{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T06:53:35Z","timestamp":1780556015910,"version":"3.54.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T00:00:00Z","timestamp":1639699200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["8177070421"],"award-info":[{"award-number":["8177070421"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100008410","name":"Shanghai Municipal Population and Family Planning Commission","doi-asserted-by":"publisher","award":["201740003"],"award-info":[{"award-number":["201740003"]}],"id":[{"id":"10.13039\/501100008410","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurosci."],"abstract":"<jats:p>The study preliminarily explored the sequence and difference of involvement in different neuroanatomical structures in idiopathic normal pressure hydrocephalus (INPH). We retrospectively analyzed the differences in diffusion tensor imaging (DTI) parameters in 15 ROIs [including the bilateral centrum semiovale (CS), corpus callosum (CC) (body, genu, and splenium), head of the caudate nucleus (CN), internal capsule (IC) (anterior and posterior limb), thalamus (TH), and the bilateral frontal horn white matter hyperintensity (FHWMH)] between 27 INPH patients and 11 healthy controls and the correlation between DTI indices and clinical symptoms, as evaluated by the INPH grading scale (INPHGS), the Mini-Mental State Examination (MMSE), and the timed up and go test (TUG-t), before and 1 month after shunt surgery. Significant differences were observed in DTI parameters from the CS (<jats:italic>p<\/jats:italic><jats:sub>FA1<\/jats:sub> = 0.004, <jats:italic>p<\/jats:italic><jats:sub>ADC1<\/jats:sub> = 0.005) and the genu (<jats:italic>p<\/jats:italic><jats:sub>FA2<\/jats:sub> = 0.022; <jats:italic>p<\/jats:italic><jats:sub>ADC2<\/jats:sub> = 0.001) and body (<jats:italic>p<\/jats:italic><jats:sub>FA3<\/jats:sub> = 0.003; <jats:italic>p<\/jats:italic><jats:sub>ADC3<\/jats:sub> = 0.002) of the CC between the groups. The DTI parameters from the CS were strongly correlated with the MMSE score both pre-operatively and post-operatively. There was association between apparent diffusion coefficient (ADC) values of anterior and posterior limbs of the IC and MMSE. The DTI parameters of the head of the CN were correlated with motion, and the ADC value was significantly associated with the MMSE score. The FA value from TH correlated with an improvement in urination after shunt surgery. We considered that different neuroanatomical structures are affected differently by disease due to their positions in neural pathways and characteristics, which is further reflected in clinical symptoms and the prognosis of shunt surgery.<\/jats:p>","DOI":"10.3389\/fnins.2021.794046","type":"journal-article","created":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T06:01:54Z","timestamp":1639720914000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Preliminary Exploration of the Sequence of Nerve Fiber Bundles Involvement for Idiopathic Normal Pressure Hydrocephalus: A Correlation Analysis Using Diffusion Tensor Imaging"],"prefix":"10.3389","volume":"15","author":[{"given":"Wenjun","family":"Huang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuhao","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shihong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renling","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuntao","family":"Ye","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangwu","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2021,12,17]]},"reference":[{"key":"B2","doi-asserted-by":"publisher","first-page":"121","DOI":"10.3171\/2017.7.Jns171005","article-title":"Brain tissue A\u03b242 levels are linked to shunt response in idiopathic normal pressure hydrocephalus.","volume":"130","author":"Abu Hamdeh","year":"2018","journal-title":"J. Neurosurg."},{"key":"B3","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1056\/nejm196507152730301","article-title":"Symptomatic occult hydrocephalus with \u201cNormal\u201d cerebrospinal-fluid pressure. A treatable syndrome.","volume":"273","author":"Adams","year":"1965","journal-title":"N. Engl. J. Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1002\/ana.22484","article-title":"White matter lesions defined by diffusion tensor imaging in older adults.","volume":"70","author":"Back","year":"2011","journal-title":"Ann. Neurol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"456","DOI":"10.1002\/nbm.783","article-title":"Diffusion-tensor MRI: theory, experimental design and data analysis - a technical review.","volume":"15","author":"Basser","year":"2002","journal-title":"NMR Biomed."