Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus from Other Dementias Using Diffusion Tensor Imaging

Kim, M. J.; Seo, Sang Won; Lee, K. M.; Kim, S. T.; Lee, J. I.; Nam, Do‐Hyun; Na, Duk L.

doi:10.3174/ajnr.a2531

Cited by 67 publications

(67 citation statements)

References 31 publications

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“…This finding conflicts with previous studies that reported higher FA values within the corticospinal tracts for INPH patients than for normal subjects. 6,22) Such changes were even reversible after shunt implantation. 22) This could mean that higher corticospinal tract FA values may be important to better characterize INPH white matter changes.…”

Section: Discussionmentioning

confidence: 79%

“…6,22) Such changes were even reversible after shunt implantation. 22) This could mean that higher corticospinal tract FA values may be important to better characterize INPH white matter changes. Recently, DTI tractography showed that neural fibers in corticospinal tracts were compressed by ventricular dilation, resulting in higher FA values for INPH patients.…”

Section: Discussionmentioning

confidence: 79%

“…37) Recent studies based on fractional anisotropy (FA) values in some brain regions, including the corpus callosum and corticospinal tracts, have reported that patients with INPH exhibit white matter changes. 6,20,22,27) Quantitative analysis of FA values would be useful to better characterize the white matter changes in INPH patients. 6,20) The present study used a computer-automated technique for FA evaluation and showed that, compared with control subjects in a similar age range, FA values in the forceps minor (anterior portion of corpus callosum) were much lower in INPH patients and that low values were associated with more severe clinical manifestations.…”

Section: Dti Of Inphmentioning

confidence: 99%

“…6,9,20,22,27) DTI can sensitively detect the direction of diffusion of water molecules and so reveals the orientation of the white matter tracts. 36) This anatomical detail enables clinically useful characterization of the degeneration of neural fibers affected by various neural diseases.…”

Section: Dti Of Inphmentioning

confidence: 99%

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Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

Koyama

Marumoto

Domen

et al. 2012

Neurol. Med. Chir.(Tokyo)

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Diffusion tensor imaging (DTI) using a 3.0 tesla magnetic resonance scanner was used to investigate white matter changes caused by idiopathic normal pressure hydrocephalus (INPH) in 10 patients diagnosed by clinical symptoms (gait disturbance, dementia, and/or urinary incontinence) and Evans index À0.3, and compared with findings for 10 age-matched controls (AE60 years). Then, using a computer-automated method, fractional anisotropy (FA) brain maps were generated and finally transformed into the standard space. Voxel-based FA values within two regions of interests (ROIs), the forceps minor and corticospinal tracts, were then separately evaluated. Within each ROI, statistical comparisons of results from the INPH and control groups were performed. In addition, for INPH patients, grading scores for clinical symptoms and FA values were correlated. The forceps minor mean FA value was much smaller for the INPH group (0.504) than for the control group (0.631). The corticospinal tract mean FA value was slightly smaller for the INPH group (0.588) than for the control group (0.632). Additional analyses indicated that lower FA values within the forceps minor tended to be associated with clinical symptoms such as urinary incontinence and gait disturbance. Our findings indicate FA values decreased in the forceps minor of INPH patients. We also found that lower values were associated with severer clinical symptoms, implying that DTI techniques may be developed for more accurate diagnosis.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 79%

Section: Dti Of Inphmentioning

confidence: 99%

Section: Dti Of Inphmentioning

confidence: 99%

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Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

Koyama

Marumoto

Domen

et al. 2012

Neurol. Med. Chir.(Tokyo)

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“…9,16,41,45,48,55,57,59,75,84,94,125 Understanding the periventricular white matter tracts is helpful not only in defining more precise surgical strategies, but also in clarifying the symptoms of and appropriate treatment for patients with hydrocephalus and periventricular lesions. 11,18,36,38,40,47,50,52,58,65,66,76,80,101 This study examines the tracts at risk in the 3 surgical routes-anterior, posterior, and lateral-to the lateral ventricle. The anterior approaches include the anterior interhemispheric transcallosal, anterior frontal transcortical, and anterior frontal interhemispheric transrostral; the posterior approaches include the posterior transcortical (superior parietal lobule), posterior interhemispheric transcallosal, posterior interhemispheric precuneal, supracere- …”

