Rationale and 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.
Materials and 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. The receiver operating
characteristic (ROC) curve and the Z-scores were used to evaluate the diagnostic efficacy
of each parameter.
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). Plasma Al in the MCI group was higher than that in the NC group, although
there was no significant difference in plasma Al between the two groups (p=0.057). There was no correlation between DKI parameters and plasma Al.
Conclusion
The DKI method might be a sensitive imaging biomarker to discriminate MCI from NC,
and could preliminarily assess the severity of cognitive impairment in Al-exposed
workers. MK in the right hippocampus appeared to be the best independent predictor.
The mechanism of cognitive decline is an important content of aluminum exposure research.
This study indicates that the DKI technique could provide valuable information for
the diagnosis of MCI.
Key Words
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Article info
Publication history
Published online: January 21, 2023
Accepted:
December 2,
2022
Received in revised form:
December 2,
2022
Received:
August 28,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Published by Elsevier Inc. on behalf of The Association of University Radiologists.
