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Research ArticleBrain
Open Access

Widespread White Matter Alterations in Patients with End-Stage Renal Disease: A Voxelwise Diffusion Tensor Imaging Study

M.-C. Chou, T.-J. Hsieh, Y.-L. Lin, Y.-T. Hsieh, W.-Z. Li, J.-M. Chang, C.-H. Ko, E.-F. Kao, T.-S. Jaw and G.-C. Liu
American Journal of Neuroradiology October 2013, 34 (10) 1945-1951; DOI: https://doi.org/10.3174/ajnr.A3511
M.-C. Chou
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
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T.-J. Hsieh
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
bDepartments of Radiology (T.-J.H., T.-S.J., G.-C.L.)
eDepartments of Medical Imaging (T.-J.H., T.-S.J., G.-C.L.)
hDepartment of Medical Imaging (T.-J.H.), Kaohsiung Municipal Ta-Tong Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
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Y.-L. Lin
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
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Y.-T. Hsieh
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
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W.-Z. Li
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
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J.-M. Chang
cRenal Care (J.-M.C.)
fInternal Medicine (J.-M.C.)
iDepartments of Internal Medicine (J.-M.C.)
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C.-H. Ko
dPsychiatry (C.-H.K.), College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
gPsychiatry (C.-H.K.), Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
jPsychiatry (C.-H.K.), Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
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E.-F. Kao
aFrom the Departments of Medical Imaging and Radiological Sciences, College of Health Sciences; (M.-C.C., T.-J.H., Y.-L.L., Y.-T.H., W.Z.L.. E.-F.K.)
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T.-S. Jaw
bDepartments of Radiology (T.-J.H., T.-S.J., G.-C.L.)
eDepartments of Medical Imaging (T.-J.H., T.-S.J., G.-C.L.)
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G.-C. Liu
bDepartments of Radiology (T.-J.H., T.-S.J., G.-C.L.)
eDepartments of Medical Imaging (T.-J.H., T.-S.J., G.-C.L.)
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    Fig 1.

    Voxelwise comparisons of AD, RD, MD, and FA between patients with ESRD and healthy subjects. Red-yellow colors indicate significant increases of AD (A–F), RD (G–L), and MD (M–R) and significant decreases of FA (S–X) in patients with ESRD. Color bars show the ranges of t-scores.

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    Fig 2.

    Voxelwise multiple regression analysis of DTI indices and the duration of hemodialysis in patients with ESRD. Red-yellow colors indicate the significant positive correlation in RD (A–C) and MD (D–I). Color bars show the ranges of t-scores.

  • Fig 3.
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    Fig 3.

    Voxelwise multiple regression analysis of DTI indices and CASI scores in patients with ESRD. Red-yellow colors indicate the significant negative correlations in RD (A–C) and MD (D–F) and a positive correlation in FA (G–I). Color bars show the ranges of t-scores.

Tables

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    Table 1:

    Demographic characteristics of enrolled subjectsa

    Patients with ESRDControl Subjects
    Age (yr)39 ± 839 ± 7
    Sex (M/F)14/1411/14
    Dialysis duration (yr)7 ± 5N/A
    CASI score93.5 ± 7.2b96.8 ± 3.7b
    • Note:—N/A indicates not applicable.

    • ↵a Data are means.

    • ↵b Statistically significant difference (P < .05).

    • View popup
    Table 2:

    MNI coordinates of major areas with significant AD differences along with means of AD values

    Brain RegionsMNI Coordinate (mm)AD (mean) × 10−3 mm2/s
    XYZESRDHealthy
    Rt RLIC25−16−121.43 ± 0.171.39 ± 0.14
    Lt RLIC−27−14−141.66 ± 0.211.57 ± 0.13
    Lt Fminor−2152−121.43 ± 0.071.33 ± 0.07
    Pons1−14−561.85 ± 0.181.73 ± 0.11
    • Note:—Fminor indicates forceps minor; RLIC, retrolenticular part of the internal capsule; MNI, Montreal Neurological Institute; Rt, right; Lt, left.

    • View popup
    Table 3:

    MNI coordinates of major areas with significant RD differences along with means of RD values

    Brain RegionsMNI Coordinate (mm)RD (mean) × 10−3 mm2/s
    XYZESRDHealthy
    GCC139−10.94 ± 0.20.86 ± 0.14
    SCC1−1450.65 ± 0.150.56 ± 0.08
    Rt. Fmajor24−54−80.66 ± 0.110.62 ± 0.09
    Lt. Fmajor−28−42−80.67 ± 0.090.61 ± 0.11
    Rt. PCR25−2370.64 ± 0.090.63 ± 0.04
    Lt. PCR−28−2070.66 ± 0.090.65 ± 0.04
    Rt. ACR1751−60.64 ± 0.060.62 ± 0.05
    Lt. ACR−2056−80.63 ± 0.060.59 ± 0.05
    Pons3−13−540.82 ± 0.190.71 ± 0.12
    • Note:—ACR indicates anterior corona radiata; Fmajor, forceps major; PCR, posterior corona radiata; SCC, splenium of the corpus callosum; MNI, Montreal Neurological Institute; GCC, genu of the corpus callosum; Rt, right; Lt, left.

