Alterations of White Matter Microstructure in Primary Aldosteronism Patients With Normal Cognitive Functioning Using Diffusion Tensor Imaging

Objective: To detect white matter microstructural alterations in patients with primary aldosteronism (PA) with normal cognitive function using diffusion tensor imaging (DTI). Methods: This study included PA patients and normotensive healthy controls (HCs). MRI (T1-weighted) and DTI data were collected for all participants. Using the Johns Hopkins University white matter fiber tractography template, we calculated the values of fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD). Results: Compared to the HC group, the PA group showed significant increases in AD in cingulum bundle cingulate part (CgC.R), forceps minor (FMi), bilateral inferior fronto-occipital fasciculi (IFO), and right temporo-superior longitudinal fasciculus (tSLF.R); RD in left IFO (IFO.L) and right superior longitudinal fasciculus (SLF.R); and MD in FMi, IFO.L, right IFO (IFO.R) and SLF.R. Conclusion: Compensatory white matter alterations occur in PA patients before cognitive impairment. These alterations may serve as early imaging biomarkers for PA-related brain function impairment, highlighting the importance of advanced neuroimaging for early diagnosis and intervention.