Anterior Callosal Angle: A New Marker of Idiopathic Normal Pressure Hydrocephalus?

Mantovani, Paolo; Albini-Riccioli, Luca; Giannini, Giulia; Milletti, David; Sorenson, Thomas J.; Stanzani-Maserati, Michelangelo; Oppi, Federico; Elder, Benjamin D.; Cevoli, Sabina; Palandri, Giorgio; Agati, R.; Calandra‐Buonaura, Giovanna; Capellari, Sabina; Chiari, Lorenzo; Ferrari, Alberto; Merola, Margherita; Parchi, Piero; Pirina, Alessandro; Piserchia, Vito Antonio; Ricci, Valentina; Sambati, Luisa; Sturiale, Carmelo Lucio; Supino, Antonella

doi:10.1016/j.wneu.2020.04.085

Cited by 17 publications

(13 citation statements)

References 21 publications

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“…Due to significant clinical and/or radiological overlap of iNPH with several other neurological disorders, markers with specificity for iNPH that are able to assist in differential diagnosis among these diseases are of paramount importance. CA and its variants such as simplified CA or ACA seem to be helpful in differentiating iNPH from ex vacuo ventriculomegaly, AD, VD, DLB, and PSP [14,22,23,62,78]. Other markers such as enlarged Sylvian fissures and focally enlarged sulci as well as a simplified composite imaging scale consisting of EI, CA, focally enlarged sulci, and enlarged sylvian fissures have also been considered useful in differential diagnosis of iNPH from its mimics [62].…”

Section: Discussionmentioning

confidence: 99%

“…The vertex of the angle is placed in the inferior point of the corpus callosum and the sides tangential to the lateral ventricles [22]. The anterior callosal angle (ACA) is a more anterior variant of this marker, measured at the level of the AC, and has also been proposed as an iNPH imaging marker [23].…”

Section: Imaging Markers Used In the Diagnosis Of Inphmentioning

confidence: 99%

“…Simplified CA in brain MRI, proposed by Cagnin et al, (2015), is a useful marker, and is able to assist in differentiating among iNPH, AD, and DLB [22]. ACA has shown high accuracy in discriminating iNPH patients from AD patients and healthy individuals [23]. z-EI followed by CMW, FHD, BVR, SVW, CA, and DESH are better at discriminating between iNPH patients and healthy individuals [32].…”

Section: Imaging Markers Used In Inph Differential Diagnosismentioning

confidence: 99%

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Imaging Markers for Normal Pressure Hydrocephalus: An Overview

et al. 2023

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Idiopathic bormal pressure hydrocephalus (iNPH) is a neurological syndrome that clinically presents with Hakim’s triad, namely cognitive impairment, gait disturbances, and urinary incontinence. The fact that iNPH is potentially reversible makes its accurate and early diagnosis of paramount importance. Its main imaging characteristic is the dilation of the brain’s ventricular system and the imaging parameters are also included in its diagnostic criteria along with clinical data. There is a variety of different modalities used and a great number of imaging markers that have been described while assessing iNPH patients. The present literature review attempts to describe the most important of these imaging markers and to shed some light on their role in diagnosis, differential diagnosis, and possibly prognosis of this potentially reversible neurological syndrome.

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Section: Discussionmentioning

confidence: 99%

Section: Imaging Markers Used In the Diagnosis Of Inphmentioning

confidence: 99%

Section: Imaging Markers Used In Inph Differential Diagnosismentioning

confidence: 99%

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Imaging Markers for Normal Pressure Hydrocephalus: An Overview

et al. 2023

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“…Anterior callosal angle (ACA) is defined as the angle between medial superior borders of the left and right ventricle on the coronal images through the anterior commissure, perpendicular to the anterior-posterior commissure plane, which could be used to explain cognitive dysfunction [ 25 ]. A previous study had identified that ACA presented high accuracy, sensitivity and specificity in distinguishing AD patients from healthy controls [ 25 ], while MCI has not been investigated using ACA up to now. Therefore, ACA should further be explored to differentiate MCI, AD and NC in the future study.…”

Section: Discussionmentioning

confidence: 99%

The Differential Diagnostic Value of the Callosal Angle and Evans Index in Mild Cognitive Impairment and Alzheimer's Disease