    • View popup
    Table 4:

    MNI coordinates of major areas with significant MD differences along with means of MD values

    Brain RegionsMNI Coordinate (mm)MD (mean) × 10−3 mm2/s
    XYZESRDHealthy
    GCC139−81.16 ± 0.071.08 ± 0.05
    SCC1−1351.12 ± 0.131.02 ± 0.06
    Rt. SS31−31−91.27 ± 0.221.21 ± 0.15
    Lt. SS−39−24−151.07 ± 0.121.04 ± 0.08
    Rt. Fmajor25−42−30.96 ± 0.110.89 ± 0.04
    Lt. Fmajor−30−34−31.15 ± 0.110.99 ± 0.09
    Rt. PCR27−2541.07 ± 0.120.92 ± 0.06
    Lt. PCR−29−2511.21 ± 0.181.11 ± 0.15
    Pons2−14−561.28 ± 0.131.13 ± 0.09
    • Note:—Fmajor indicates forceps major; PCR, posterior corona radiata; SCC, splenium of the corpus callosum; SS, sagittal stratum; MNI, Montreal Neurological Institute; GCC, genu of the corpus callosum; Rt, right; Lt, left.

    • View popup
    Table 5:

    MNI coordinates of major areas with significant FA differences along with means of FA values

    Brain RegionsMNI Coordinate (mm)FA (mean)
    XYZESRDHealthy
    GCC340−80.6 ± 0.060.67 ± 0.04
    SCC3−1450.65 ± 0.050.72 ± 0.05
    Rt. SS31−28−60.50 ± 0.040.56 ± 0.04
    Lt. SS−27−39−60.46 ± 0.050.56 ± 0.07
    Rt. MCP13−18−580.45 ± 0.030.53 ± 0.04
    • Note:—MCP indicates middle cerebellar peduncle; SCC, splenium of the corpus callosum; SS, sagittal stratum; MNI, Montreal Neurological Institute; GCC, genu of the corpus callosum; Rt, right; Lt, left.

    • View popup
    Table 6:

    MNI coordinates of areas with significant correlations along with their correlation coefficients

    Brain RegionsMNI Coordinate (mm)Correlation Coefficient
    XYZ
    RD and duration
        Lt. Pons−16−3−460.7093
    RD and CASI
        Lt. ACR−283319−0.7442
        Rt. SCR31721−0.6154
    MD and duration
        Rt. RLIC33−20−60.6009
        Lt. FWM−2163−50.6287
        Lt. Pons−12−3−460.6675
    MD and CASI
        Lt. ACR−283319−0.7657
        Rt. SCR31721−0.5463
    FA and CASI
        Lt. ACR−1740180.7067
        Lt. PCR−20−29240.6117
        Rt. SCR336260.6815
    • Note:—ACR indicates anterior corona radiata; PCR, posterior corona radiata; RLIC, retrolenticular part of the internal capsule; SCR, superior corona radiata; MNI, Montreal Neurological Institute; FWM, frontal white matter; Rt, right; Lt, left.

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American Journal of Neuroradiology: 34 (10)
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M.-C. Chou, T.-J. Hsieh, Y.-L. Lin, Y.-T. Hsieh, W.-Z. Li, J.-M. Chang, C.-H. Ko, E.-F. Kao, T.-S. Jaw, G.-C. Liu
Widespread White Matter Alterations in Patients with End-Stage Renal Disease: A Voxelwise Diffusion Tensor Imaging Study
American Journal of Neuroradiology Oct 2013, 34 (10) 1945-1951; DOI: 10.3174/ajnr.A3511

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Widespread White Matter Alterations in Patients with End-Stage Renal Disease: A Voxelwise Diffusion Tensor Imaging Study
M.-C. Chou, T.-J. Hsieh, Y.-L. Lin, Y.-T. Hsieh, W.-Z. Li, J.-M. Chang, C.-H. Ko, E.-F. Kao, T.-S. Jaw, G.-C. Liu
American Journal of Neuroradiology Oct 2013, 34 (10) 1945-1951; DOI: 10.3174/ajnr.A3511
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