White matter changes in idiopathic normal pressure hydrocephalus evaluated by diffusion MRI including diffusion tensor and QSI

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Since histological evaluation of iNPH is difficult, we explored the white matter changes of idiopathic normal pressure hydrocephalus (iNPH) using diffusion analysis of MRI (dMRI). White matter changes related to cognitive decline were observed using diffusion tensor imaging (DTI). The corticospinal tract of iNPH showed diffusional changes due to compression without significant axonal deterioration using DTI. Advanced diffusional MRI (QSI,DKI) showed increased non-Gaussianity consistent with DTI findings. Diffusional MRI might become a unique biomarker of iNPH.