Attempting suicide by burning charcoal can lead to carbon monoxide (CO) intoxication and cognitive deficits. Changes in white matter (WM) quantified by diffusion tensor imaging (DTI)-derived parameters have been validated to reflect cognitive test scores. As diffusion kurtosis imaging (DKI) measures biological microstructures using non-Gaussian diffusivity, we assessed the added-information of DKI with neuropsychological test scores as the major outcome measure.

A total of 45 patients were enrolled and compared with 30 age-matched controls. The patients were stratified into acute or chronic phase according to the intervals of intoxication and assessments. WM status was assessed using tract-based spatial statistics for DKI and DTI topographies, and the sensitivity/specificity of either model was tested using area under the curve (AUC) analysis. To evaluate their clinical significance, values of DKI- and DTI-derived parameters were extracted from seven regions of interest (ROI) and correlated with neuropsychiatric scores.

The kurtosis parameters were lower in the patients than in the controls but none of the parameters provided differentiations between the acute or chronic phase. Kurtosis fractional anisotropy (KFA) had a higher AUC than fractional anisotropy while the other 3 DTI parameters had higher AUC than the corresponding DKI ones. In clinical correlations, KFA value of right posterior WM correlated with visual memory (r = 0.326, p = 0.029), and KFA values of bilateral posterior WM correlated with the digit forward score (right: r = 0.302, p = 0.043; left: r = 0.314, p = 0.036).

Although DTI was more sensitive in reflecting disease status, KFA may be more sensitive and specific than fractional anisotropy in cognitive test score predictions.

通过燃烧木炭自杀会导致一氧化碳（CO）中毒和认知缺陷。通过弥散张量成像（DTI）派生的参数量化的白质（WM）的变化已得到验证，可以反映认知测试得分。由于扩散峰度成像（DKI）使用非高斯扩散率来测量生物微观结构，因此我们以神经心理学测试分数作为主要结局指标来评估DKI的附加信息。

共有45位患者入选，并与30位年龄相匹配的对照组进行了比较。根据中毒和评估的时间间隔，将患者分为急性期或慢性期。使用基于通道的DKI和DTI地形统计数据评估WM状态，并使用曲线下面积（AUC）分析测试任一模型的敏感性/特异性。为了评估其临床意义，从七个感兴趣区域（ROI）提取了DKI和DTI派生参数的值，并将其与神经精神病学评分相关联。

患者的峰度参数低于对照组，但没有参数可区分急性期或慢性期。峰度分数各向异性（KFA）的AUC高于分数各向异性，而其他3个DTI参数的AUC则高于相应的DKI参数。在临床相关性中，右后WM的KFA值与视觉记忆相关（r = 0.326，p = 0.029），双侧后WM的KFA值与手指向前得分相关（右：r = 0.302，p = 0.043；左： r = 0.314，p = 0.036）。

尽管DTI在反映疾病状态方面更为敏感，但在认知测验分数预测中，KFA可能比分数各向异性更敏感和更具特异性。