Section: Discussionmentioning

confidence: 99%

The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

Güngör¹,

Baydın²,

Middlebrooks

et al. 2017

JNS

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S urgical approaches to the lateral ventricle always require passage through one and often multiple fiber tracts to reach their target. These approaches remain a challenge because of the deep location and variable shape and size of the ventricles, their covering mantle of tracts, and relationships to important neural structures such as the thalamus and internal capsule. 55,75,84 In addition, a number of tracts course in the walls of the ventricle where they are separated from the cerebrospinal fluid by only a thin layer of ependyma and would likely be exposed to the greatest possibility of damage by hydrocephalus.84,124 Recent studies have focused on the relationships of the fiber tracts to eloquent cortical areas and avoiding the optic radiations in approaches to the lateral ventricle. 16,41,48,59,63,75,89,92,94,125 The aim of the present study was to explore the relationships of the tracts to the lateral ventricles and the various surgical approaches to the ventricles and to examine the anatomy and syndromes related to ventricular enlargement. MethodsForty adult human formalin-fixed cadaveric hemispheres (20 brains) were examined under magnification that ranged from ×6 to ×40. The dura, pia, arachnoid, and surface vessels were gently removed. All specimens were frozen in water for at least 2 weeks at -16°C, as described by Klingler, to separate the tracts and facilitate dissection. 51 After freezing, the specimens were thawed and rinsed of formalin under tap water for at least 1 hour. Prior OBJECTIVEThe relationship of the white matter tracts to the lateral ventricles is important when planning surgical approaches to the ventricles and in understanding the symptoms of hydrocephalus. The authors' aim was to explore the relationship of the white matter tracts of the cerebrum to the lateral ventricles using fiber dissection technique and MR tractography and to discuss these findings in relation to approaches to ventricular lesions. METHODS Forty adult human formalin-fixed cadaveric hemispheres (20 brains) and 3 whole heads were examined using fiber dissection technique. The dissections were performed from lateral to medial, medial to lateral, superior to inferior, and inferior to superior. MR tractography showing the lateral ventricles aided in the understanding of the 3D relationships of the white matter tracts with the lateral ventricles. RESULTS The relationship between the lateral ventricles and the superior longitudinal I, II, and III, arcuate, vertical occipital, middle longitudinal, inferior longitudinal, inferior frontooccipital, uncinate, sledge runner, and lingular amygdaloidal fasciculi; and the anterior commissure fibers, optic radiations, internal capsule, corona radiata, thalamic radiations, cingulum, corpus callosum, fornix, caudate nucleus, thalamus, stria terminalis, and stria medullaris thalami were defined anatomically and radiologically. These fibers and structures have a consistent relationship to the lateral ventricles. CONCLUSIONS Knowledge of the relationship of the white matter tracts o...

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Dynamic functional networks in idiopathic normal pressure hydrocephalus: Alterations and reversibility byCSFtap test

Griffa

Bommarito

Assal

et al. 2020

Human Brain Mapping

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Idiopathic Normal Pressure Hydrocephalus (iNPH)—the leading cause of reversible dementia in aging—is characterized by ventriculomegaly and gait, cognitive and urinary impairments. Despite its high prevalence estimated at 6% among the elderlies, iNPH remains underdiagnosed and undertreated due to the lack of iNPH‐specific diagnostic markers and limited understanding of pathophysiological mechanisms. INPH diagnosis is also complicated by the frequent occurrence of comorbidities, the most common one being Alzheimer's disease (AD). Here we investigate the resting‐state functional magnetic resonance imaging dynamics of 26 iNPH patients before and after a CSF tap test, and of 48 normal older adults. Alzheimer's pathology was evaluated by CSF biomarkers. We show that the interactions between the default mode, and the executive‐control, salience and attention networks are impaired in iNPH, explain gait and executive disturbances in patients, and are not driven by AD‐pathology. In particular, AD molecular biomarkers are associated with functional changes distinct from iNPH functional alterations. Finally, we demonstrate a partial normalization of brain dynamics 24 hr after a CSF tap test, indicating functional plasticity mechanisms. We conclude that functional changes involving the default mode cross‐network interactions reflect iNPH pathophysiological mechanisms and track treatment response, possibly contributing to iNPH differential diagnosis and better clinical management.

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Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus from Other Dementias Using Diffusion Tensor Imaging

Cited by 67 publications

References 31 publications

Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

Diffusion Tensor Imaging of Idiopathic Normal Pressure Hydrocephalus: A Voxel-Based Fractional Anisotropy Study

The white matter tracts of the cerebrum in ventricular surgery and hydrocephalus

Dynamic functional networks in idiopathic normal pressure hydrocephalus: Alterations and reversibility byCSFtap test

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