Neuropathology and structural changes in hydrocephalus

Bigio, Marc R. Del

doi:10.1002/ddrr.94

Cited by 200 publications

(168 citation statements)

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“…30 Similar patterns of changes in DTI metrics have been observed after closed head injuries accompanied by brain swelling. 12 Fractional anisotropy is the most commonly reported DTI-derived metric in the literature. It is quantified as a scaled difference between isotropic and linear diffusion within a voxel, and reflects neuronal properties such as axon diameter, fiber density, and degree of myelination.…”

Section: Discussionmentioning

confidence: 99%

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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OBJECT No previous reports exist that have evaluated the relationships of white matter (WM) integrity with the number of shunt revisions, ventricular volume after shunting, and cognition in medically stable children who have spina bifida and hydrocephalus (SBH). The authors hypothesized that enlarged ventricles and a greater number of shunt revisions decrease WM integrity in children. METHODS In total, 80 children (mean age 13.7 years) who had SBH underwent MRI and IQ testing. Probabilistic diffusion tractography was performed to determine mean diffusion tensor imaging (DTI) metrics along the frontal and parietal tectocortical pathways. The DTI metrics were evaluated for significant correlation with a composite IQ measure and with the total number of shunt revisions and the total lateral ventricular volume obtained through semiautomated parcellation of T1-weighted MRI scans. RESULTS An enlargement in total lateral ventricle volume and an increase in the number of shunt revisions were both associated with higher fractional anisotropy (FA) and with lower radial diffusivity (RD) along both frontal and parietal tectocortical pathways. Children who had not undergone a shunt revision had on average a greater lateral ventricle volume and higher FA and lower RD along frontal and parietal pathways than those who had undergone multiple shunt revisions. The mean DTI metrics along parietal pathways predicted IQ scores, but intellectual ability was not significantly correlated with ventricular volume or with the number of lifetime shunt revisions. CONCLUSIONS Significant changes in DTI metrics were observed as a function of ventricular volume. An increased lateral ventricle volume was associated with elevated FA and decreased RD. Given that the participants were medically stable at the time of the MRI examination, the results suggested that those who have enlarged ventricles show a DTI pattern consistent with axonal compression due to increased intracranial pressure (ICP) in attenuated hydrocephalus. Although limited by a cross-sectional design, the study's findings suggest that DTI metrics may serve as sensitive indicators for chronic, mild hydrocephalus in the absence of overt clinical symptoms due to increased ICP. Having enlarged ventricles and undergoing multiple shunt revisions did not affect intellectual ability in children with SBH.

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Section: Discussionmentioning

confidence: 99%

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Williams

Juranek²,

Stuebing

et al. 2015

PED

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“…[22][23][24][25]27,57,79,80,136 Metabolic disturbances contribute to reversible dysfunction, but the clinical syndrome of hydrocephalic brain dysfunction may be due predominantly to a subcortical disconnection syndrome. Possible causes of ventricular dilation include obstructed CSF flow with associated increased CSF pulsatility.…”

Section: Pathophysiological Modificationsmentioning

confidence: 99%

An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

McAllister

Williams

Walker

et al. 2015

JNS

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abbreviatioNs CPC = choroid plexus cauterization; DTI = diffusion tensor imaging; ETV = endoscopic third ventriculostomy; HCRN = Hydrocephalus Clinical Research Network; ICP = intracranial pressure; iNPH = idiopathic NPH; LPA = lysophosphatidic acid; NIH = National Institutes of Health; NPC = neural precursor cell; NPH = normal pressure hydrocephalus; NSC = neural stem cell; PreOL = precursor oligodendroglia; RCT = randomized controlled trial; SVZ = subventricular zone; TNF = tumor necrosis factor; VP = ventriculoperitoneal; VZ = ventricular zone. . International experts gave plenary talks, and extensive group discussions were held for each of the major themes.The conference emphasized patient-centered care and translational research, with the main objective to arrive at a consensus on priorities in hydrocephalus that have the potential to impact patient care in the next 5 years. The current state of hydrocephalus research and treatment was presented, and the following priorities for research were recommended for each theme. 1) Causes of Hydrocephalus-CSF absorption, production, and related drug therapies; pathogenesis of human hydrocephalus; improved animal and in vitro models of hydrocephalus; developmental and macromolecular transport mechanisms; biomechanical changes in hydrocephalus; and age-dependent mechanisms in the development of hydrocephalus. 2) Diagnosis of Hydrocephalus-implementation of a standardized set of protocols and a shared repository of technical information; prospective studies of multimodal techniques including MRI and CSF biomarkers to test potential pharmacological treatments; and quantitative and cost-effective CSF assessment techniques. 3) Treatment of Hydrocephalus-improved bioengineering efforts to reduce proximal catheter and overall shunt failure; external or implantable diagnostics and support for the biological infrastructure research that informs these efforts; and evidencebased surgical standardization with longitudinal metrics to validate or refute implemented practices, procedures, or tests. 4) Outcome in Hydrocephalus-development of specific, reliable batteries with metrics focused on the hydrocephalic 1427

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“…Volumetry may provide an outcome measure that could reliably distinguish between disease-modifying effects and purely symptomatic relief. Enlargement of the ventricles is also characteristic of other medical conditions such as schizophrenia, Parkinson's disease, hydrocephalus, and trauma to the brain (3)(4)(5)(6). Ventricular measurement many be relevant to these conditions and related new treatment approaches as well.…”

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confidence: 99%

A novel MRI‐compatible brain ventricle phantom for validation of segmentation and volumetry methods

Khan

Drozd

Moreland

et al. 2012

Magnetic Resonance Imaging

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and the Alzheimer's Disease Neuroimaging InitiativePurpose: To create a standardized, MRI-compatible, lifesized phantom of the brain ventricles to evaluate ventricle segmentation methods using T 1 -weighted MRI. An objective phantom is needed to test the many different segmentation programs currently used to measure ventricle volumes in patients with Alzheimer's disease. Materials and Methods:A ventricle model was constructed from polycarbonate using a digital mesh of the ventricles created from the 3 Tesla (T) MRI of a subject with Alzheimer's disease. The ventricle was placed in a brain mold and surrounded with material composed of 2% agar in water, 0.01% NaCl and 0.0375 mM gadopentetate dimeglumine to match the signal intensity properties of brain tissue in 3T T 1 -weighted MRI. The 3T T 1 -weighted images of the phantom were acquired and ventricle segmentation software was used to measure ventricle volume. Results:The images acquired of the phantom successfully replicated in vivo signal intensity differences between the ventricle and surrounding tissue in T 1 -weighted images and were robust to segmentation. The ventricle volume was quantified to 99% accuracy at 1-mm voxel size. Conclusion:The phantom represents a simple, realistic and objective method to test the accuracy of lateral ventricle segmentation methods and we project it can be extended to other anatomical structures.

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Neuropathology and structural changes in hydrocephalus

Cited by 200 publications

References 168 publications

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

Postshunt lateral ventricular volume, white matter integrity, and intellectual outcomes in spina bifida and hydrocephalus

An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium “Opportunities for Hydrocephalus Research: Pathways to Better Outcomes”

A novel MRI‐compatible brain ventricle phantom for validation of segmentation and volumetry methods

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