them and bias NEXI parameter estimates. Furthermore, the barrier-limited exchange assumed in the Karger model that underlies NEXI may also be violated in realistic conditions. Therefore, in this work, we evaluate NEXIs accuracy in numerical substrates that incorporate realistic GM features and membrane permeability. To this end, we generated several GM-like substrates with neurite beading, undulation, orientation dispersion, and somas across a range of membrane permeabilities. Diffusion signals were generated with Monte Carlo simulations of water diffusion and subsequently fitted with NEXI. Overall, NEXI accurately recovered exchange times across permeability levels and successfully disentangled exchange effects from other microstructural features, showing only minor bias in estimates from the realistic geometries. These results support its potential for in vivo GM microstructure mapping and studies of brain disorders.