White matter microstructural disruption in minimal hepatic encephalopathy: a neurite orientation dispersion and density imaging (NODDI) study

Qiu-Yi Dong; Jia-Hui Lin; Ye Wu; Yun-Bin Cao; Min-Xiong Zhou; Hua-Jun Chen

doi:10.1007/s00234-023-03201-1

White matter microstructural disruption in minimal hepatic encephalopathy: a neurite orientation dispersion and density imaging (NODDI) study

Neuroradiology. 2023 Nov;65(11):1589-1604. doi: 10.1007/s00234-023-03201-1. Epub 2023 Jul 24.

Authors

Qiu-Yi Dong¹, Jia-Hui Lin¹, Ye Wu², Yun-Bin Cao¹, Min-Xiong Zhou³, Hua-Jun Chen⁴

Affiliations

¹ Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China.
² School of Computer Science and Engineering, Nanjing University of Science and Technology, Nanjing, 210094, China.
³ College of Medical Imaging, Shang Hai University of Medicine & Health Sciences, Shanghai, 201318, China.
⁴ Department of Radiology, Fujian Medical University Union Hospital, Fuzhou, 350001, China. chj0075@126.com.

PMID: 37486421
DOI: 10.1007/s00234-023-03201-1

Abstract

Purpose: To evaluate the ability of neurite orientation dispersion and density imaging (NODDI) for detecting white matter (WM) microstructural abnormalities in minimal hepatic encephalopathy (MHE).

Methods: Diffusion-weighted images, enabling the estimation of NODDI and diffusion tensor imaging (DTI) parameters, were acquired from 20 healthy controls (HC), 22 cirrhotic patients without MHE (NHE), and 15 cirrhotic patients with MHE. Tract-based spatial statistics were used to determine differences in DTI (including fractional anisotropy [FA] and mean/axial/radial diffusivity [MD/AD/RD]) and NODDI parameters (including neurite density index [NDI], orientation dispersion index [ODI], and isotropic volume fraction [ISO]). Voxel-wise analyses of correlations between diffusion parameters and neurocognitive performance determined by Psychometric Hepatic Encephalopathy Score (PHES) were completed.

Results: MHE patients had extensive NDI reduction and rare ODI reduction, primarily involving the genu and body of corpus callosum and the bilateral frontal lobe, corona radiata, external capsule, anterior limb of internal capsule, temporal lobe, posterior thalamic radiation, and brainstem. The extent of NDI and ODI reduction expanded from NHE to MHE. In both MHE and NHE groups, the extent of NDI change was quite larger than that of FA change. No significant intergroup difference in ISO/MD/AD/RD was observed. Tissue specificity afforded by NODDI revealed the underpinning of FA reduction in MHE. The NDI in left frontal lobe was significantly correlated with PHES.

Conclusion: MHE is characterized by diffuse WM microstructural impairment (especially neurite density reduction). NODDI can improve the detection of WM microstructural impairments in MHE and provides more precise information about MHE-related pathology than DTI.

Keywords: Biomarker; Minimal hepatic encephalopathy; Neurite orientation dispersion and density imaging; Neurocognitive impairment; White matter.

Abstract

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