},{"key":"B6","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1007\/s00234-009-0649-x","article-title":"Assessment of damage to cerebral white matter fiber in the subacute phase after carbon monoxide poisoning using fractional anisotropy in diffusion tensor imaging.","volume":"52","author":"Beppu","year":"2010","journal-title":"Neuroradiology"},{"key":"B7","doi-asserted-by":"publisher","first-page":"S48","DOI":"10.1161\/strokeaha.108.537704","article-title":"Understanding white matter disease: imaging-pathological correlations in vascular cognitive impairment.","volume":"40","author":"Black","year":"2009","journal-title":"Stroke"},{"key":"B8","doi-asserted-by":"publisher","first-page":"753","DOI":"10.1007\/s00234-011-1001-9","article-title":"Metabolic gray matter changes of adolescents with anorexia nervosa in combined MR proton and phosphorus spectroscopy.","volume":"54","author":"Blasel","year":"2012","journal-title":"Neuroradiology"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.3233\/jad-210534","article-title":"Alzheimer\u2019s disease biomarkers in idiopathic normal pressure hydrocephalus: linking functional connectivity and clinical outcome.","volume":"83","author":"Bommarito","year":"2021","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"B10","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1148\/radiol.2019182528","article-title":"White matter by diffusion MRI following methylphenidate treatment: a randomized control trial in males with attention-deficit\/hyperactivity disorder.","volume":"293","author":"Bouziane","year":"2019","journal-title":"Radiology"},{"key":"B11","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1212\/01.wnl.0000438225.02729.04","article-title":"White matter perivascular spaces: an MRI marker in pathology-proven cerebral amyloid angiopathy?","volume":"82","author":"Charidimou","year":"2014","journal-title":"Neurology"},{"key":"B12","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1007\/bf00687430","article-title":"Periventricular pathology in hydrocephalic rabbits before and after shunting.","volume":"77","author":"Del Bigio","year":"1988","journal-title":"Acta Neuropathol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"328","DOI":"10.1111\/j.1600-0404.2007.00906.x","article-title":"Caudate structural abnormalities in idiopathic normal pressure hydrocephalus.","volume":"116","author":"DeVito","year":"2007","journal-title":"Acta Neurol. Scand."},{"key":"B14","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1097\/nen.0000000000000191","article-title":"Correlations between mini-mental state examination score, cerebrospinal fluid biomarkers, and pathology observed in brain biopsies of patients with normal-pressure hydrocephalus.","volume":"74","author":"Elobeid","year":"2015","journal-title":"J. Neuropathol. Exp. Neurol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"369","DOI":"10.1002\/cne.901710305","article-title":"An intricately patterned prefronto-caudate projection in the rhesus monkey.","volume":"72","author":"Goldman","year":"1977","journal-title":"J. Comp. Neurol."},{"key":"B16","doi-asserted-by":"publisher","first-page":"174","DOI":"10.1016\/j.neuroimage.2017.03.024","article-title":"Classification and characterization of periventricular and deep white matter hyperintensities on MRI: a study in older adults.","volume":"170","author":"Griffanti","year":"2018","journal-title":"Neuroimage"},{"key":"B17","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":"B18","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1016\/j.jns.2016.02.067","article-title":"Diffusion tensor imaging of idiopathic normal-pressure hydrocephalus and the cerebrospinal fluid tap test.","volume":"364","author":"Kang","year":"2016","journal-title":"J. Neurol. Sci."},{"key":"B19","doi-asserted-by":"publisher","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":"B20","doi-asserted-by":"publisher","first-page":"350","DOI":"10.3171\/2015.1.Jns141633","article-title":"Default mode network connectivity in patients with idiopathic normal pressure hydrocephalus.","volume":"124","author":"Khoo","year":"2016","journal-title":"J. Neurosurg."