, Volume 56, Issue 2, pp 97–106

Diffusion tensor tractography and neuropsychological assessment in patients with vitamin B12 deficiency

  • Pradeep Kumar Gupta
  • Ravindra Kumar Garg
  • Rakesh Kumar Gupta
  • Hardeep Singh Malhotra
  • Vimal Kumar Paliwal
  • Ram Kishore Singh Rathore
  • Rajesh Verma
  • Maneesh Kumar Singh
  • Yogita Rai
  • Chandra Mani Pandey
Diagnostic Neuroradiology



Structural imaging of the brain does not demonstrate any changes in a vast majority of patients with vitamin B12 deficiency, even in advanced stages. In this study, we aimed to assess and correlate the functional integrity of the brain fiber tracts using diffusion tensor tractography with neuropsychological examination in patients with vitamin B12 deficiency.


The study was conducted at two tertiary care centers. Thirty-two patients with vitamin B12 deficiency were enrolled and subjected to diffusion tensor tractography, as an extension of diffusion tensor imaging, and neuropsychological assessment. Tests of significance were done to detect changes, pre- and post-vitamin B12 supplementation in the diffusivity parameters (fractional anisotropy and mean diffusivity) and the neuropsychological test scores.


Statistically significant changes were observed in the diffusivity parameters and the neuropsychological test scores between the controls and the patients with vitamin B12deficiency in the pre- and post-treatment phases.


This is the first study to evaluate the diffusion tensor tractography (DTT) parameters in the light of clinical neuropsychological assessment in patients with vitamin B12 deficiency. Utilization of DTT parameters may antedate structural changes and may quantify the neurocognitive deficits.


Magnetic resonance imaging Diffusion tensor imaging Diffusion tensor tractography Folic acid Cognition 


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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Pradeep Kumar Gupta
    • 1
  • Ravindra Kumar Garg
    • 1
  • Rakesh Kumar Gupta
    • 6
  • Hardeep Singh Malhotra
    • 1
  • Vimal Kumar Paliwal
    • 3
  • Ram Kishore Singh Rathore
    • 4
  • Rajesh Verma
    • 1
  • Maneesh Kumar Singh
    • 1
  • Yogita Rai
    • 2
  • Chandra Mani Pandey
    • 5
  1. 1.Department of NeurologyKing George’s Medical UniversityLucknowIndia
  2. 2.Department of RadiodiagnosisSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  3. 3.Department of NeurologySanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  4. 4.Department of Mathematics and StatisticsIndian Institute of TechnologyKanpurIndia
  5. 5.Department of BiostatisticsSanjay Gandhi Postgraduate Institute of Medical SciencesLucknowIndia
  6. 6.Departments of Radiology and ImagingFortis Memorial Research InstituteGurgaonIndia

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