Andrea Quattrone1, Alessia Sarica2, Domenico La Torre3, Maurizio Morelli1, Alessandro Mechelli1, Pier Paolo Arcuri4, Aldo Quattrone5,6,7. 1. Institute of Neurology, University "Magna Graecia", Catanzaro, Italy. 2. Department of Medical and Surgical Sciences, Neuroscience Centre, University "Magna Graecia", Catanzaro, Italy. 3. Institute of Neurosurgery, University "Magna Graecia", Catanzaro, Italy. 4. Department of Radiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy. 5. Neuroscience Research Center, University "Magna Graecia", Catanzaro, Italy. quattrone@unicz.it. 6. Institute of Molecular Bioimaging and Physiology, National Research Council (IBFM-CNR), Catanzaro, Italy. quattrone@unicz.it. 7. Neuroscience Centre and Neuroimaging Research Unit, Institute of Molecular Bioimaging and Physiology, National Research Council, Magna Graecia University, 88100, Catanzaro, Italy. quattrone@unicz.it.
Abstract
BACKGROUND: Progressive supranuclear palsy (PSP) patients can show ventricular enlargement mimicking normal pressure hydrocephalus (NPH). The aim of this study was to distinguish PSP patients with marked ventricular dilatation (PSP-vd) from those with normal ventricular system and to evaluate the coexistence of NPH in PSP-vd patients. METHODS: One hundred three probable PSP patients, 18 definite NPH patients, and 41 control subjects were enrolled in the study. Evans index (EI) > 0.32 associated with callosal angle (CA) < 100° was used to identify PSP-vd patients. Automated ventricular volumetry (AVV) and Magnetic Resonance Hydrocephalic Index (MRHI) were performed on T1-weighted MR images to evaluate the presence of NPH in PSP-vd patients. RESULTS: Twelve (11.6%) out of 103 PSP patients had both abnormal EI and CA values (PSP-vd). In two of these 12 patients, AVV and MRHI values suggested PSP + NPH. In the remaining 10 PSP-vd patients, AVV and MRHI values were higher than PSP patients with normal ventricular system and controls, but lower than PSP + NPH and NPH patients, suggesting a non-hydrocephalic ventricular enlargement. DISCUSSION: Our study provides evidence that the combination of EI and CA biomarkers allowed to identify PSP patients with marked ventricular dilatation mimicking NPH. Only a few of these patients had PSP + NPH. Recognition of these PSP patients with enlarged ventricles can positively impact the care of this disease, helping clinicians to identify patients with PSP + NPH who could benefit from shunt procedure and avoid surgery in those with enlarged ventricles without NPH.
BACKGROUND: Progressive supranuclear palsy (PSP) patients can show ventricular enlargement mimicking normal pressure hydrocephalus (NPH). The aim of this study was to distinguish PSP patients with marked ventricular dilatation (PSP-vd) from those with normal ventricular system and to evaluate the coexistence of NPH in PSP-vd patients. METHODS: One hundred three probable PSP patients, 18 definite NPH patients, and 41 control subjects were enrolled in the study. Evans index (EI) > 0.32 associated with callosal angle (CA) < 100° was used to identify PSP-vd patients. Automated ventricular volumetry (AVV) and Magnetic Resonance Hydrocephalic Index (MRHI) were performed on T1-weighted MR images to evaluate the presence of NPH in PSP-vd patients. RESULTS: Twelve (11.6%) out of 103 PSP patients had both abnormal EI and CA values (PSP-vd). In two of these 12 patients, AVV and MRHI values suggested PSP + NPH. In the remaining 10 PSP-vd patients, AVV and MRHI values were higher than PSP patients with normal ventricular system and controls, but lower than PSP + NPH and NPH patients, suggesting a non-hydrocephalic ventricular enlargement. DISCUSSION: Our study provides evidence that the combination of EI and CA biomarkers allowed to identify PSP patients with marked ventricular dilatation mimicking NPH. Only a few of these patients had PSP + NPH. Recognition of these PSP patients with enlarged ventricles can positively impact the care of this disease, helping clinicians to identify patients with PSP + NPH who could benefit from shunt procedure and avoid surgery in those with enlarged ventricles without NPH.
Authors: I Appollonio; M Leone; V Isella; F Piamarta; T Consoli; M L Villa; E Forapani; A Russo; P Nichelli Journal: Neurol Sci Date: 2005-06 Impact factor: 3.307
Authors: Andrea Quattrone; Angelo Antonini; David E Vaillancourt; Klaus Seppi; Roberto Ceravolo; Antonio P Strafella; Maurizio Morelli; Salvatore Nigro; Basilio Vescio; Maria G Bianco; Roberta Vasta; Pier Paolo Arcuri; Luca Weis; Eleonora Fiorenzato; Roberta Biundo; Roxana G Burciu; Florian Krismer; Nikolaus R McFarland; Christoph Mueller; Elke R Gizewski; Mirco Cosottini; Eleonora Del Prete; Sonia Mazzucchi; Aldo Quattrone Journal: Mov Disord Date: 2020-11-05 Impact factor: 10.338