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1496","DOI":"10.3174\/ajnr.A2531","article-title":"Differential diagnosis of idiopathic normal pressure hydrocephalus from other dementias using diffusion tensor imaging.","volume":"32","author":"Kim","year":"2011","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e70141","DOI":"10.1371\/journal.pone.0070141","article-title":"Beyond cytoarchitectonics: the internal and external connectivity structure of the caudate nucleus.","volume":"8","author":"Kotz","year":"2013","journal-title":"PLoS One"},{"key":"B23","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1002\/jmri.1076","article-title":"Diffusion tensor imaging: concepts and applications.","volume":"13","author":"Le Bihan","year":"2001","journal-title":"J. Magn. Reson. Imaging"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1302","DOI":"10.1093\/cercor\/bhh091","article-title":"3-D diffusion tensor axonal tracking shows distinct SMA and pre-SMA projections to the human striatum.","volume":"14","author":"Leh\u00e9ricy","year":"2004","journal-title":"Cereb. Cortex"},{"key":"B25","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1136\/jnnp.2010.223529","article-title":"Reduced thalamic N-acetylaspartate in idiopathic normal pressure hydrocephalus: a controlled 1H-magnetic resonance spectroscopy study of frontal deep white matter and the thalamus using absolute quantification.","volume":"82","author":"Lundin","year":"2011","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"B26","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.neuroimage.2012.05.021","article-title":"An anterior-posterior gradient of cognitive control within the dorsomedial striatum.","volume":"62","author":"Mestres-Miss\u00e9","year":"2012","journal-title":"Neuroimage"},{"key":"B27","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1016\/s0165-0173(99)00040-5","article-title":"Basal ganglia and cerebellar loops: motor and cognitive circuits.","volume":"31","author":"Middleton","year":"2000","journal-title":"Brain Res. Brain Res. Rev."},{"key":"B28","doi-asserted-by":"publisher","first-page":"3327","DOI":"10.1007\/s00330-015-4178-1","article-title":"Increased fractional anisotropy in the motor tracts of Parkinson\u2019s disease suggests compensatory neuroplasticity or selective neurodegeneration.","volume":"26","author":"Mole","year":"2016","journal-title":"Eur. Radiol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"63","DOI":"10.2176\/nmc.st.2020-0292","article-title":"Guidelines for management of idiopathic normal pressure hydrocephalus (Third Edition): endorsed by the Japanese society of normal pressure hydrocephalus.","volume":"61","author":"Nakajima","year":"2021","journal-title":"Neurol. Med. Chirurg."},{"key":"B30","doi-asserted-by":"publisher","first-page":"832","DOI":"10.3171\/2009.7.Jns09550","article-title":"Evaluation of ventriculomegaly using diffusion tensor imaging: correlations with chronic hydrocephalus and atrophy.","volume":"112","author":"Osuka","year":"2010","journal-title":"J. Neurosurg."},{"key":"B31","doi-asserted-by":"publisher","first-page":"191","DOI":"10.3348\/kjr.2008.9.3.191","article-title":"Evaluation of the somatotopic organization of corticospinal tracts in the internal capsule and cerebral peduncle: results of diffusion-tensor MR tractography.","volume":"9","author":"Park","year":"2008","journal-title":"Korean J. Radiol."},{"key":"B32","doi-asserted-by":"publisher","first-page":"228","DOI":"10.1016\/s0959-4388(96)80077-8","article-title":"Neurobehavioural mechanisms of reward and motivation.","volume":"6","author":"Robbins","year":"1996","journal-title":"Curr. Opin. Neurobiol."},{"key":"B33","doi-asserted-by":"publisher","first-page":"2661","DOI":"10.1016\/j.neuroimage.2011.08.054","article-title":"Direct evidence of intra- and interhemispheric corticomotor network degeneration in amyotrophic lateral sclerosis: an automated MRI structural connectivity study.","volume":"59","author":"Rose","year":"2012","journal-title":"Neuroimage"},{"key":"B34","doi-asserted-by":"publisher","first-page":"102862","DOI":"10.1016\/j.nicl.2021.102862","article-title":"Corticospinal tract abnormalities and ventricular dilatation: a transdiagnostic comparative tractography study.","volume":"32","author":"Sarica","year":"2021","journal-title":"Neuroimage Clin."},{"key":"B35","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1523\/jneurosci.05-03-00776.1985","article-title":"Longitudinal topography and interdigitation of corticostriatal projections in the rhesus monkey.","volume":"5","author":"Selemon","year":"1985","journal-title":"J. Neurosci."