Tang Yufeng, Yuan Xiaoqin, Duan Jinfeng, Zhang Xianwen, Chen Jiao, Zhou Ying, Song Fangzhou, Zhou Dong
Department of Neurology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Department of Radiology, Mianyang Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Mianyang, China.
Front Neurosci. 2021 Dec 3;15:774638. doi: 10.3389/fnins.2021.774638. eCollection 2021.
The present study was designed to systemically evaluate changes in the diffusion tensor imaging (DTI)-derived parameters of iNPH (idiopathic normal pressure hydrocephalus) patients with different responses to the tap test (TT), and to correlate cognitive impairment with white matter (WM) degeneration. This study included 22 iNPH patients and 14 healthy controls with structural magnetic resonance imaging (MRI) and DTI scanning. DTI was used to explore the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) for all participants. DTI parameters were evaluated using an ROI (region of interest)-based and tract-based spatial statistics (TBSS) approach. Neuropsychological assessments and the idiopathic normal pressure hydrocephalus grading scoring scale (iNPHGS) were performed. Compared to the TT non-responders, the TT responders group had significantly lower FA values in the corpus callosum, cingulum cingulate gyrus, superior longitudinal fasciculus, and lower AD values in the right cingulum cingulate gyrus and the left posterior thalamic radiation. Besides, the MD values were significantly increased in the corpus callosum, left anterior corona radiata, and the RD values in the corpus callosum and cingulum cingulate gyrus. In addition, the cognitive improvement was negatively correlated with FA of the corpus callosum, cingulum cingulate gyrus, and MD values of the genu of corpus callosum. While, the cognitive improvement was positively related to the AD of the cingulum cingulate gyrus, superior longitudinal, and RD values of the corpus callosum, cingulum cingulate gyrus and uncinate fasciculus. The ROI specific WM lesions in iNPH patients are the underlying basis for cognitive impairment.
本研究旨在系统评估特发性正常压力脑积水（iNPH）患者在不同腰穿试验（TT）反应下，其扩散张量成像（DTI）衍生参数的变化，并将认知障碍与白质（WM）变性相关联。本研究纳入了22例iNPH患者和14名健康对照者，进行了结构磁共振成像（MRI）和DTI扫描。使用DTI探索所有参与者在分数各向异性（FA）、平均扩散率（MD）、轴向扩散率（AD）和径向扩散率（RD）方面的差异。使用基于感兴趣区域（ROI）和基于纤维束的空间统计学（TBSS）方法评估DTI参数。进行了神经心理学评估和特发性正常压力脑积水分级评分量表（iNPHGS）。与TT无反应者相比，TT有反应者组在胼胝体、扣带束扣带回、上纵束中的FA值显著较低，在右侧扣带束扣带回和左侧丘脑后辐射中的AD值较低。此外，胼胝体、左侧放射冠前部的MD值显著增加，胼胝体和扣带束扣带回的RD值增加。此外，认知改善与胼胝体、扣带束扣带回的FA以及胼胝体膝部的MD值呈负相关。同时，认知改善与扣带束扣带回、上纵束的AD以及胼胝体、扣带束扣带回和钩束的RD值呈正相关。iNPH患者中ROI特定的WM病变是认知障碍的潜在基础。
