Takashi Suehiro1, Hiroaki Kazui1,2, Hideki Kanemoto1,3,4, Kenji Yoshiyama1, Shunsuke Sato1, Yukiko Suzuki1,5, Shingo Azuma1, Takuya Matsumoto1, Haruhiko Kishima6, Kazunari Ishii7, Manabu Ikeda1. 1. Department of Psychiatry, Osaka University Graduate School of Medicine, Suita, Japan. 2. Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan. 3. Department of Psychiatry, Mizuma Hospital, Kaizuka, Japan. 4. Cognitive Reserve Research Center, Osaka Kawasaki Rehabilitation University, Kaizuka, Japan. 5. Department of Behavioral Neurology and Neuropsychiatry, Osaka University United Graduate School of Child Development, Suita, Japan. 6. Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan. 7. Faculty of Medicine, Department of Radiology, Kindai University, Osakasyama, Japan.
Abstract
BACKGROUND: Specific ventriculomegaly features, including tight high-convexity and medial subarachnoid spaces, are found on magnetic resonance images in patients with idiopathic normal pressure hydrocephalus (iNPH). However, some healthy elderly individuals with no typical triad symptoms of iNPH also exhibit specific magnetic resonance image features of iNPH. Therefore, this study quantitatively clarified the brain morphology of suspected iNPH patients with no objective triad symptoms (iNPH-NOS). METHODS: We recruited patients with suspected iNPH and divided them into two groups based on their iNPH grading scale scores: the iNPH-NOS group and the iNPH with apparent objective triad symptoms (iNPH-AOS) group. Data for normal controls (NC) were taken from the database used in our previous study. We compared the relative volumes of ventricle systems (VS), Sylvian fissures (SF), and sulci at high convexity and the midline (SHM), adjusted by the intracranial volume, of the iNPH-NOS, iNPH-AOS, and NC groups. Additionally, we compared the relative volumes of VS, SF, and SHM in iNPH-NOS patients between their first visit and follow-up 1 year later. RESULTS: Fifteen iNPH-NOS patients and 45 iNPH-AOS patients were recruited, and 24 NCs were found in the database. The relative volumes of VS and SF were significantly smaller than in NCs than in the iNPH-NOS and iNPH-AOS groups, and the relative volume of SHM was significantly larger in NCs. The relative volume of SHM was significantly larger in the iNPH-NOS group than in the iNPH-AOS group, but there were no significant differences in the relative volumes of VS and SF between these groups. In the iNPH-NOS group, the relative volumes of VS and SF were significantly smaller at the first visit than 1 year later, whereas the relative volume of SHM was significantly larger. In 6 of 15 iNPH-NOS patients, objective symptoms appeared during the observation period. CONCLUSIONS: Our results indicate that iNPH-NOS patients were in the transitional stage between normal and iNPH-AOS, both morphologically and clinically.
BACKGROUND: Specific ventriculomegaly features, including tight high-convexity and medial subarachnoid spaces, are found on magnetic resonance images in patients with idiopathic normal pressure hydrocephalus (iNPH). However, some healthy elderly individuals with no typical triad symptoms of iNPH also exhibit specific magnetic resonance image features of iNPH. Therefore, this study quantitatively clarified the brain morphology of suspected iNPH patients with no objective triad symptoms (iNPH-NOS). METHODS: We recruited patients with suspected iNPH and divided them into two groups based on their iNPH grading scale scores: the iNPH-NOS group and the iNPH with apparent objective triad symptoms (iNPH-AOS) group. Data for normal controls (NC) were taken from the database used in our previous study. We compared the relative volumes of ventricle systems (VS), Sylvian fissures (SF), and sulci at high convexity and the midline (SHM), adjusted by the intracranial volume, of the iNPH-NOS, iNPH-AOS, and NC groups. Additionally, we compared the relative volumes of VS, SF, and SHM in iNPH-NOS patients between their first visit and follow-up 1 year later. RESULTS: Fifteen iNPH-NOS patients and 45 iNPH-AOS patients were recruited, and 24 NCs were found in the database. The relative volumes of VS and SF were significantly smaller than in NCs than in the iNPH-NOS and iNPH-AOS groups, and the relative volume of SHM was significantly larger in NCs. The relative volume of SHM was significantly larger in the iNPH-NOS group than in the iNPH-AOS group, but there were no significant differences in the relative volumes of VS and SF between these groups. In the iNPH-NOS group, the relative volumes of VS and SF were significantly smaller at the first visit than 1 year later, whereas the relative volume of SHM was significantly larger. In 6 of 15 iNPH-NOS patients, objective symptoms appeared during the observation period. CONCLUSIONS: Our results indicate that iNPH-NOS patients were in the transitional stage between normal and iNPH-AOS, both morphologically and clinically.
Keywords:
asymptomatic ventriculomegaly with features of iNPH on MRI (AVIM); brain morphology; disproportionately enlarged subarachnoid space hydrocephalus (DESH); idiopathic normal pressure hydrocephalus (iNPH); preclinical stage; voxel-based morphometry
Authors: J F Carlsen; A D L Backlund; C A Mardal; S Taudorf; A V Holst; T N Munch; A E Hansen; S G Hasselbalch Journal: AJNR Am J Neuroradiol Date: 2021-12-30 Impact factor: 3.825
Authors: Jonathan Frederik Carlsen; Tina Nørgaard Munch; Adam Espe Hansen; Steen Gregers Hasselbalch; Alexander Malcolm Rykkje Journal: Neuroradiology Date: 2022-07-24 Impact factor: 2.995