Disproportionate Subarachnoid Space Hydrocephalus-outcome and Perivascular Space

Overview

Journal Ann Clin Transl Neurol

Specialty Neurology

Date 2014 Oct 31

PMID 25356428

Citations 9

Authors

Ichiro Akiguchi

Yoshitomo Shirakashi

Herbert Budka

Yuko Watanabe

Toshiyuki Watanabe

Akihiko Shiino

Mihoko Ogita

Yasuhiro Kawamoto

Susanne Jungwirth

Wolfgang Krampla

Peter Fischer

Affiliations

Soon will be listed here.

Abstract

Objective: We sought to identify the prevalence of MRI features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH-iNPH) and to describe the clinico-radiological features and outcomes of a community-based investigation (The Vienna Trans-Danube Aging study).

Methods: Of the 697 inhabitants (all 75 years old), 503 completed extensive neurological examinations at baseline and were followed up every 30 months thereafter with MRIs, mini-mental state examination (MMSE), and the Unified Parkinson Disease Rating Scale-Motor Section (UPDRSM). The DESH-iNPH participant data were compared with the data from participants with Evans index ratios >0.3 (ex vacuo hydrocephalus), cerebral small-vessel diseases, and normal MRIs. The widening of perivascular space was also evaluated by MRI in these groups.

Results: Eight participants with DESH-iNPH (1.6%) and 76 with ex vacuo hydrocephalus (16.1%) at baseline were identified. The mean MMSE in DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs was 26.4, 27.9, and 28.3, respectively, and the mean UPDRSM was 9.75, 2.96, and 1.87, respectively. After a 90-month follow-up, the mortality rates for DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs were 25.0%, 21.3%, and 10.9%, respectively. The perivascular-space widening scores were significantly smaller in the DESH-iNPH cases, particularly at the centrum semiovale, compared to cerebral small-vessel disease and ex vacuo hydrocephalus cases.

Interpretation: The prevalence of DESH-iNPH was 1.6% for participants aged 75 years and revealed significantly lower MMSE and higher UPDRSM scores compared to the ex vacuo hydrocephalus and controls. Moreover, it is suggested that perivascular-space narrowing is a morphological and pathophysiological marker of DESH-iNPH.

Citing Articles

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The association of disproportionately enlarged subarachnoid space hydrocephalus with cognitive deficit in a general population: the Ohasama study.

Nishikawa T, Akiguchi I, Satoh M, Hara A, Hirano M, Hosokawa A Sci Rep. 2021; 11(1):17061.

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Nakajima M, Miyajima M, Ogino I, Akiba C, Kawamura K, Kurosawa M Front Neurol. 2018; 9:421.

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Andersson J, Rosell M, Kockum K, Soderstrom L, Laurell K eNeurologicalSci. 2018; 7:27-31.

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References

Shoesmith C, Buist R, Del Bigio M . Magnetic resonance imaging study of extracellular fluid tracer movement in brains of immature rats with hydrocephalus. Neurol Res. 2000; 22(1):111-6. DOI: 10.1080/01616412.2000.11741045. View

Bradley Jr W, Bahl G, Alksne J . Idiopathic normal pressure hydrocephalus may be a "two hit" disease: benign external hydrocephalus in infancy followed by deep white matter ischemia in late adulthood. J Magn Reson Imaging. 2006; 24(4):747-55. DOI: 10.1002/jmri.20684. View

Koto A, Rosenberg G, ZINGESSER L, Horoupian D, Katzman R . Syndrome of normal pressure hydrocephalus: possible relation to hypertensive and arteriosclerotic vasculopathy. J Neurol Neurosurg Psychiatry. 1977; 40(1):73-9. PMC: 492607. DOI: 10.1136/jnnp.40.1.73. View

Kida S, Pantazis A, Weller R . CSF drains directly from the subarachnoid space into nasal lymphatics in the rat. Anatomy, histology and immunological significance. Neuropathol Appl Neurobiol. 1993; 19(6):480-8. DOI: 10.1111/j.1365-2990.1993.tb00476.x. View

Nishida N, Nagata N, Toda H, Jingami N, Uemura K, Ozaki A . Association of lipocalin-type prostaglandin D synthase with disproportionately enlarged subarachnoid-space in idiopathic normal pressure hydrocephalus. Fluids Barriers CNS. 2014; 11(1):9. PMC: 3991874. DOI: 10.1186/2045-8118-11-9. View