Liu

Zhang

Zong

et al. 2021

CMIR

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Background: Callosal angle (CA) and Evans index (EI) had been considered as imaging biomarkers to diagnosis normal-pressure hydrocephalus as traditional MR measurement methods. Objective: The current study was aimed to evaluate the differential diagnostic value of CA and EI in the mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Methods: Five-hundred and two subjects were selected from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, which included 168 normal controls (NC), 233 MCI and 101 AD patients. The structural MR images were interactively applied with multiplanar reconstruction to measure the CA and EI. Results: CA presented no significant difference among NC, MCI and AD groups (H value = 3.848, P value = 0.146), and EI was demonstrated the higher in MCI and AD groups than that in NC groups (P = 0.000 and 0.001, respectively). MCI group had significant larger EI (0.29±0.04) than that (0.27±0.03) in NC group in 70-75 years old sub-groups. ROC showed that the area under the curve was 0.704±0.045 for NC-MCI in 70-75 years old groups. The correlation analysis indicated that EI was significantly negatively related with MMSE scores of MCI patients (r = -0.131, P = 0.046). Conclusion: EI might serve as a screening imaging biomarker for MCI in 70-75 years old, and show limited differential value for the diagnosis of AD. CA could present no diagnostic value for MCI and AD in the current study.

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“…Changin et al proposed a simplified CA (simpCA) measure to overcome the need for extensive image processing to obtain the CA and showed that it was significantly lowered in NPH patients as seen on MRI sequences ( 27 ). To mitigate nonuniformity and examination of multiple slices required to measure the EI-x, another quantitative measure called the anteroposterior diameter of the lateral ventricle index (ALVI) on a fixed a standard plane was demonstrated to be better correlated with ventricular volume as compared to the EI-x, and a threshold of 0.5 could detect patients with ventriculomegaly in definite NPH when compared to healthy controls on CT ( 36 ).…”

Section: Normal Pressure Hydrocephalusmentioning

confidence: 99%

Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer’s dementia and Parkinson’s disease, and hydrocephalus versus atrophy in chronic TBI—a narrative review

Kadaba Sridhar,

Dysterheft Robb,

Gupta

et al. 2024

Front. Neurol.

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IntroductionNormal Pressure Hydrocephalus (NPH) is a prominent type of reversible dementia that may be treated with shunt surgery, and it is crucial to differentiate it from irreversible degeneration caused by its symptomatic mimics like Alzheimer’s Dementia (AD) and Parkinson’s Disease (PD). Similarly, it is important to distinguish between (normal pressure) hydrocephalus and irreversible atrophy/degeneration which are among the chronic effects of Traumatic Brain Injury (cTBI), as the former may be reversed through shunt placement. The purpose of this review is to elucidate the structural imaging markers which may be foundational to the development of accurate, noninvasive, and accessible solutions to this problem.MethodsBy searching the PubMed database for keywords related to NPH, AD, PD, and cTBI, we reviewed studies that examined the (1) distinct neuroanatomical markers of degeneration in NPH versus AD and PD, and atrophy versus hydrocephalus in cTBI and (2) computational methods for their (semi-) automatic assessment on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans.ResultsStructural markers of NPH and those that can distinguish it from AD have been well studied, but only a few studies have explored its structural distinction between PD. The structural implications of cTBI over time have been studied. But neuroanatomical markers that can predict shunt response in patients with either symptomatic idiopathic NPH or post-traumatic hydrocephalus have not been reliably established. MRI-based markers dominate this field of investigation as compared to CT, which is also reflected in the disproportionate number of MRI-based computational methods for their automatic assessment.ConclusionAlong with an up-to-date literature review on the structural neurodegeneration due to NPH versus AD/PD, and hydrocephalus versus atrophy in cTBI, this article sheds light on the potential of structural imaging markers as (differential) diagnostic aids for the timely recognition of patients with reversible (normal pressure) hydrocephalus, and opportunities to develop computational tools for their objective assessment.

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Anterior Callosal Angle: A New Marker of Idiopathic Normal Pressure Hydrocephalus?

Cited by 17 publications

References 21 publications

Imaging Markers for Normal Pressure Hydrocephalus: An Overview

Imaging Markers for Normal Pressure Hydrocephalus: An Overview

The Differential Diagnostic Value of the Callosal Angle and Evans Index in Mild Cognitive Impairment and Alzheimer's Disease

Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer’s dementia and Parkinson’s disease, and hydrocephalus versus atrophy in chronic TBI—a narrative review

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