Clinical assessment and prevalence of parkinsonism in Japanese elderly people

Nakashita, Satoko; Wada‐Isoe, Kenji; Uemura, Yoshiko; Tanaka, Kenichiro; Yamamoto, Masaichi; Yamawaki, Mika; Nakashima, Kenichiro

doi:10.1111/ane.12472

Cited by 19 publications

(15 citation statements)

References 30 publications

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“…Previous reports showed a prevalence of iNPH, diagnosed with Japanese criteria, 5) of 0.3–2.8% of elderly subjects in Japan. 9,12–14) In the present study, the prevalence of iNPH was 0.63%, consistent with these previous findings. Furthermore, we found a prevalence of cases with AVIM of 32 (1.45%) in 2196 enrolled patients, which corresponds with the prevalence of eight (1.0%) in 790 cases reported by Iseki et al 9) This correspondence with previous epidemiology reports confirms the appropriateness of our study.…”

Section: Discussionsupporting

confidence: 93%

The Tight Medial and High Convexity Subarachnoid Spaces Is the First Finding of Idiopathic Normal Pressure Hydrocephalus at the Preclinical Stage

Miyazaki

Ishii

Hanaoka

et al. 2019

Neurol. Med. Chir.(Tokyo)

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Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) findings are often reported as characteristic radiological features of idiopathic normal pressure hydrocephalus (iNPH). However, the process of development of DESH remains unclear. The aim of the present study was to determine the dynamic deforming process and pathophysiology of iNPH. All patients >50 years of age who underwent whole body FDG-PET/CT scanning at Kindai University Hospital between May 2017 and April 2018 were included in this retrospective study, and their brain image findings and clinical information were assessed. We defined DESH-like findings, which had one or two equivocal features of the three components of DESH findings, as preclinical morphologic features of DESH (PMD). PMD were classified into six subtypes based on their component of DESH findings: PMD-T, only tight medial and high convexity subarachnoid spaces (TMC); PMD-S, only enlarged Sylvian fissures; PMD-V, only ventriculomegaly; PMD-TV, TMC and ventriculomegaly; PMD-TS, TMC and enlarged Sylvian fissures; PMD-SV, enlarged Sylvian fissures and ventriculomegaly. A total of 2196 cases (70.5 ± 9.3 years) were enrolled, with 54 cases (77.1 ± 5.9 years) with DESH findings, and 42 cases (72.9 ± 7.9 years) with PMD (five PMD-T, two PMD-V, 12 PMD-TV, 18 PMD-TS, and five PMD-SV). In each component of DESH, 35 of 42 (83.3%) cases with PMD had TMC. We suggest that the TMC is the first change on DESH findings in most iNPH cases, and may be an important part of the pathophysiology of iNPH.

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Section: Discussionsupporting

confidence: 93%

The Tight Medial and High Convexity Subarachnoid Spaces Is the First Finding of Idiopathic Normal Pressure Hydrocephalus at the Preclinical Stage

Miyazaki

Ishii

Hanaoka

et al. 2019

Neurol. Med. Chir.(Tokyo)

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“…There are other previous reports that use different neuroimaging features; however, as their neuroimaging features share similarities with DESH, these reports provide us useful information. For example, the prevalence of cases with ventriculomegaly combined with high convexity tightness was reported to be 2.8% [20] and 2.9% in Japanese community dwelling subjects aged over 65 [21]. The prevalence of DESH increased with age in the present study.…”

Section: Discussionsupporting

confidence: 47%

The prevalence and clinical associations of disproportionately enlarged subarachnoid space hydrocephalus (DESH), an imaging feature of idiopathic normal pressure hydrocephalus in community and memory clinic based Singaporean cohorts

