{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T05:09:10Z","timestamp":1784956150382,"version":"3.55.0"},"reference-count":67,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>The object of this study was to use diffusion tensor imaging (DTI) and tract-based spatial statistics (TBSS) to characterize the long-term effects of hydrocephalus and shunting on white matter integrity and to investigate the relationship of ventricular size and alterations in white matter integrity with headache and quality-of-life outcome measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Patients with shunt-treated hydrocephalus and age- and sex-matched healthy controls were recruited into the study and underwent anatomical and DTI imaging on a 3-T MRI scanner. All patients were clinically stable, had undergone CSF shunt placement before 2 years of age, and had a documented history of complaints of headaches. Outcome was scored based on the Headache Disability Inventory and the Hydrocephalus Outcome Questionnaire. Fractional anisotropy (FA) and other DTI-based measures (axial, radial, and mean diffusivity; AD, RD, and MD, respectively) were extracted in the corpus callosum and internal capsule with manual region-of-interest delineation and in other regions with TBSS. Paired t-tests, corrected with a 5% false discovery rate, were used to identify regions with significant differences between patients and controls. Within the patient group, linear regression models were used to investigate the relationship between FA or ventricular volume and outcome, as well as the effect of shunt-related covariates.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Twenty-one hydrocephalus patients and 21 matched controls completed the study, and their data were used in the final analysis. The authors found significantly lower FA for patients than for controls in 20 of the 48 regions, mostly posterior white matter structures, in periventricular as well as more distal tracts. Of these 20 regions, 17 demonstrated increased RD, while only 5 showed increased MD and 3 showed decreased AD. No areas of increased FA were observed. Higher FA in specific periventricular white matter tracts, tending toward FA in controls, was associated with increased ventricular size, as well as improved clinical outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The study shows that TBSS-based DTI is a sensitive technique for elucidating changes in white matter structures due to hydrocephalus and chronic CSF shunting and provides preliminary evidence that DTI may be a valuable tool for tailoring shunt procedures to monitor ventricular size following shunting and achieve optimal outcome, as well as for guiding the development of alternate therapies for hydrocephalus.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2017.6.jns162784","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T14:59:33Z","timestamp":1516373973000},"page":"1611-1622","source":"Crossref","is-referenced-by-count":27,"title":["Diffusion tensor imaging and ventricle volume quantification in patients with chronic shunt-treated hydrocephalus: a matched case-control study"],"prefix":"10.3171","volume":"129","author":[{"given":"Kristy","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Radiology, Gruss Magnetic Resonance Research Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Avital","family":"Meiri","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gruss Magnetic Resonance Research Center, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenzhu B.","family":"Mowrey","sequence":"additional","affiliation":[{"name":"Departments of Epidemiology and Population Health,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rick","family":"Abbott","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Children\u2019s Hospital at Montefiore; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T.","family":"Goodrich","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Children\u2019s Hospital at Montefiore; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam L.","family":"Sandler","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Children\u2019s Hospital at Montefiore; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asif K.","family":"Suri","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gruss Magnetic Resonance Research Center, and"},{"name":"Department of Radiology, Montefiore Medical Center, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Lipton","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gruss Magnetic Resonance Research Center, and"},{"name":"Neuroscience,"},{"name":"Department of Radiology, Montefiore Medical Center, Bronx, New York"},{"name":"Psychiatry and Behavioral Sciences, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark E.","family":"Wagshul","sequence":"additional","affiliation":[{"name":"Department of Radiology, Gruss Magnetic Resonance Research Center, and"},{"name":"Physiology and Biophysics, Albert Einstein College of Medicine;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1","series-title":"J Neurosurg Pediatr","doi-asserted-by":"publisher","first-page":"385","DOI":"10.3171\/2009.11.PEDS09343","article-title":"Longitudinal comparison of pre- and postoperative diffusion tensor imaging parameters in young children with hydrocephalus","volume":"5","author":"Air EL","year":"2010","unstructured":"Air EL, Yuan W, Holland SK, Jones BV, Bierbrauer K, Altaye M, : Longitudinal comparison of pre- and postoperative diffusion tensor imaging parameters in young children with hydrocephalus. 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