title: Callosal damage and cognitive deficits in chronic carbon monoxide intoxication: A diffusion tensor imaging study.
abstract: OBJECTIVE
  To evaluate the correlation between microstructural damage in the corpus callosum (CC) and the cognitive performance of patients with or without delayed encephalopathy (DE) after carbon monoxide (CO) intoxication in the chronic stage.
  
  
  METHODS
  Diffusion tensor imaging (DTI) was performed more than 6 months after CO intoxication for 10 patients with DE and 10 patients without DE recruited from out-patient clinics, as well as for 15 normal controls (NCs). Using a probabilistic tractography method to parcel the CC based on fiber projections to cortical connectivity patterns, the DTI indices were calculated in the CC subregions and further correlated with cognitive performance.
  
  
  RESULTS
  The DE group exhibited significantly lower fractional anisotropy (FA) and higher radial diffusivity (RD) values in the prefrontal, premotor, primary motor, primary sensory, parietal, and occipital CC subregions than did the NCs. The DE group also exhibited significantly lower FA values in the prefrontal and premotor subregions than did the non-DE group. Lower FA and higher RD values in the CC subregions were associated with poorer scores on the symbol search test.
  
  
  CONCLUSIONS
  CO intoxication may cause lower FA and higher RD in the CC subregions, with subsequent cognitive impairment. This finding suggests that selective CC damage after CO intoxication is more profound in patients with DE.
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: pachin1117@gmail.com.
authors.forename: Pei-Chin
authors.initials: PC
authors.lastname: Chen
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: sperfect@msn.com.
authors.forename: Meng-Hsiang
authors.initials: MH
authors.lastname: Chen
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan; Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan. Electronic address: suring.tw@gmail.com.
authors.forename: Hsiu-Ling
authors.initials: HL
authors.lastname: Chen
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: chlu99@cgmh.org.tw.
authors.forename: Cheng-Hsien
authors.initials: CH
authors.lastname: Lu
authors.affiliation: Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address: dargonchow@gmail.com.
authors.forename: Kun-Hsien
authors.initials: KH
authors.lastname: Chou
authors.affiliation: Department of Orthopedic Surgery, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: ray4595@adm.cgmh.org.tw.
authors.forename: Re-Wen
authors.initials: RW
authors.lastname: Wu
authors.affiliation: Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: tsainw@yahoo.com.tw.
authors.forename: Nai-Wen
authors.initials: NW
authors.lastname: Tsai
authors.affiliation: Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan; Brain Research Center, National Yang-Ming University, Taipei, Taiwan. Electronic address: chingpo@ntu.edu.tw.
authors.forename: Ching-Po
authors.initials: CP
authors.lastname: Lin
authors.affiliation: Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: lee0624@adm.cgmh.org.tw.
authors.forename: Shau-Hsuan
authors.initials: SH
authors.lastname: Li
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: tiffany3262@gmail.com.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Chen
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: cheng.yufan@msa.hinet.net.
authors.forename: Yu-Fan
authors.initials: YF
authors.lastname: Cheng
authors.affiliation: Department of Diagnostic Radiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taiwan. Electronic address: u64lin@yahoo.com.tw.
authors.forename: Wei-Che
authors.initials: WC
authors.lastname: Lin
mesh_terms: D000328:Adult; D016880:Anisotropy; D002249:Carbon Monoxide Poisoning / Q000150:complications* / Q000473:pathology*; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003072:Cognition Disorders / Q000209:etiology*; D003337:Corpus Callosum / Q000473:pathology*; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D013223:Statistics as Topic
keywords: Carbon monoxide intoxication; Corpus callosum; Delayed encephalopathy; Diffusion tensor image; Magnetic resonance imaging; White matter