Abnormal White Matter Integrity in Elderly Patients with Idiopathic Normal-Pressure Hydrocephalus: A Tract-Based Spatial Statistics Study

Kang, Kyunghun; Choi, Woohyuk; Yoon, Uicheul; Lee, Jongmin; Lee, Ho Won

doi:10.1159/000443206

Cited by 15 publications

(20 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Studies of directional diffusion parameters such as FA values were found to be elevated in the corticospinal tracts of patients with iNPH (8). The FA values also showed significant differences in the axons of white matter in iNPH patients compared with patients with neurodegenerative diseases and healthy groups in previous studies (25). Our study found that the MD and AD values increased in iNPH patients, which is consistent with the results in the literature that implied an increase in the diffusion of water molecules.…”

Section: Discussionsupporting

confidence: 91%

Diffusion Spectrum Imaging of Corticospinal Tracts in Idiopathic Normal Pressure Hydrocephalus

Zhang

Liang

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

Purpose: The purpose of this study was to measure the diffusion spectrum imaging (DSI) parameters of corticospinal tracts (CSTs) and evaluate diffusional changes in CSTs in patients with idiopathic normal pressure hydrocephalus (iNPH) by DSI.Methods: Twenty-three iNPH patients and twenty-one healthy controls (HCs) were involved in this study. Brain DSI data for all participants were collected through the same MR scanning procedure. The diffusion parameters measured and analyzed included quantitative anisotropy (QA), the isotropic diffusion component (ISO), general fractional anisotropy (GFA), fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of corticospinal tracts.Results: The QA and ISO values of corticospinal tracts in iNPH patients were significantly lower than those in HCs (PLQA = 0.008, PRQA = 0.016, PLISO = 0.024, PRISO = 0.016). The mean MD, AD, and RD values in iNPH patients were significantly higher than those in HCs (PMD = 0.032, PAD = 0.032, PRD = 0.048,). No significant differences in GFA and FA values were noted between iNPH patients and HCs.Conclusion: Decreased QA and ISO values of corticospinal tracts were found in iNPH patients. Quantitative CST evaluation using DSI may lead to information that can improve the present understanding of the disease mechanism.

show abstract

Section: Discussionsupporting

confidence: 91%

Diffusion Spectrum Imaging of Corticospinal Tracts in Idiopathic Normal Pressure Hydrocephalus

Zhang

Liang

et al. 2021

Front. Neurol.

View full text Add to dashboard Cite

show abstract

“…Many measures were used as assessments of cognitive function (Mini Mental State Examination (MMSE), 21–29,31,32,35–37,43–45,48,49 trail making test A (TMT-A), 23,32,33,35,36,43,49 DemTect test, 25 , 32 Montreal Cognitive Assessment (MOCA) 54 ; learning and memory (Hopkins Verbal Learning Task-Revised (HVLT-R) 39 ); verbal fluency and executive function (COWAT), 20 , 39 Wechsler Memory Scale III (WMS-WL), 20 Rey complex figure test (RCFT), 20 according to Deckersbach et al. 71 ); conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control and environmental autonomy due to frontal lobe dysfunction (frontal assessment battery (FAB) 22,24,33,36,37,41,45,49 ); grade of dementia (Clinical Dementia Rating Scale (CDR), 29,35,36 , Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) 29 ); motor impairment and gait (gait velocity, 43 Timed Up and Go (TUG) test, 22,23,30,35–38,41,…”

Section: Resultsmentioning

confidence: 99%

“…showed lower FA and higher MD in the anterior corona radiate, CC, superior longitudinal fasciculus, thalamic radiation, external capsule and middle cerebellar peduncle in iNPH patients in comparison with AD. 36 Ades-Aron et al. found that AD and axial kurtosis differ between iNPH and AD in an area close to the superior IC and corona radiate, reporting greater AD and lower axial kurtosis in the iNPH group in comparison with AD with a p < 0.05.…”

Section: Discussionmentioning

confidence: 97%

“…16–17 in 1994, and recently, many papers investigated its role in analyzing white matter (WM) alterations in patients with iNPH. 12 , 18–54 DTI is a non-invasive MR technique that provides information about the orientation and anisotropy of the WM tracts, and may delineate microstructural changes in cerebral WM; high-resolution, multitensor imaging (more than six diffusion directions) is currently combined with various other advanced MR techniques to study connectivity within the brain. In fact, illnesses that disrupt the normal organization or integrity of cerebral WM have a qualitative and quantitative impact on DTI measures.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review

