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Abstract #2345

Diffusion microstructural imaging of reversible and irreversible changes within the corticospinal tract in idiopathic normal pressure hydrocephalus

Kouhei Kamiya1, Masaaki Hori2, Ryusuke Irie2, Masakazu Miyajima3, Madoka Nakajima3, Koji Kamagata2, Kouhei Tsuruta2, Yuichi Suzuki1, Asami Saito2, Misaki Nakazawa4, Harushi Mori1, Akira Kunimatsu1, Hajime Arai3, Shigeki Aoki2, and Osamu Abe1

1Department of Radiology, the University of Tokyo, Tokyo, Japan, 2Department of Radiology, Juntendo University School of Medicine, Tokyo, Japan, 3Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan, 4Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan

Microstructural changes of the corticospinal tract (CST) in idiopathic normal pressure hydrocephalus (iNPH) before and after CSF shunt surgery were studied using NODDI and WMTI. Pathological increase of orientational coherence and its postoperative normalization were shown, indicating axon stretching and its recovery. To the contrary, decrease of axon density was present in iNPH and remained after the surgery. Simulation using undulating cylinder model demonstrated both NODDI and WMTI can separate the effects from axon density and undulation. These results suggest possibilities of diffusion MRI to distinguish between reversible and irreversible microstructural changes in iNPH, and raise expectation for prediction of treatment outcome.

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