Differences in Brain Morphology Between Hydrocephalus Ex Vacuo and Idiopathic Normal Pressure Hydrocephalus

Overview

Journal Psychiatry Investig

Specialty Psychiatry

Date 2021 Jul 15

PMID 34265199

Citations 4

Authors

Minkyung Kim

Sun-Won Park

Jun-Young Lee

Hongrae Kim

Jung Hyo Rhim

Soowon Park

Jee-Young Lee

Hwancheol Son

Yu Kyeong Kim

Sang Hyung Lee

Affiliations

Soon will be listed here.

Abstract

Objective: The distinction between idiopathic normal pressure hydrocephalus (iNPH) and hydrocephalus ex vacuo caused by encephalic volume loss remains to be established. This study aims to investigate radiological parameters as clinically useful tools to discriminate iNPH from hydrocephalus ex vacuo caused by Alzheimer's disease (AD).

Methods: A total of 54 patients with ventriculomegaly (iNPH, 25; hydrocephalus ex vacuo, 29) were recruited in this study. Consequently, nine radiological parameters were compared between iNPH and hydrocephalus ex vacuo using magnetic resonance imaging (MRI).

Results: A small callosal angle (CA), the Sylvian fissure dilatation, and absence of narrowing of superior parietal sulci discriminated the iNPH group from the hydrocephalus ex vacuo group (p<0.05). The final binary logistic regression model included narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure after controlling for age and global Clinical Dementia Rating (CDR). The composite score made from these three indicators (narrowing of superior parietal sulci, degrees of the CA, and height of the Sylvian fissure) was statistically different between iNPH and hydrocephalus ex vacuo.

Conclusion: The narrowing of the CA, dilatation of the Sylvain fissure, and narrowing of superior parietal sulci may be used as radiological key indices and noninvasive tools for the differential diagnosis of iNPH from hydrocephalus ex vacuo.

Citing Articles

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References

Holodny A, George A, Golomb J, de Leon M, Kalnin A . The perihippocampal fissures: normal anatomy and disease states. Radiographics. 1998; 18(3):653-65. DOI: 10.1148/radiographics.18.3.9599389. View

Martin-Laez R, Caballero-Arzapalo H, Valle-San Roman N, Lopez-Menendez L, Arango-Lasprilla J, Vazquez-Barquero A . Incidence of Idiopathic Normal-Pressure Hydrocephalus in Northern Spain. World Neurosurg. 2015; 87:298-310. DOI: 10.1016/j.wneu.2015.10.069. View

Hebb A, Cusimano M . Idiopathic normal pressure hydrocephalus: a systematic review of diagnosis and outcome. Neurosurgery. 2002; 49(5):1166-84; discussion 1184-6. DOI: 10.1097/00006123-200111000-00028. View

Virhammar J, Laurell K, Cesarini K, Larsson E . Preoperative prognostic value of MRI findings in 108 patients with idiopathic normal pressure hydrocephalus. AJNR Am J Neuroradiol. 2014; 35(12):2311-8. PMC: 7965311. DOI: 10.3174/ajnr.A4046. View

Zimmerman R, Fleming C, Lee B, Saint-Louis L, Deck M . Periventricular hyperintensity as seen by magnetic resonance: prevalence and significance. AJR Am J Roentgenol. 1986; 146(3):443-50. DOI: 10.2214/ajr.146.3.443. View

Akai K, Uchigasaki S, Tanaka U, Komatsu A . Normal pressure hydrocephalus. Neuropathological study. Acta Pathol Jpn. 1987; 37(1):97-110. View

Holodny A, George A, de Leon M, Golomb J, Kalnin A, Cooper P . Focal dilation and paradoxical collapse of cortical fissures and sulci in patients with normal-pressure hydrocephalus. J Neurosurg. 1998; 89(5):742-7. DOI: 10.3171/jns.1998.89.5.0742. View

Kojoukhova M, Koivisto A, Korhonen R, Remes A, Vanninen R, Soininen H . Feasibility of radiological markers in idiopathic normal pressure hydrocephalus. Acta Neurochir (Wien). 2015; 157(10):1709-18. DOI: 10.1007/s00701-015-2503-8. View

McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan E . Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology. 1984; 34(7):939-44. DOI: 10.1212/wnl.34.7.939. View

10.

Relkin N, Marmarou A, Klinge P, Bergsneider M, Black P . Diagnosing idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005; 57(3 Suppl):S4-16. DOI: 10.1227/01.neu.0000168185.29659.c5. View

11.

Yasar S, Jusue-Torres I, Lu J, Robison J, Patel M, Crain B . Alzheimer's disease pathology and shunt surgery outcome in normal pressure hydrocephalus. PLoS One. 2017; 12(8):e0182288. PMC: 5546572. DOI: 10.1371/journal.pone.0182288. View

12.

Marmarou A, Bergsneider M, Klinge P, Relkin N, Black P . The value of supplemental prognostic tests for the preoperative assessment of idiopathic normal-pressure hydrocephalus. Neurosurgery. 2005; 57(3 Suppl):S17-28. DOI: 10.1227/01.neu.0000168184.01002.60. View

13.

Ambarki K, Israelsson H, Wahlin A, Birgander R, Eklund A, Malm J . Brain ventricular size in healthy elderly: comparison between Evans index and volume measurement. Neurosurgery. 2010; 67(1):94-9. DOI: 10.1227/01.NEU.0000370939.30003.D1. View

14.

Fazekas F, Chawluk J, Alavi A, Hurtig H, Zimmerman R . MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol. 1987; 149(2):351-6. DOI: 10.2214/ajr.149.2.351. View

15.

Graff-Radford N, Jones D . Normal Pressure Hydrocephalus. Continuum (Minneap Minn). 2019; 25(1):165-186. DOI: 10.1212/CON.0000000000000689. View

16.

Ryska P, Slezak O, Eklund A, Malm J, Salzer J, Zizka J . Radiological markers of idiopathic normal pressure hydrocephalus: Relative comparison of their diagnostic performance. J Neurol Sci. 2019; 408:116581. DOI: 10.1016/j.jns.2019.116581. View

17.

Ishii K, Kanda T, Harada A, Miyamoto N, Kawaguchi T, Shimada K . Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus. Eur Radiol. 2008; 18(11):2678-83. DOI: 10.1007/s00330-008-1044-4. View

18.

Virhammar J, Laurell K, Cesarini K, Larsson E . The callosal angle measured on MRI as a predictor of outcome in idiopathic normal-pressure hydrocephalus. J Neurosurg. 2013; 120(1):178-84. DOI: 10.3171/2013.8.JNS13575. View

19.

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

20.

Ieva A, Valli M, Cusimano M . Distinguishing Alzheimer's disease from normal pressure hydrocephalus: a search for MRI biomarkers. J Alzheimers Dis. 2013; 38(2):331-50. DOI: 10.3233/JAD-130581. View