Hashimoto M, Ishikawa M, Mori E, Kuwana N . Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res. 2010; 7:18. PMC: 2987762. DOI: 10.1186/1743-8454-7-18. View

Patankar T, Mitra D, Varma A, Snowden J, Neary D, Jackson A . Dilatation of the Virchow-Robin space is a sensitive indicator of cerebral microvascular disease: study in elderly patients with dementia. AJNR Am J Neuroradiol. 2005; 26(6):1512-20. PMC: 8149063. View

Akiguchi I, Tomimoto H, Wakita H, Yamamoto Y, Suenaga T, Ueno M . Cytopathological alterations and therapeutic approaches in Binswanger's disease. Neuropathology. 2009; 19(1):119-28. DOI: 10.1046/j.1440-1789.1999.00208.x. View

Akiguchi I, Ishii M, Watanabe Y, Watanabe T, Kawasaki T, Yagi H . Shunt-responsive parkinsonism and reversible white matter lesions in patients with idiopathic NPH. J Neurol. 2008; 255(9):1392-9. DOI: 10.1007/s00415-008-0928-1. View

10.

Carare R, Bernardes-Silva M, Newman T, Page A, Nicoll J, Perry V . Solutes, but not cells, drain from the brain parenchyma along basement membranes of capillaries and arteries: significance for cerebral amyloid angiopathy and neuroimmunology. Neuropathol Appl Neurobiol. 2008; 34(2):131-44. DOI: 10.1111/j.1365-2990.2007.00926.x. View

11.

Adams R, Fisher C, Hakim S, Ojemann R, SWEET W . SYMPTOMATIC OCCULT HYDROCEPHALUS WITH "NORMAL" CEREBROSPINAL-FLUID PRESSURE. A TREATABLE SYNDROME. N Engl J Med. 1965; 273:117-26. DOI: 10.1056/NEJM196507152730301. View

12.

Bech R, Waldemar G, Gjerris F, Klinken L, Juhler M . Shunting effects in patients with idiopathic normal pressure hydrocephalus; correlation with cerebral and leptomeningeal biopsy findings. Acta Neurochir (Wien). 2000; 141(6):633-9. DOI: 10.1007/s007010050353. View

13.

Mao X, Enno T, Del Bigio M . Aquaporin 4 changes in rat brain with severe hydrocephalus. Eur J Neurosci. 2006; 23(11):2929-36. DOI: 10.1111/j.1460-9568.2006.04829.x. View

14.

Golomb J, Wisoff J, Miller D, Boksay I, Kluger A, Weiner H . Alzheimer's disease comorbidity in normal pressure hydrocephalus: prevalence and shunt response. J Neurol Neurosurg Psychiatry. 2000; 68(6):778-81. PMC: 1736969. DOI: 10.1136/jnnp.68.6.778. View

15.

Iliff J, Wang M, Liao Y, Plogg B, Peng W, Gundersen G . A paravascular pathway facilitates CSF flow through the brain parenchyma and the clearance of interstitial solutes, including amyloid β. Sci Transl Med. 2012; 4(147):147ra111. PMC: 3551275. DOI: 10.1126/scitranslmed.3003748. View

16.

Fischer P, Jungwirth S, Krampla W, Weissgram S, Kirchmeyr W, Schreiber W . Vienna Transdanube Aging "VITA": study design, recruitment strategies and level of participation. J Neural Transm Suppl. 2002; (62):105-16. DOI: 10.1007/978-3-7091-6139-5_11. View

17.

Wuerfel J, Haertle M, Waiczies H, Tysiak E, Bechmann I, Wernecke K . Perivascular spaces--MRI marker of inflammatory activity in the brain?. Brain. 2008; 131(Pt 9):2332-40. DOI: 10.1093/brain/awn171. View

18.

Ballard C, Burton E, Barber R, Stephens S, Kenny R, Kalaria R . NINDS AIREN neuroimaging criteria do not distinguish stroke patients with and without dementia. Neurology. 2004; 63(6):983-8. DOI: 10.1212/01.wnl.0000138435.19761.93. View

19.

Roman G, Erkinjuntti T, Wallin A, Pantoni L, Chui H . Subcortical ischaemic vascular dementia. Lancet Neurol. 2003; 1(7):426-36. DOI: 10.1016/s1474-4422(02)00190-4. View

20.

Kwee R, Kwee T . Virchow-Robin spaces at MR imaging. Radiographics. 2007; 27(4):1071-86. DOI: 10.1148/rg.274065722. View