{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T01:06:18Z","timestamp":1793927178137,"version":"4.8.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>The present study was designed to systemically evaluate changes in the diffusion tensor imaging (DTI)-derived parameters of iNPH (idiopathic normal pressure hydrocephalus) patients with different responses to the tap test (TT), and to correlate cognitive impairment with white matter (WM) degeneration. This study included 22 iNPH patients and 14 healthy controls with structural magnetic resonance imaging (MRI) and DTI scanning. DTI was used to explore the differences in fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) for all participants. DTI parameters were evaluated using an ROI (region of interest)-based and tract-based spatial statistics (TBSS) approach. Neuropsychological assessments and the idiopathic normal pressure hydrocephalus grading scoring scale (iNPHGS) were performed. Compared to the TT non-responders, the TT responders group had significantly lower FA values in the corpus callosum, cingulum cingulate gyrus, superior longitudinal fasciculus, and lower AD values in the right cingulum cingulate gyrus and the left posterior thalamic radiation. Besides, the MD values were significantly increased in the corpus callosum, left anterior corona radiata, and the RD values in the corpus callosum and cingulum cingulate gyrus. In addition, the cognitive improvement was negatively correlated with FA of the corpus callosum, cingulum cingulate gyrus, and MD values of the genu of corpus callosum. While, the cognitive improvement was positively related to the AD of the cingulum cingulate gyrus, superior longitudinal, and RD values of the corpus callosum, cingulum cingulate gyrus and uncinate fasciculus. The ROI specific WM lesions in iNPH patients are the underlying basis for cognitive impairment.<\/jats:p>","DOI":"10.3389\/fnins.2021.774638","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T05:35:03Z","timestamp":1638509703000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["White Matter Characteristics of Cognitive Impairment in Tap-Test Positive Idiopathic Normal Pressure Hydrocephalus: A Diffusion Tensor Tract-Based Spatial Study"],"prefix":"10.3389","volume":"15","author":[{"given":"Yufeng","family":"Tang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoqin","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinfeng","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianwen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fangzhou","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1016\/j.nurt.2007.05.011","article-title":"Diffusion tensor imaging of the brain.","volume":"4","author":"Alexander","year":"2007","journal-title":"Neurotherapeutics"},{"key":"B2","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.neuropsychologia.2016.03.001","article-title":"Neuroanatomical substrates of executive functions: beyond prefrontal structures.","volume":"85","author":"Bettcher","year":"2016","journal-title":"Neuropsychologia"},{"key":"B3","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1159\/000117297","article-title":"The mental deterioration battery: normative data, diagnostic reliability and qualitative analyses of cognitive impairment. the group for the standardization of the mental deterioration battery.","volume":"36","author":"Carlesimo","year":"1996","journal-title":"Eur. Neurol."},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fnhum.2013.00042","article-title":"PANDA: a pipeline toolbox for analyzing brain diffusion images.","volume":"7","author":"Cui","year":"2013","journal-title":"Front. Hum. Neurosci."},{"key":"B5","doi-asserted-by":"publisher","first-page":"992","DOI":"10.1177\/0284185113508112","article-title":"Relationship between cerebrospinal fluid flow, ventricles morphology, and DTI properties in internal capsules: differences between Alzheimer\u2019s disease and normal-pressure hydrocephalus.","volume":"55","author":"Daouk","year":"2014","journal-title":"Acta Radiol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","article-title":"Mini-mental state. A practical method for grading the cognitive state of patients for the clinician.","volume":"12","author":"Folstein","year":"1975","journal-title":"J. Psychiatr. Res."},{"key":"B7","doi-asserted-by":"publisher","first-page":"778","DOI":"10.1136\/jnnp.68.6.778","article-title":"Alzheimer\u2019s disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response.","volume":"68","author":"Golomb","year":"2000","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B8","doi-asserted-by":"crossref","first-page":"97","DOI":"10.3174\/ajnr.A2706","article-title":"White matter alteration in idiopathic normal pressure hydrocephalus: tract-based spatial statistics study.","volume":"33","author":"Hattori","year":"2012","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1681","DOI":"10.3174\/ajnr.A2570","article-title":"Altered microstructure in corticospinal tract in idiopathic normal pressure hydrocephalus: comparison with Alzheimer disease and Parkinson disease with dementia.","volume":"32","author":"Hattori","year":"2011","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"36","DOI":"10.1016\/0001-6918(66)90004-7","article-title":"The stroop color-word test: a review.","volume":"25","author":"Jensen","year":"1966","journal-title":"Acta Psychol."},{"key":"B11","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1007\/s00234-013-1289-8","article-title":"Directional diffusion of corticospinal tract supports therapy decisions in idiopathic normal-pressure hydrocephalus.","volume":"56","author":"Jurcoane","year":"2014","journal-title":"Neuroradiology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1016\/j.jns.2013.07.014","article-title":"Idiopathic normal-pressure hydrocephalus, cortical thinning, and the cerebrospinal fluid tap test.","volume":"334","author":"Kang","year":"2013","journal-title":"J. Neurol. Sci."},{"key":"B13","doi-asserted-by":"crossref","first-page":"1949","DOI":"10.1007\/s00415-011-6038-5","article-title":"White matter involvement in idiopathic normal pressure hydrocephalus: a voxel-based diffusion tensor imaging study.","volume":"258","author":"Kanno","year":"2011","journal-title":"J. Neurol."