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Updated: Sep 13, 2025
Diffusion Tensor Magnetic Resonance Imaging in the Analysis of Neurodegenerative Diseases
Published on: July 28, 2013
Assessment of microstructural abnormalities in gray and white matter of minimal hepatic encephalopathy patients using
Qing Sun1,2,3, Wenliang Fan1,2,3, Yuan Liu1,2,3
1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Aims:
Although neural activity abnormalities have been reported in cirrhosis patients with minimal hepatic encephalopathy (MHE), the neurophysiological mechanisms underlying microstructural brain alterations remain poorly understood. This prospective study aimed to assess microstructural abnormalities in both gray matter and white matter of MHE patients by using diffusion kurtosis imaging (DKI), and to examine associations between these alterations and neurocognitive and clinical measurements.
Methods:
Thirty-one Hepatitis B Virus-related cirrhotic patients without MHE (NMHE), thirty Hepatitis B Virus-related cirrhotic patients with MHE, and 59 gender-, age-, education-matched healthy controls underwent diffusional kurtosis imaging and neurocognitive assessments. We used tract-based spatial statistics (TBSS) analysis to estimate group differences of white matter (WM) microstructure and voxel-based morphometry analysis to determine gray matter (GM) abnormalities. Correlation analyses were further performed to assess relationships between altered diffusional parameters and clinical variables, such as neurocognitive performances and disease duration.
Results:
The TBSS analysis results showed that MHE patients had significantly decreased fractional anisotropy (FA) in the temporal part of the left superior longitudinal fasciculus and decreased kurtosis fractional anisotropy (KFA) in the left corticospinal tract and anterior thalamic radiation (p < 0.05, threshold-free cluster enhancement corrected). Notably, lower KFA in WM regions correlated with worse neurocognitive test scores in MHE patients. For GM, MHE patients exhibited increased volume of thalamus. No significant WM or GM differences were observed between NMHE patients and the other two groups.
Conclusion:
Minimal hepatic encephalopathy patients demonstrated microstructural abnormalities in both WM and GM, predominantly affecting regions involved in cognitive, attention, and motor functions. These findings suggest that disruption of microstructural integrity may underlie the pathophysiological underpinnings of neurocognitive dysfunction in MHE, offering neuroimaging evidence for disease mechanisms.
Insights
Minimal hepatic encephalopathy (MHE) patients show brain microstructural abnormalities in white and gray matter, impacting cognitive and motor functions. These changes correlate with neurocognitive deficits, suggesting they underlie MHE
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Minimal hepatic encephalopathy (MHE) is associated with neural activity abnormalities, but the underlying brain microstructural changes are not well understood.
- Cirrhosis patients with MHE may experience neurocognitive dysfunction due to poorly understood neurophysiological mechanisms.
Purpose of the Study:
- To assess white matter (WM) and gray matter (GM) microstructural abnormalities in MHE patients using diffusion kurtosis imaging (DKI).
- To investigate the association between these microstructural alterations and neurocognitive/clinical measurements in MHE patients.
Main Methods:
- Prospective study involving 30 MHE patients, 31 non-MHE cirrhotic patients, and 59 healthy controls.
- Diffusion kurtosis imaging (DKI) and neurocognitive assessments were performed.
- Tract-based spatial statistics (TBSS) and voxel-based morphometry (VBM) analyzed WM and GM, respectively. Correlation analyses examined relationships with clinical variables.
Main Results:
- MHE patients exhibited decreased fractional anisotropy (FA) in the left superior longitudinal fasciculus and decreased kurtosis fractional anisotropy (KFA) in the left corticospinal tract and anterior thalamic radiation.
- Lower KFA in WM correlated with poorer neurocognitive scores in MHE patients.
- MHE patients showed increased thalamus volume; no significant differences were found between non-MHE patients and controls.
Conclusions:
- MHE patients demonstrate significant microstructural abnormalities in both WM and GM, affecting cognitive, attention, and motor function regions.
- Disruption of microstructural integrity in the brain is implicated in the neurocognitive dysfunction observed in MHE.
- These neuroimaging findings provide evidence for the pathophysiological mechanisms underlying MHE.
