Diffusion tensor imaging profiles reveal specific neural tract distortion in normal pressure hydrocephalus

Area of Science:

• Neuroimaging
• Neurology
• Biomarkers

Background:

• The exact cause of normal pressure hydrocephalus (NPH) is unknown, hindering early diagnosis and prognosis.
• The impact of interventions on complex white matter injuries in NPH is not well understood.

Purpose of the Study:

• To investigate the characteristics and reversibility of white matter injury in NPH using diffusion tensor imaging (DTI).
• To explore DTI as a potential non-invasive biomarker for NPH-related white matter changes.

Main Methods:

• Diffusion tensor imaging (DTI) was performed on 16 NPH patients and 9 healthy controls, pre- and post-intervention.
• Analysis included a comprehensive set of DTI measures and p:q plots to characterize white matter integrity.

Main Results:

• NPH patients exhibited distinct DTI profiles compared to controls, with injury patterns varying by white matter tract and proximity to ventricles.
• Post-shunting, a decrease in axial diffusivity in the posterior limb of the internal capsule suggested improvement in stretch/compression injury.
• PQ plots indicated a potential return to normal white matter characteristics in specific tracts after intervention.

Conclusions:

• DTI profiling, combined with p:q correlation, shows promise as a non-invasive biomarker for potentially reversible white matter injury in NPH.
• This approach may aid in characterizing the nature and extent of white matter damage in NPH.