},{"key":"B14","doi-asserted-by":"crossref","first-page":"S40","DOI":"10.1227\/01.NEU.0000168187.01077.2F","article-title":"Outcome of shunting in idiopathic normal-pressure hydrocephalus and the value of outcome assessment in shunted patients.","volume":"57","author":"Klinge","year":"2005","journal-title":"Neurosurgery"},{"key":"B15","doi-asserted-by":"publisher","first-page":"327","DOI":"10.1159\/000472712","article-title":"Frontal assessment battery and cerebrospinal fluid tap test in idiopathic normal-pressure hydrocephalus.","volume":"77","author":"Ko","year":"2017","journal-title":"Eur. Neurol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"601","DOI":"10.2176\/nmc.oa2012-0307","article-title":"White matter characteristics of idiopathic normal pressure hydrocephalus: a diffusion tensor tract-based spatial statistic study.","volume":"53","author":"Koyama","year":"2013","journal-title":"Neurol. Med. Chir."},{"key":"B17","doi-asserted-by":"publisher","first-page":"34","DOI":"10.1016\/j.clineuro.2016.02.013","article-title":"Clinical outcomes after ventriculoatrial shunting for idiopathic normal pressure hydrocephalus.","volume":"143","author":"Liu","year":"2016","journal-title":"Clin. Neurol. Neurosurg."},{"key":"B18","doi-asserted-by":"publisher","first-page":"237","DOI":"10.1007\/3-211-32318-x_48","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus: progress to date.","volume":"95","author":"Marmarou","year":"2005","journal-title":"Acta Neurochir. Suppl."},{"key":"B19","doi-asserted-by":"publisher","first-page":"298","DOI":"10.1016\/j.wneu.2015.10.069","article-title":"Incidence of idiopathic normal-pressure hydrocephalus in Northern Spain.","volume":"87","author":"Mart\u00edn-L\u00e1ez","year":"2016","journal-title":"World Neurosurg."},{"key":"B20","doi-asserted-by":"publisher","first-page":"415","DOI":"10.1002\/ana.22212","article-title":"Brain drain: a bottom-up approach to normal pressure hydrocephalus.","volume":"68","author":"McKhann","year":"2010","journal-title":"Anna. Neurol."},{"key":"B21","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1007\/s10592-005-9056-y","article-title":"Beyond bonferroni: less conservative analyses for conservation genetics.","volume":"7","author":"Narum","year":"2006","journal-title":"Conserv. Genet."},{"key":"B22","doi-asserted-by":"publisher","first-page":"614","DOI":"10.1177\/0284185113504570","article-title":"Effect of surgery on periventricular white matter in normal pressure hydrocephalus patients: comparison of two methods of DTI analysis.","volume":"55","author":"Nicot","year":"2014","journal-title":"Acta Radiol."},{"key":"B23","doi-asserted-by":"crossref","first-page":"183","DOI":"10.1016\/j.nrl.2015.07.009","article-title":"Practical application of brief cognitive tests.","volume":"31","author":"Olazar\u00e1n","year":"2016","journal-title":"Neurologia"},{"key":"B24","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1002\/1097-4679(197704)33:2<579::AID-JCLP2270330254>3.0.CO;2-R","article-title":"Assessment of cognitive recovery in alcoholics by use of the trail-making test.","volume":"33","author":"O\u2019Leary","year":"1977","journal-title":"J. Clin. Psychol."},{"key":"B25","first-page":"143","article-title":"Spectrum of cognitive disorders in idiopathic normal pressure hydrocephalus.","volume":"31","author":"Picascia","year":"2016","journal-title":"Funct. Neurol."},{"key":"B26","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1007\/s00701-016-2861-x","article-title":"Fractional anisotropy in patients with disproportionately enlarged subarachnoid space hydrocephalus.","volume":"158","author":"Radovnick\u00fd","year":"2016","journal-title":"Acta Neurochir."},{"key":"B27","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1016\/S0010-9452(08)70493-3","article-title":"Measures of short-term memory: a historical review.","volume":"43","author":"Richardson","year":"2007","journal-title":"Cortex"},{"key":"B28","doi-asserted-by":"crossref","first-page":"515","DOI":"10.1007\/s00701-002-0936-3","article-title":"Five-year outcome of normal pressure hydrocephalus with or without a shunt: predictive value of the clinical signs, neuropsychological evaluation and infusion test.","volume":"144","author":"Savolainen","year":"2002","journal-title":"Acta Neurochir."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1699","DOI":"10.1007\/s00701-012-1377-2","article-title":"Diffusion tensor imaging in hydrocephalus\u2013findings before and after shunt surgery.","volume":"154","author":"Scheel","year":"2012","journal-title":"Acta Neurochir."},{"key":"B30","doi-asserted-by":"crossref","first-page":"129","DOI":"10.3988\/jcn.2018.14.2.129","article-title":"Current clinical applications of diffusion-tensor imaging in neurological disorders.","volume":"14","author":"Tae","year":"2018","journal-title":"J. Clin. Neurol."},{"key":"B31","doi-asserted-by":"crossref","DOI":"10.1227\/01.NEU.0000253648.75523.74","article-title":"Diagnosis, treatment, and analysis of long-term outcomes in idiopathic normal-pressure hydrocephalus.","volume":"60","author":"Tarnaris","year":"2007","journal-title":"Neurosurgery"},{"key":"B32","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus.","volume":"22","author":"Williams","year":"2016","journal-title":"Continuum"},{"key":"B33","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1016\/j.jns.2017.06.028","article-title":"Cognitive impairment predicts worse short-term response to spinal tap test in normal pressure hydrocephalus.","volume":"379","author":"Wolfsegger","year":"2017","journal-title":"J. Neurol. Sci."}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2021.774638\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T05:35:18Z","timestamp":1638509718000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2021.774638\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,3]]},"references-count":33,"alternative-id":["10.3389\/fnins.2021.774638"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2021.774638","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,3]]},"article-number":"774638"}}