Study On The Changes Of White Matter Microstructure In Patients With Post Stroke Depression By Diffusion Kurtosis Imaging

Objective:The present study aimed to investigate the changes of white matter microstructure in patients with early post stroke depression(PSD),and to explore the relationship between white matter integrity and early PSD by diffusion kurtosis imaging(DKI),providing a possible mechanism of structure Imaging for PSD.Methods:Thirty-eight patients with acute cerebral infarction who were hospitalized at the Second Hospital of Shanxi Medical University from May 2017 to December 2017 were selected,including 17 patients with post-stroke depression group(PSD group),and 21 patients without post-stroke depression group(N-PSD group).In addition,20 normal controls(NORM group)matched with gender and age were selected.At the time of admission,demographic data and stroke characteristics were collected.7-14 days after onset,the Hamilton Depression Scale was evaluated.MRI scans were performed using a GE MR750 W 3.0T magnetic resonance scanner,including T1 weighted images,T2 weighted images,DWI sequences,and DKI sequences.The white matter of frontal,temporal,parietal lobe,occipital lobe,the anterior limb of internal capsule and the posterior limb of the internal capsule,in addition to the genu of corpus callosum and the splenium of corpus callosum were selected,a total of 14 regions of interest(ROI).using by function tool 9.4.05 post-processing software of GE AW4.6 post-processing workstation.Selected parameters include fractional anisotropy(FA),mean diffusivity(MD),mean kurtosis(MK),radial kurtosis(RK),axial kurtosis(AK).The differences among various parameters in each region of interest between the three groups were analyzed,and the correlation between HAMD score and each parameter was analyzed in PSD group.Results:1.Compared with N-PSD group and NORM group,FA value of left frontal lobe of PSD group was statistically significant(P <0.05).2.There was no significant difference between the three groups in MD,no statistical significance(P > 0.05).3.The MK value of bilateral frontal lobe,bilateral temporal lobe and the genu of corpus callosum in PSD group was smaller than those in N-PSD group and NORM group(P<0.05).MK value of left frontal lobe and bilateral temporal lobe in PSD group was negatively correlated with HAMD score(P <0.05).4.Compared with N-PSD group and NORM group,RK values of left frontal lobe and bilateral temporal lobe in PSD group were both smaller and statistically significant(P <0.05).5.There was no significant difference in AK between the three groups(P > 0.05).Conclusion:1.The early PSD patients may have white matter microstructure abnormalities or injuries in frontal lobe,temporal lobe and the genu of corpus callosum.This suggests that the changes in the white matter microstructure in the frontal lobe,temporal lobe,the genu of corpus callosum may be related to the pathophysiological changes of post-stroke depression.2.DKI can provide multiple parameters such as FA,MD,MK,RK,and AK,which can provide a more comprehensive and accurate imaging reference for the detection of early microscopic structural damage of white matter in PSD patients,which can be used as an imaging predictor of early PSD.