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Research ArticleAdult Brain
Open Access

Diffusional Kurtosis along the Corticospinal Tract in Adult Normal Pressure Hydrocephalus

B. Ades-Aron, S. Yeager, N. Miskin, E. Fieremans, A. George and J. Golomb
American Journal of Neuroradiology December 2018, 39 (12) 2218-2223; DOI: https://doi.org/10.3174/ajnr.A5845
B. Ades-Aron
aFrom the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
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S. Yeager
aFrom the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
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N. Miskin
cDepartment of Radiology (N.M.), Brigham and Women's Hospital, Boston, Massachusetts.
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E. Fieremans
aFrom the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
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A. George
aFrom the Center for Biomedical Imaging (B.A.-A., S.Y., E.F., A.G.), Department of Radiology
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J. Golomb
bDepartment of Neurology (J.G.), New York University School of Medicine, New York, New York
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  • Fig 1.
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    Fig 1.

    Axial diffusion and axial kurtosis overlaid onto the corticospinal tract as a scalar value and represented by a color: Red indicates higher axial kurtosis or axial diffusivity, while blue indicates lower values. From left to right, we show sample tracts for patients with Alzheimer disease, healthy controls, and patients with hydrocephalus. Patients with NPH have much lower axial diffusion in periventricular regions than control groups and much greater axial kurtosis values in the same region next to the ventricles.

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    Fig 2.

    Sample parametric maps for patients with Alzheimer disease, healthy controls, and those with normal pressure hydrocephalus to qualitatively demonstrate values that are being mapped to the CST. From upper to lower, the maps show values for axial diffusivity, axial kurtosis, and axonal water fraction.

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    Fig 3.

    A: Along-tract group differences in axial diffusivity among patient groups. A1: Axial diffusion at each point along the CST in the right hemisphere. A2: ANCOVA F-test results show a significant difference between the NPH group and the Alzheimer and control groups at distances between 56% and 88%. B: Along-tract group differences in axial kurtosis among patient groups. B1: Axial kurtosis at each point along the CST in the right hemisphere. B2: ANCOVA F-test results show a significant difference between the NPH group and the Alzheimer and control groups at distances between 50% and 90%. C: Along-tract group differences in the axonal water fraction among patient groups. C1: Axonal water fraction at each point along the CST in the right hemisphere. C2: ANCOVA F-test results show a significant difference between the NPH group and the Alzheimer and control groups at distances between 67% and 86%.

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    Fig 4.

    Leukoaraiosis heat maps. Yellow areas show regions where patients are most likely to have leukoaraiosis. Probability maps are shown on top of the 1-mm brain of the Montreal Neurological Institute 152 space.

Tables

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    Table 1:

    Key demographic information

    No. of SubjectsAge (Range) (Mean) (yr)Male/Female Ratio
    NPH2358–87 (76.9)13:10
    Alzheimer disease1056–81 (74.9)5:5
    Controls1160–87 (75)6:5
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    Table 2:

    Values measured in the corona radiata, located at 70%–75% of the distance along the CSTa

    NC (n = 11) (Mean)Alzheimer Disease (n = 10) (Mean)NPH (n = 23) (Mean)NPH vs Alzheimer DiseaseNPH vs NCAlzheimer Disease vs NC
    P ValueAUCP ValueAUCP ValueAUC
    FA0.44 ± 0.070.39 ± 0.050.51 ± 0.100.01b0.880.040.760.120.76
    MD0.88 ± 0.050.89 ± 0.061.30 ± 0.370.02b0.87<0.01b0.940.800.79
    RD0.67 ± 0.050.69 ± 0.070.93 ± 0.370.180.650.04b0.760.530.84
    AD1.30 ± 0.081.26 ± 0.072.04 ± 0.39<0.01c0.96<0.01c1.00.600.51
    MK1.08 ± 0.091.04 ± 0.090.99 ± 0.190.940.520.350.730.660.82
    RK1.40 ± 0.141.19 ± 0.221.54 ± 0.420.030.820.340.620.100.82
    AK0.86 ± 0.070.97 ± 0.060.63 ± 0.11<0.01c0.97<0.01c0.980.110.67
    AWF0.42 ± 0.020.39 ± 0.030.38 ± 0.070.880.660.220.740.120.86
    • Note:—MD indicates mean diffusivity; RD, radial diffusivity; MK, mean kurtosis; RK, radial kurtosis; NC, healthy controls.

    • ↵a Values for the left and right hemispheres did not differ significantly (paired sample t test) and were averaged.

    • ↵b P < .05.

    • ↵c P < .01.

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American Journal of Neuroradiology: 39 (12)
American Journal of Neuroradiology
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1 Dec 2018
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B. Ades-Aron, S. Yeager, N. Miskin, E. Fieremans, A. George, J. Golomb
Diffusional Kurtosis along the Corticospinal Tract in Adult Normal Pressure Hydrocephalus
American Journal of Neuroradiology Dec 2018, 39 (12) 2218-2223; DOI: 10.3174/ajnr.A5845

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Diffusional Kurtosis along the Corticospinal Tract in Adult Normal Pressure Hydrocephalus
B. Ades-Aron, S. Yeager, N. Miskin, E. Fieremans, A. George, J. Golomb
American Journal of Neuroradiology Dec 2018, 39 (12) 2218-2223; DOI: 10.3174/ajnr.A5845
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