Diffusion Magnetic Resonance Imaging (dMRI) enables a non invasive in-vivo characterization of the brain tissue. The disentanglement of each microstructural property reflected on the total dMRI signal is one of the hottest topics in the field. The dMRI reconstruction techniques ground on assumptions on the signal model and consider the neurons axons as impermeable cylinders. Nevertheless, interactions with the environment is characteristic of the biological life and diffusional water exchange takes place through cell membranes. Myelin wraps axons with multiple layers constitute a barrier modulating exchange between the axon and the extracellular tissue. Due to the short transverse relaxation time (T2) of water trapped between sheets, myelin contribution to the diffusion signal is often neglected. This thesis aims to explore how the exchange influences the dMRI signal and how this can be informative on myelin structure. We also aimed to explore how recent dMRI signal reconstruction techniques could be applied in clinics proposing a strategy for investigating the potential as biomarkers of the derived tissue descriptors. The first goal of the thesis was addressed performing Monte Carlo simulations of a system with three compartments: intra-axonal, spiraling myelin and extra-axonal. The experiments showed that the exchange time between intra- and extra-axonal compartments was on the sub-second level (and thus possibly observable) for geometries with small axon diameter and low number of wraps such as in the infant brain and in demyelinating diseases. The second goal of the thesis was reached by assessing the indices derived from three dimensional simple harmonics oscillator-based reconstruction and estimation (3D-SHORE) in stroke disease. The tract-based analysis involving motor networks and the region-based analysis in grey matter (GM) were performed. 3D-SHORE indices proved to be sensitive to plasticity in both white matter (WM) and GM, highlighting their viability as biomarkers in ischemic stroke. The overall study could be considered the starting point for a future investigation of the interdependence of different phenomena like exchange and relaxation related to the established dMRI indices. This is valuable for the accurate dMRI data interpretation in heterogeneous tissues and different physiological conditions