2020

View full text Add to dashboard Cite

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that comprises a triad of gait disturbance, dementia and urinary incontinence, associated with ventriculomegaly in the absence of elevated intraventricular cerebrospinal fluid (CSF) pressure. It is important to identify patients with iNPH because some of its clinical features may be reversed by the insertion of a CSF shunt. The diagnosis is based on clinical history, physical examination and brain imaging, especially magnetic resonance imaging (MRI). Recently, some papers have investigated the role of diffusion tensor imaging (DTI) in evaluating white matter alterations in patients with iNPH. DTI analysis in specific anatomical regions seems to be a promising MR biomarker of iNPH and could also be used in the differential diagnosis from other dementias. However, there is a substantial lack of structured reviews on this topic. Thus, we performed a literature search and analyzed the most recent and pivotal articles that investigated the role of DTI in iNPH in order to provide an up-to-date overview of the application of DTI in this setting. We reviewed studies published between January 2000 and June 2020. Thirty-eight studies and four reviews were included. Despite heterogeneity in analysis approaches, the majority of studies reported significant correlations between DTI and clinical symptoms in iNPH patients, as well as different DTI patterns in patients with iNPH compared to those with Alzheimer or Parkinson diseases. It remains to be determined whether DTI could predict the success after CSF shunting.

show abstract

“…For example, a systematic review reported that T -tau and p -tau may differentiate iNPH from AD and Aβ 42 from HC (Manniche et al, 2019 ). Diffusion tensor imaging as an MRI technique determining diffusion characteristics of white matter (WM) has been performed in most studies of patients with iNPH (Hattingen et al, 2010 ; Kanno et al, 2011 ; Lenfeldt et al, 2011 ; Hattori et al, 2012 ; Kang et al, 2016 ; Kamiya et al, 2017 ; Saito et al, 2020 ). Griffa et al concluded regarding white matter microstructural alteration of the periventricular, frontal, and temporal regions in patients with iNPH (Griffa et al, 2020 ); however, few studies have investigated gray matter structural changes in such patients.…”

Section: Introductionmentioning

confidence: 99%

White Matter Microstructural Damage Associated With Gait Abnormalities in Idiopathic Normal Pressure Hydrocephalus

Tang

Yao

et al. 2021

Front. Aging Neurosci.

View full text Add to dashboard Cite

Background: Idiopathic normal pressure hydrocephalus (iNPH) is a common disease in elderly adults. Patients with iNPH are generally characterized by progressive gait impairment, cognitive deficits, and urinary urgency and/or incontinence. A number of radiographic studies have shown that iNPH patients have enlarged ventricles and altered brain morphology; however, few studies have focused on the relationships between altered brain structure and gait dysfunction due to iNPH. Thus, this study aimed to evaluate the abnormalities of white matter (WM) correlated with gait impairment in iNPH patients and to gain a better understanding of its underlying pathology.Methods: Fifteen iNPH patients (five women, 10 men) were enrolled in this study, and each patient’s demographic and gait indices were collected. First, we performed a correlation analysis between the demographic and gait indices. Then, all gait indices were grouped according to the number of WM hyperintensities (WMH) among each WM tract (JHU WM tractography atlas), to perform comparative analysis.Results: Considering sex and illness duration as covariates, correlation analysis showed a significantly negative correlation between step length (r = −0.80, p = 0.001), pace (r = −0.84, p = 2.96e-4), and age. After removing the effects of age, sex, and illness duration, correlation analysis showed negative correlation between step length (r = −0.73, p = 0.007), pace (r = −0.74, p = 0.005), and clinical-grade score and positive correlation between 3-m round trip time (r = 0.66, p = 0.021), rising time (r = 0.76, p = 0.004), and clinical-grade score. Based on WMH of each white matter tract, gait indices showed significant differences (p < 0.05/48, corrected by Bonferroni) between fewer WMH patients and more WMH in the middle cerebellar peduncle, left medial lemniscus, left posterior limb of the internal capsule (IC), and right posterior limb of the IC.Conclusions: Our results indicated that iNPH patients exhibited gait-related WM abnormalities located in motor and sensory pathways around the ventricle, which is beneficial to understand the underlying pathology of iNPH.

show abstract

Abnormal White Matter Integrity in Elderly Patients with Idiopathic Normal-Pressure Hydrocephalus: A Tract-Based Spatial Statistics Study

Cited by 15 publications

References 28 publications

Diffusion Spectrum Imaging of Corticospinal Tracts in Idiopathic Normal Pressure Hydrocephalus

Diffusion Spectrum Imaging of Corticospinal Tracts in Idiopathic Normal Pressure Hydrocephalus

The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review

White Matter Microstructural Damage Associated With Gait Abnormalities in Idiopathic Normal Pressure Hydrocephalus

Contact Info

Product

Resources

About