Article Figures & Data
Figures
- Fig 1.
Clusters in which the apparent diffusion coefficient (ADC) was found to be significantly reduced in patients with Creutzfeldt-Jakob disease (CJD) compared with healthy controls at P < .001 and K > 5. Clusters were overlaid onto averaged T1-weighted images. A, Result at b = 1000 s/mm2. B, Result at b = 2000 s/mm2. The left and right hemispheres are identified as L and R.
- Fig 2.
Representative ADC maps of a patient with sporadic CJD (sCJD) (case 2018) at b = 1000 s/mm2 and b = 2000 s/mm2. For illustration purposes, images were smoothed with a 3-mm isotropic smoothing kernel. Signal-intensity abnormality involves the caudate, putamen, and thalamus bilaterally and becomes more extensive at b = 2000 s/mm2 compared with b= 1000 s/mm2. The left and right hemispheres are identified as L and R.
- Fig 3.
Bar graphs (b = 1000 s/mm2 in black, b = 2000 s/mm2 in gray) depict the patient ADC as a percentage of the control ADC. Mean ± SD ADC values are listed in the table for each structure.
- Fig 4.
Representative imaging findings on diffusion-weighted imaging at b = 1000 s/mm2 and b = 2000 s/mm2 sequences in 4 symptomatic patients (2 with familial CJD [fCJD] and 2 with sCJD). Signal-intensity abnormalities involve the caudate nucleus, putamen, thalamus, and cortex. The left and right hemispheres are identified as L and R.
Tables
Patients Controls P Value N 13 15 Age 59.72 ± 7.72 57.45 ± 10.34 NS Sex (% male) 62 47 NS CNS 9.85 ± 3.72 0.33 ± 0.62 <.0001 MMSE 25.22 ± 3.11 28.50 ± 1.62 <.005 -
Note:—CNS indicates Clinical Neurological Scale; MMS, Mini-Mental State Examination; NS, not significant.
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a Significant differences between the groups were assessed by t test for continuous measures and χ2 for gender distributions. Symptom severity was quantified by the CNS12 and MMS.11
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- Table 2:
Summary of clusters in which ADC was found to be significantly reduced (P < .001) among patients compared with normal controlsa
MNI (x,y,z) K t Controls Patients % Difference Anatomical Locations Side Mean SD Mean SD b = 1000 (−12,−16,8) 20 4.96 777 45 684 63 12 Thalamus (medial dorsal nucleus, ventral lateral nucleus, ventral posterior lateral nucleus) L (10,−12,0) 30 4.90 769 40 683 60 11 Thalamus (medial dorsal nucleus, ventral lateral nucleus) R (18,12,−2) 6 4.47 782 68 670 76 14 Caudate body, caudate head, putamen R (24,4, −4) 31 4.24 725 46 613 80 15 Putamen R (16,10,10) 6 4.12 746 58 632 96 15 Caudate body R b = 2000 (16,−16,8) 121 6.37 722 40 624 70 13 Thalamus (medial dorsal nucleus, ventral lateral nucleus, ventral posterior lateral nucleus, pulvinar) R (26,6,2) 195 5.67 706 35 582 77 17 Caudate body, caudate head, putamen R (28,−14,2) 38 5.27 702 37 593 82 15 Putamen R (−6,−16,6) 43 5.05 700 35 607 67 13 Thalamus (medial dorsal nucleus, ventral lateral nucleus, ventral posterior lateral nucleus, ventral posterior medial nucleus) L (−16,−26,8) 6 4.27 737 59 641 80 13 Pulvinar L (−24,6,4) 20 3.87 712 40 585 123 18 Putamen L -
Note:—ADC indicates apparent diffusion coefficient; MNI (x,y,z), Montreal Neurological Institute coordinates of voxel at a peak t value; K, size of clusters in the unit of voxels; t, corresponding t value of a peak height.
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a Mean and SD were computed within each cluster. Percentage difference is defined by taking the ratio between mean ADC of patients and controls. The left and right hemisphere are identified as L and R.
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