Akiba

Gyanwali

Villaraza

et al. 2020

Journal of the Neurological Sciences

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Introduction: Disproportionately Enlarged Subarachnoid space Hydrocephalus (DESH) is considered as an important imaging feature of idiopathic normal pressure hydrocephalus (iNPH). Method: Subjects aged 60 and over in a memory clinic and a community-based cohort were assessed for the presence of ventriculomegaly, Sylvian dilatation, and high convexity tightness by neuroimaging, and a clinical triad of iNPH symptoms, i.e. cognitive, gait and urinary symptoms. Results: In the memory clinic-based study (548 subjects), the prevalence of DESH was 1.1% and increased with age. The clinical triad was significantly more frequent in subjects with DESH (50%) compared to those with normal images (none), Sylvian dilatation (7%), and ventriculomegaly (12%). Gait disturbance was also significantly more frequent in DESH (83%) compared to those with normal images (2%), Sylvian dilatation (14%), and ventriculomegaly (26%). In the community-based cohort (946 subjects), the prevalence of DESH was 1.0% and increased with age. The clinical triad (11%) was significantly more common in subjects with DESH compared to those with normal images (none), Sylvian dilatation (2%), and ventriculomegaly (7%). Gait disturbance was also significantly more common in DESH (33%) compared to those with normal images (1%), Sylvian dilatation (4%), and ventriculomegaly (10%). Conclusion: The reported prevalence of DESH was approximately 1%, and increased with age. DESH and high convexity tightness were specifically associated with the clinical triad of iNPH. Of the triad, gait disturbance was associated to DESH and high convexity tightness. 1. Introduction With rapidly aging societies globally, the medical care of the elderly has become an important social issue. As aging is the strongest risk factor for dementia, the burden of dementia is increasing worldwide, and has major impact on quality of life as well as the economy [1,2]. Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease of the elderly, marked by triad of symptoms:

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“…Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that often develops in the elderly and is characterized by a classic triad of gait disturbance, mental deterioration, and urinary incontinence, accompanied by ventricular enlargement but normal cerebrospinal fluid pressure [1–3]. iNPH is an important disease in the elderly population, with a prevalence of approximately 1% [4–7]. Although dysfunctions caused by iNPH are treatable with shunt surgery, the cause and pathology of iNPH remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Changes in cerebral glucose metabolism caused by morphologic features of prodromal idiopathic normal pressure hydrocephalus

et al. 2019

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BackgroundDecreased cerebral glucose metabolism has been reported in idiopathic normal pressure hydrocephalus (iNPH). However, the timing of appearance in the preclinical stage of iNPH remains unknown. Herein, we evaluated the changes in regional cerebral glucose metabolism with respect to the characteristic morphologic features of iNPH.MethodsWe performed a cross-sectional study in > 2000 elderly patients who received a whole body 18F-fluorodeoxyglucose-positron emission tomography/computed tomography scanning and recruited subjects with clinical and preclinical iNPH. We included 12 subjects with iNPH, 32 subjects with asymptomatic ventriculomegaly with features of iNPH on magnetic resonance imaging (AVIM), and 33 subjects with preclinical morphologic features of DESH (PMD). We previously reported that iNPH develops in the order of PMD (asymptomatic subjects with incomplete DESH), AVIM (asymptomatic subjects with DESH), and iNPH (symptomatic subjects with DESH). We measured the median regional standardized uptake value ratio (SUVR) on 18F-fluorodeoxyglucose-positron emission tomography/computed tomography images between the three groups and compared them with background-matched normal controls in the frontal lobes, temporal lobes, medial parietal lobes, striata, and thalami.ResultsIn the frontal and temporal lobes, the SUVR distributions of the PMD, AVIM, and PMD groups were significantly lower than for each NC (p < 0.05 for all). In the medial parietal lobes, the SUVR distributions were significantly higher in PMD and AVIM groups (p < 0.05 for all). In the thalami and striata, the SUVR distributions were significantly lower in the iNPH group (p < 0.05 for all).ConclusionsChanges in brain glucose metabolism in the cortices are observed in preclinical iNPH, while metabolic decline in the basal ganglia is only detected in clinical iNPH.

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Clinical assessment and prevalence of parkinsonism in Japanese elderly people

Abstract: Parkinsonism occurs in association with several diseases in elderly people. Parkinsonism was also found to be commonly associated with cognitive impairment.

Cited by 19 publications

References 30 publications

The Tight Medial and High Convexity Subarachnoid Spaces Is the First Finding of Idiopathic Normal Pressure Hydrocephalus at the Preclinical Stage

The Tight Medial and High Convexity Subarachnoid Spaces Is the First Finding of Idiopathic Normal Pressure Hydrocephalus at the Preclinical Stage

The prevalence and clinical associations of disproportionately enlarged subarachnoid space hydrocephalus (DESH), an imaging feature of idiopathic normal pressure hydrocephalus in community and memory clinic based Singaporean cohorts

Changes in cerebral glucose metabolism caused by morphologic features of prodromal idiopathic normal pressure hydrocephalus

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