Gilles Allali1,2,3, Valentina Garibotto4, Ismini C Mainta4, Nicolas Nicastro5, Frederic Assal6. 1. Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. gilles.allali@hcuge.ch. 2. Division of Cognitive and Motor Aging, Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, Bronx, Newyork, USA. gilles.allali@hcuge.ch. 3. Department of Neurology, Geneva University Hospitals, 4 rue Gabrielle-Perret-Gentil, 1211, Geneva, Switzerland. gilles.allali@hcuge.ch. 4. Division of Nuclear Medicine, and Molecular Imaging, Department of Medical Imaging and Information Sciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. 5. Division of Neurorehabilitation, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland. 6. Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Abstract
OBJECTIVE: Idiopathic normal pressure hydrocephalus (iNPH) and iNPH mimics (i.e., Parkinson's disease, progressive supranuclear palsy or dementia with Lewy bodies) share similar clinical features, and discrimination between both conditions relies on invasive time-consuming investigations. This study aims to compare [123I]FP-CIT SPECT imaging-visual rating and semiquantitative values-between iNPH and iNPH mimics. METHODS: Among 56 patients with a suspicion of iNPH (76.5 ± 6.1 years; 23.2% women), 26 fulfilled the iNPH diagnostic criteria and the remaining 30 were classified as iNPH mimics. Patients were visually categorized as having normal or abnormal [123I]FP-CIT SPECT; and for the quantification of the [123I]FP-CIT SPECT imaging, we calculated striatal binding ratios (SBR) using BRASS™ automated brain analysis while applying locally established reference limits (adjusted for age). Logistic regressions were used to assess the association between [123I]FP-CIT SPECT and diagnostic groups. RESULTS: A normal SBR [123I]FP-CIT SPECT was present in 69.2% of iNPH and 37.9% of mimics (p value = .020), while visual rating did not differ between the two groups. Normal SBR [123I]FP-CIT SPECT values were associated with the diagnosis of iNPH, even after adjusting for white matter changes and comorbidities (adjusted odds ratio: 4.17; 95% CI 1.26-13.80). CONCLUSION: Semi-quantitative [123I]FP-CIT SPECT evaluation, but not visual assessment, discriminates iNPH patients from their mimics. [123I]FP-CIT SPECT represents an interesting neuroimaging biomarker to improve the selection of patients with iNPH for invasive shunt surgery.
OBJECTIVE: Idiopathic normal pressure hydrocephalus (iNPH) and iNPH mimics (i.e., Parkinson's disease, progressive supranuclear palsy or dementia with Lewy bodies) share similar clinical features, and discrimination between both conditions relies on invasive time-consuming investigations. This study aims to compare [123I]FP-CIT SPECT imaging-visual rating and semiquantitative values-between iNPH and iNPH mimics. METHODS: Among 56 patients with a suspicion of iNPH (76.5 ± 6.1 years; 23.2% women), 26 fulfilled the iNPH diagnostic criteria and the remaining 30 were classified as iNPH mimics. Patients were visually categorized as having normal or abnormal [123I]FP-CIT SPECT; and for the quantification of the [123I]FP-CIT SPECT imaging, we calculated striatal binding ratios (SBR) using BRASS™ automated brain analysis while applying locally established reference limits (adjusted for age). Logistic regressions were used to assess the association between [123I]FP-CIT SPECT and diagnostic groups. RESULTS: A normal SBR [123I]FP-CIT SPECT was present in 69.2% of iNPH and 37.9% of mimics (p value = .020), while visual rating did not differ between the two groups. Normal SBR [123I]FP-CIT SPECT values were associated with the diagnosis of iNPH, even after adjusting for white matter changes and comorbidities (adjusted odds ratio: 4.17; 95% CI 1.26-13.80). CONCLUSION: Semi-quantitative [123I]FP-CIT SPECT evaluation, but not visual assessment, discriminates iNPH patients from their mimics. [123I]FP-CIT SPECT represents an interesting neuroimaging biomarker to improve the selection of patients with iNPH for invasive shunt surgery.
Entities:
Keywords:
Aging; Mimics; Normal pressure hydrocephalus; Parkinsonism; [123I]FP-CIT SPECT imaging
Authors: Elina Mäkinen; Juho Joutsa; Jarkko Johansson; Maija Mäki; Marko Seppänen; Valtteri Kaasinen Journal: J Neural Transm (Vienna) Date: 2016-06-20 Impact factor: 3.575
Authors: Alberto J Espay; Gustavo A Da Prat; Alok K Dwivedi; Federico Rodriguez-Porcel; Jennifer E Vaughan; Michela Rosso; Johnna L Devoto; Andrew P Duker; Mario Masellis; Charles D Smith; George T Mandybur; Aristide Merola; Anthony E Lang Journal: Ann Neurol Date: 2017-10-04 Impact factor: 10.422
Authors: Nicolas Nicastro; Valentina Garibotto; Antoine Poncet; Simon Badoud; Pierre R Burkhard Journal: Mol Imaging Biol Date: 2016-04 Impact factor: 3.488
Authors: Nadia K Magdalinou; Helen Ling; James D Shand Smith; Jonathan M Schott; Laurence D Watkins; Andrew J Lees Journal: J Neurol Date: 2012-11-23 Impact factor: 4.849