The Ventricular System Enlarges Abnormally in the Seventies, Earlier in Men, and First in the Frontal Horn: A Study Based on More Than 3,000 Scans

Currà, Antonio; Pierelli, Francesco; Gasbarrone, Riccardo; Mannarelli, Daniela; Nofroni, Italo; Matone, Vittoria; Marinelli, Lucio; Trompetto, Carlo; Fattapposta, Francesco; Missori, Paolo

doi:10.3389/fnagi.2019.00294

Cited by 11 publications

(20 citation statements)

References 17 publications

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“…This is despite methodological differences between studies in terms of the neuroimaging features used to calculate brain ageing, such as cerebral perfusion [ 27 ], brain volume and/or density [ 30 , 38 , 41 , 49 , 66 ] and combinations of cortical thickness, fractional anisotropy, and cognitive performance scores [ 34 ]. This corroborates the neuroimaging literature, whereby brain changes overlap those observed in healthy ageing (reductions in brain volume, ventricular enlargement, and cortical thinning) [ 95 – 98 ]. However, concluding mechanisms still vary among studies (i.e., SZ is causative, or the consequence of accelerated ageing), and, in some accounts, limited by the cross-sectional design [ 27 , 32 , 34 , 38 , 41 , 49 ].…”

Section: Discussionsupporting

confidence: 89%

Factors associated with brain ageing - a systematic review

et al. 2021

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Background Brain age is a biomarker that predicts chronological age using neuroimaging features. Deviations of this predicted age from chronological age is considered a sign of age-related brain changes, or commonly referred to as brain ageing. The aim of this systematic review is to identify and synthesize the evidence for an association between lifestyle, health factors and diseases in adult populations, with brain ageing. Methods This systematic review was undertaken in accordance with the PRISMA guidelines. A systematic search of Embase and Medline was conducted to identify relevant articles using search terms relating to the prediction of age from neuroimaging data or brain ageing. The tables of two recent review papers on brain ageing were also examined to identify additional articles. Studies were limited to adult humans (aged 18 years and above), from clinical or general populations. Exposures and study design of all types were also considered eligible. Results A systematic search identified 52 studies, which examined brain ageing in clinical and community dwelling adults (mean age between 21 to 78 years, ~ 37% were female). Most research came from studies of individuals diagnosed with schizophrenia or Alzheimer’s disease, or healthy populations that were assessed cognitively. From these studies, psychiatric and neurologic diseases were most commonly associated with accelerated brain ageing, though not all studies drew the same conclusions. Evidence for all other exposures is nascent, and relatively inconsistent. Heterogenous methodologies, or methods of outcome ascertainment, were partly accountable. Conclusion This systematic review summarised the current evidence for an association between genetic, lifestyle, health, or diseases and brain ageing. Overall there is good evidence to suggest schizophrenia and Alzheimer’s disease are associated with accelerated brain ageing. Evidence for all other exposures was mixed or limited. This was mostly due to a lack of independent replication, and inconsistency across studies that were primarily cross sectional in nature. Future research efforts should focus on replicating current findings, using prospective datasets. Trial registration A copy of the review protocol can be accessed through PROSPERO, registration number CRD42020142817.

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Section: Discussionsupporting

confidence: 89%

Factors associated with brain ageing - a systematic review

et al. 2021

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“…It may be difficult to associate exact reasons for such difference in mean EI values in both males and females. Finally, the increase in EI with age observed in our study suggests that normal aging causes gradual ventricular enlargement but EI values remain within normal range [16]. However, neurological conditions which result in a reduction in brain volume or abnormal cerebrospinal fluid flow occur more with aging.…”

Section: Discussionsupporting

confidence: 44%

“…Therefore, individuals presenting with EI > 0.30 should be screened for degenerative diseases like Alzheimer's disease, vascular diseases, Parkinson's disease and other primary dementias causing NPH [8]. EI alone is not sufficient to alert for a neurological condition, but when associated with other abnormal measurements it becomes a strong predictor [8,16].…”

