Diffusional Kurtosis Imaging in Idiopathic Normal Pressure Hydrocephalus: Correlation with Severity of Cognitive Impairment

  • KAMIYA Kouhei
    Department of Radiology, Graduate School of Medicine, University of Tokyo Department of Radiology, Juntendo University Graduate School of Medicine
  • KAMAGATA Koji
    Department of Radiology, Juntendo University Graduate School of Medicine
  • MIYAJIMA Masakazu
    Department of Neurosurgery, Juntendo University Graduate School of Medicine
  • NAKAJIMA Madoka
    Department of Neurosurgery, Juntendo University Graduate School of Medicine
  • HORI Masaaki
    Department of Radiology, Juntendo University Graduate School of Medicine
  • TSURUTA Kohei
    Department of Radiological Sciences, Graduate School of Human Health Sciences
  • MORI Harushi
    Department of Radiology, Graduate School of Medicine, University of Tokyo
  • KUNIMATSU Akira
    Department of Radiology, Graduate School of Medicine, University of Tokyo
  • ARAI Hajime
    Department of Neurosurgery, Juntendo University Graduate School of Medicine
  • AOKI Shigeki
    Department of Radiology, Juntendo University Graduate School of Medicine
  • OHTOMO Kuni
    Department of Radiology, Graduate School of Medicine, University of Tokyo

抄録

Purpose: Diffusional kurtosis imaging (DKI) is an emerging technique that describes diffusion of water molecules in terms of deviation from Gaussian distribution. This study investigated correlations between DKI metrics and cognitive function in patients with idiopathic normal pressure hydrocephalus (iNPH).<br>Materials and Methods: DKI was performed in 29 iNPH patients and 14 age-matched controls. Mini-mental state examination (MMSE), frontal assessment battery (FAB), and trail making test A (TMT-A) were used as cognitive measures. Tract-based spatial statistics (TBSS) analyses were performed to investigate the between-group differences and correlations with the cognitive measures of the diffusion metrics, including mean kurtosis (MK), fractional anisotropy (FA), apparent diffusion coefficient (ADC), axial diffusivity (AD), and radial diffusivity (RD).<br>Results: In iNPH patients, FA and MK identified positive correlations with cognitive function in similar regions, predominantly in the frontal lobes (P < 0.05, corrected for multiple comparisons). The frontoparietal subcortical white matter showed significant correlations with FAB and TMT-A across more extensive areas in MK analyses than in FA. ADC, AD, and RD analyses showed no significant correlations with MMSE and FAB, while negative correlation with TMT-A was observed in the limited portion of the frontal deep white matter.<br>Conclusion: Both FA and MK correlated well with cognitive impairment in iNPH. The observed differences between FA and MK results suggest DKI may play a complementary role to conventional FA and ADC analyses, especially for evaluation of the subcortical white matter.

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