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The value of diffusion kurtosis imaging in evaluating the mild cognitive impairment of occupational aluminum workers
Wenji Xu1, Xiaochun Wang2, Hui Zhang2, and Yan Tan*2
1College of Medical Imaging, Shanxi Medical University, Taiyuan, China, 2Department of Radiology, First Hospital of Shanxi Medical University, Taiyuan, China

Synopsis

Keywords: Alzheimer's Disease, Alzheimer's Disease, Alzheimer’s disease; aluminum exposure; diffusion kurtosis imaging

In this work, we focused on the Al-exposed workers and confirm the findings that DKI can discriminate MCI from NC, furthermore we assess the severity of cognitive impairment in Al-exposed workers, and find the MK, Kr, MD and FA values are correlated with MoCA scores，which may provide quantitative imaging biomarkers for Al-exposed MCI workers.

Objectives

To investigate whether diffusion kurtosis imaging (DKI) can distinguish mild cognitive impairment (MCI) from normal controls (NC) in aluminum (Al)-exposed workers, and to explore the association of DKI with cognitive performance and plasma Al concentration.

Methods

28 patients with MCI and 25 NC at Al factory were enrolled in this study. All subjects underwent conventional MRI and DKI scans. The mean kurtosis (MK), axial kurtosis (Ka), radial kurtosis (Kr), mean diffusivity (MD) and fractional anisotropy (FA) parameters of the hippocampus, substantia nigra, red nucleus, thalamus, anterior cingulate gyrus, genu and crus of the corpus callosum, frontal, parietal and temporal lobe were measured. To compare the parameters between the two groups, the Mann-Whitney rank sum test was used. The correlation of parameter values with cognitive performance and plasma Al concentration was analyzed using Spearman correlation analysis.

Results

Compared with the NC group, the MK, Ka, Kr, and FA values in the MCI group were significantly decreased, and the MD values were significantly increased (P<0.05). For the diagnosis of MCI, MK in the right hippocampus showed the largest AUC (0.924). The MK, Kr, MD and FA values were correlated with the Montreal Cognitive Assessment (MoCA) scores, and MK values in the right hippocampus showed the greatest correlation with MoCA scores,(r=0.744，P<0.001). For the diagnosis of MCI, MK in the right hippocampus showed the largest AUC. Although there was no significant difference in plasma Al between the two groups (P=0.057), plasma Al in the MCI group was higher than that in the NC group. There was no correlation between DKI parameters and plasma Al.

Conclusions

The DKI method can provide sensitive imaging biomarkers to discriminate MCI from NC and assess the severity of cognitive impairment. MK in the right hippocampus appeared to be the best independent predictor. There was no significant difference in plasma Al between the two groups. No correlation was found between DKI parameters and plasma Al. The pathogenesis of MCI still needs to be further studied.

Acknowledgements

Thanks to all the people who have worked hard for this work and their families. Thanks to the participants who took part in the study and data collection.

References

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Figures

Fig. 1. Placement of ROI. Red areas represent ROIs of temporal lobe (A, right), hippocampus (A, left), red nucleus (B, right) and substantia nigra (B, left), thalamus (C), corpus callosum knee (D, upper) and corpus callosum pressure (D, lower), cingulate gyrus (E), frontal lobe (F, right), and parietal lobe (F, left).

Fig. 2 A-F: A 46-year-old man with MCI. The volume in the right hippocampus shows slight atrophy on 3D-*) with decreased on MK (B), Ka (C), Kr (D) and FA (F) maps, increased on MD (E) maps. G-L：A 49-year-old man with NC. The volume in the right hippocampus shows slight atrophy on 3D-T1WI (G) with increased on MK (H), Ka (I), Kr (J) and FA (L) maps, decreased on MD (K) maps.

Fig. 3 The AUCs of DKI parameters for the differential diagnosis

Fig. 4 The correlation between DKI parameters and MoCA scores. A-MK of right hippocampus; B-MK of left substantia nigra; C-MK of right thalamus; D-MK of right frontal lobe; E-Kr of left substantia nigra; F-Kr of right thalamus; G-Kr of right thalamus; H-MD of right hippocampus; I-FA of left substantia nigra.

Proc. Intl. Soc. Mag. Reson. Med. 31 (2023)
3513
DOI: https://doi.org/10.58530/2023/3513