Section: Discussionmentioning

confidence: 99%

“…Other newer measurement systems like Schiersmann's Index, Bicaudate-Frontal (ventricular) Index and Huckman Number developed, are partially operator dependent [11]. Also, these advanced neuroimaging measuring techniques for ventricular volume consume a lot of time, require specialized software and skill, and above all are not readily available in most resource-limited countries, hence, not helpful for use in routine quantitation of ventricular size [16]. EI is technically simple, easily reproducible and is the most frequently used tool for the evaluation of ventricular enlargement [11].…”

Section: Discussionmentioning

confidence: 99%

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Evans index among adult Ghanaians on normal head computerized tomography scan

Dzefi-Tettey

Edzie

Gorleku

et al. 2021

Heliyon

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Introduction: Normal-Pressure Hydrocephalus (NPH) is a neurological condition which is made up of a clinical triad of gait disturbance, dementia and urinary incontinence and can be reversed by ventricular shunting. Currently, some guidelines suggest the use of Evans' index (EI) for diagnosis of hydrocephalus radiologically. Most of the studies are based on the Western population data. None of these studies have been performed in the Ghanaian population setting yet. The aim of this study was to quantitatively establish normal borderline value for Evans Index in the Ghanaian adult population with respect to age and sex. Methods: This study was retrospectively conducted on normal enhanced head CT scan images of 266 males and 241 females. EI was calculated as the linear ratio of Maximum Anterior Horn Width (MAHW) of the frontal horns of the lateral ventricles at the level of foramina of Monroe and the Maximum Intracranial Diameter (MICD) of the inner skull. Student T-test, ANOVA and Pearson's correlation were used to analyze the data. A test for a relationship was performed with a scatter plot and a linear regression was performed based on age, sex and different EI of ventricular size. Results: The mean and median value of EI was 0.24 AE 0.02. There was no statistically significant difference in the EI values between males and females, (p-value ¼ 0.61). A steady increase in EI with age was observed. There was a strong correlation coefficient r ¼ 0.89 of EI and age, which suggested a strong linear relationship between EI and Age. The overall linear relationship model was EI ¼ 0.1879 þ 0.0011*Age. Conclusions: The mean EI of 0.24 AE 0.02 in our study agrees with adapted international guidelines cut-off value for normal adult patients of (<0.30) and can be a useful tool in determining ventricular enlargement particularly in resource limited settings.

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“…The manual measurement is very time-consuming, subjective, and not highly reproducible and requires the operator to have professional knowledge of ventricular anatomy (Dubost et al, 2020 ). The automatic measurement overcomes the above shortcomings but needs to rely on special software, and the measurement results are not necessarily accurate (Kempton et al, 2011 ; Curra et al, 2019 ). Finally, the semi-automatic measurement is based on automatic measurement, with an operator making manual adjustments (Ntiri et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Application of Evans Index in Normal Pressure Hydrocephalus Patients: A Mini Review

Zhou

Xia

2022

Front. Aging Neurosci.

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With an ever-growing aging population, the prevalence of normal pressure hydrocephalus (NPH) is increasing. Clinical symptoms of NPH include cognitive impairment, gait disturbance, and urinary incontinence. Surgery can improve symptoms, which leads to the disease's alternative name: treatable dementia. The Evans index (EI), defined as the ratio of the maximal width of the frontal horns to the maximum inner skull diameter, is the most commonly used index to indirectly assess the condition of the ventricles in NPH patients. EI measurement is simple, fast, and does not require any special software; in clinical practice, an EI >0.3 is the criterion for ventricular enlargement. However, EI's measurement methods, threshold setting, correlation with ventricle volume, and even its clinical value has been questioned. Based on the EI, the z-EI and anteroposterior diameter of the lateral ventricle index were derived and are discussed in this review.

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The Ventricular System Enlarges Abnormally in the Seventies, Earlier in Men, and First in the Frontal Horn: A Study Based on More Than 3,000 Scans

Cited by 11 publications

References 17 publications

Factors associated with brain ageing - a systematic review

Factors associated with brain ageing - a systematic review

Evans index among adult Ghanaians on normal head computerized tomography scan

Application of Evans Index in Normal Pressure Hydrocephalus Patients: A Mini Review

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