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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