Related Experiment Video
Updated: Jun 5, 2025
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
MR study on white matter injury in patients with acute diquat poisoning
Xueshan Cao1, Bo Sui2, Bailin Wu2
1Department of Occupational Health and Environmental Health, School of Public Health, Hebei Medical University, Shijiazhuang 050017, PR China; Hebei Key Laboratory of Environment and Human Health, Shijiazhuang 050017, PR China.
Objective:
To explore the microstructural damage of white matter in acute diquat (DQ) poisoning patients using diffusion kurtosis imaging (DKI) and Tract-based Spatial Statistics (TBSS).
Methods:
This study included 19 DQ poisoning patients and 19 age-matched controls. MRI was performed using a 3.0 T Philips Achieva scanner with sequences including 3D T1WI, T2WI, DWI, 3D T2WI-FLAIR, and DKI (3 b-values, 15 directions). DICOM to NIFTI image form conversion was done using MRIcron's Dcm2niigui, followed by motion and eddy current correction with FSL to create a brain mask. Scalar indicators (MK, AK, RK, FAK) were calculated with DKE software. TBSS was used for spatial normalization, skeletonization, and projection of DKI indices for group analysis with TFCE for multiple comparison correction (P < 0.025).
Results:
After the screening and enrollment process, 19 DQ-poisoned patients and 19 healthy volunteers were analyzed. No significant age or sex differences were found between groups. For Mean Kurtosis (MK), the right corticospinal tract showed a significant difference with a mean difference of 0.21 (95 % CI: 0.15-0.27) and P = 0.000503. Axial Kurtosis (AK) in the left superior longitudinal fasciculus had a mean difference of 0.18 (95 % CI: 0.12-0.24) and P = 0.0024. Fractional Anisotropy of Kurtosis (FAK) in the right corticospinal tract showed a mean difference of 0.19 (95 % CI: 0.13-0.25) and P = 0.0000318. Axial Kurtosis (AK) positively correlated with blood drug levels (r = 0.52, P < 0.05). Seven patients developed subcortical leukodystrophy, mainly in the frontal parietal lobe, with possible insular lobe involvement.
Conclusions:
DQ poisoning primarily damages the right corticospinal tract, right cingulate gyrus, and left superior longitudinal fasciculus, potentially causing movement and visual impairments. The injury involves demyelination and axonal degeneration, with asymmetrical damage between hemispheres. The left superior longitudinal fasciculus injury is dose-dependent, and unlike prior studies, dopaminergic nuclei were unaffected. The frontal parietal lobe is predominantly affected, with some insular lobe involvement in DQ poisoning patients.
Insights
Acute diquat (DQ) poisoning causes white matter damage, particularly in the corticospinal tract and superior longitudinal fasciculus, potentially leading to movement and vision issues. This injury involves demyelination and axonal degeneration, with severity linked to drug levels.
Area of Science:
- Neuroimaging
- Toxicology
- Neurology
Background:
- Diquat (DQ) poisoning is a severe condition with potential neurological sequelae.
- Understanding the specific white matter microstructural changes is crucial for diagnosis and management.
Purpose of the Study:
- To investigate white matter microstructural damage in acute diquat (DQ) poisoning patients.
- To utilize diffusion kurtosis imaging (DKI) and Tract-based Spatial Statistics (TBSS) for detailed analysis.
Main Methods:
- 19 DQ poisoning patients and 19 controls underwent MRI, including DKI sequences.
- Image analysis involved motion correction, DKI scalar calculation (MK, AK, RK, FAK), and TBSS for group comparisons.
- Statistical analysis used FSL with TFCE for correction, with P < 0.025 as the significance threshold.
Main Results:
- Significant microstructural differences were observed in the right corticospinal tract (Mean Kurtosis, Fractional Anisotropy of Kurtosis) and left superior longitudinal fasciculus (Axial Kurtosis).
- Axial Kurtosis showed a positive correlation with blood drug levels (r=0.52, P<0.05).
- Seven patients exhibited subcortical leukodystrophy, predominantly in the frontal parietal lobe, with possible insular involvement.
Conclusions:
- Diquat poisoning primarily affects the right corticospinal tract, right cingulate gyrus, and left superior longitudinal fasciculus, suggesting potential motor and visual impairments.
- The observed injury patterns indicate demyelination and axonal degeneration, with asymmetrical hemispheric damage and a dose-dependent effect on the left superior longitudinal fasciculus.
- Unlike previous findings, dopaminergic nuclei remained unaffected, and the frontal parietal lobe was the most impacted region, with some insular lobe involvement.
![PET Imaging of Neuroinflammation Using [11C]DPA-713 in a Mouse Model of Ischemic Stroke](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F57243.jpg&w=3840&q=50)