},{"key":"B36","doi-asserted-by":"publisher","first-page":"111","DOI":"10.1016\/j.neulet.2012.06.053","article-title":"Anatomical location of the corticospinal tract according to somatotopies in the centrum semiovale.","volume":"523","author":"Seo","year":"2012","journal-title":"Neurosci. Lett."},{"key":"B37","doi-asserted-by":"publisher","first-page":"E12","DOI":"10.3171\/2016.6.Focus16192","article-title":"The role of diffusion tensor imaging and fractional anisotropy in the evaluation of patients with idiopathic normal pressure hydrocephalus: a literature review.","volume":"41","author":"Siasios","year":"2016","journal-title":"Neurosurg. Focus"},{"key":"B38","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/2045-8118-12-2","article-title":"Kaolin-induced chronic hydrocephalus accelerates amyloid deposition and vascular disease in transgenic rats expressing high levels of human APP.","volume":"12","author":"Silverberg","year":"2015","journal-title":"Fluids Barriers CNS"},{"key":"B39","doi-asserted-by":"publisher","first-page":"842","DOI":"10.1111\/j.1651-2227.2009.01634.x","article-title":"White matter changes in extremely preterm infants, a population-based diffusion tensor imaging study.","volume":"99","author":"Ski\u00f6ld","year":"2010","journal-title":"Acta Paediatr."},{"key":"B40","doi-asserted-by":"publisher","first-page":"646","DOI":"10.1148\/radiol.2019190406","article-title":"Diffusion tensor MRI to distinguish progressive supranuclear palsy from \u03b1-Synucleinopathies.","volume":"293","author":"Spotorno","year":"2019","journal-title":"Radiology"},{"key":"B41","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1007\/bf00691271","article-title":"The pathology of experimental obstructive hydrocephalus. Electron microscopic observations.","volume":"38","author":"Torvik","year":"1977","journal-title":"Acta Neuropathol."},{"key":"B42","doi-asserted-by":"publisher","first-page":"4504","DOI":"10.1007\/s00330-018-5488-x","article-title":"Changes in sensorimotor-related thalamic diffusion properties and cerebrospinal fluid hydrodynamics predict gait responses to tap test in idiopathic normal-pressure hydrocephalus.","volume":"28","author":"Tsai","year":"2018","journal-title":"Eur. Radiol."},{"key":"B43","doi-asserted-by":"publisher","first-page":"17318","DOI":"10.1038\/s41598-019-53888-7","article-title":"Longitudinal morphological changes during recovery from brain deformation due to idiopathic normal pressure hydrocephalus after ventriculoperitoneal shunt surgery.","volume":"9","author":"Yamada","year":"2019","journal-title":"Sci. Rep."},{"key":"B44","doi-asserted-by":"publisher","first-page":"5675014","DOI":"10.1155\/2019\/5675014","article-title":"Diagnostic performance of glymphatic system evaluation using diffusion tensor imaging in idiopathic normal pressure hydrocephalus and mimickers.","volume":"2019","author":"Yokota","year":"2019","journal-title":"Curr. Gerontol. Geriatr. Res."},{"key":"B45","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1111\/jon.12581","article-title":"Diffusion tensor imaging of the superior thalamic radiation and cerebrospinal fluid distribution in idiopathic normal pressure hydrocephalus.","volume":"29","author":"Younes","year":"2019","journal-title":"J. Neuroimaging"},{"key":"B46","first-page":"411","article-title":"Functional MRI and cognition assessment in subcortical ischemic vascular disease.","volume":"50","author":"Zhang","year":"2011","journal-title":"Zhonghua Nei Ke Za Zhi"},{"key":"B47","first-page":"1635","article-title":"Experts consensus on diagnosis and treatment of normal pressure hydrocephalus in China (2016 edition)","volume":"96","year":"","journal-title":"Zhonghua yi Xue za Zhi"}],"container-title":["Frontiers in Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2021.794046\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,17]],"date-time":"2021-12-17T06:01:58Z","timestamp":1639720918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnins.2021.794046\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,17]]},"references-count":46,"alternative-id":["10.3389\/fnins.2021.794046"],"URL":"https:\/\/doi.org\/10.3389\/fnins.2021.794046","relation":{},"ISSN":["1662-453X"],"issn-type":[{"value":"1662-453X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,17]]},"article-number":"794046"}}