title: Widespread white matter alterations in patients with end-stage renal disease: a voxelwise diffusion tensor imaging study.
abstract: OBJECTIVE
  ESRD results in excessive accumulation of urea and toxic metabolites. Hemodialysis is usually performed to maintain health in patients with ESRD; however, it may cause silent white matter alterations in the earlier stages. Hence, this study aimed to perform voxelwise diffusion tensor analysis for global detection of subtle white matter alterations in patients with ESRD.
  
  
  METHODS
  Twenty-eight patients with ESRD and 25 age-matched control subjects were enrolled in this study. Each subject underwent CASI assessment and DTI. After spatial normalization of DTI images, voxelwise statistical analyses were performed to compare DTI parameters between the 2 groups.
  
  
  RESULTS
  In patients with ESRD, AD, RD, and MD values were significantly increased, whereas the FA value was significantly decreased, mostly in the corpus callosum, bilateral sagittal stratum, and pons. Multiple regression analysis further revealed that both RD and MD were positively correlated with the duration of hemodialysis in the pons; however, no significant correlation was observed with FA. Negative correlations of RD and MD and a positive correlation of FA with the CASI score were observed in the corona radiata.
  
  
  CONCLUSIONS
  We concluded that voxelwise DTI analysis is helpful in the detection of white matter alterations caused by hemodialysis.
authors.affiliation: Departments of Medical Imaging and Radiological Sciences, College of Health Sciences;
authors.forename: M-C
authors.initials: MC
authors.lastname: Chou
authors.forename: T-J
authors.initials: TJ
authors.lastname: Hsieh
authors.forename: Y-L
authors.initials: YL
authors.lastname: Lin
authors.forename: Y-T
authors.initials: YT
authors.lastname: Hsieh
authors.forename: W-Z
authors.initials: WZ
authors.lastname: Li
authors.forename: J-M
authors.initials: JM
authors.lastname: Chang
authors.forename: C-H
authors.initials: CH
authors.lastname: Ko
authors.forename: E-F
authors.initials: EF
authors.lastname: Kao
authors.forename: T-S
authors.initials: TS
authors.lastname: Jaw
authors.forename: G-C
authors.initials: GC
authors.lastname: Liu
mesh_terms: D000328:Adult; D016880:Anisotropy; D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000209:etiology / Q000473:pathology; D003337:Corpus Callosum / Q000473:pathology*; D056324:Diffusion Tensor Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D056784:Leukoencephalopathies / Q000209:etiology* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology; D006435:Renal Dialysis / Q000009:adverse effects*