Correlation of right frontal hypoperfusion and urinary dysfunction in iNPH: A SPECT study

Abstract

Urinary dysfunction was found to be closely related with right frontal hypoperfusion in iNPH using [(123) I]-IMP SPECT. This right frontal area is one of the critical areas for regulating micturition. While secondary incontinence can result from gait disturbance or dementia, there may also be a neurogenic mechanism underlying urinary dysfunction, which is a significant burden in patients with iNPH and their caregivers.

Effect of cerebrospinal fluid shunt surgery on lower urinary tract dysfunction in idiopathic normal pressure hydrocephalus

“…On the other hand, patients with iNPH have the opportunity to improve LUTD with appropriate CSF shunt surgery. Sakakibara et al employed using [123I]‐iodoamphetamine (IMP)‐single‐photon emission CT (SPECT) and reported that iNPH patients with severe urinary frequency and incontinence showed significantly decreased right frontal hypoperfusion compared with the patients with mild symptoms . This study compared brain blood perfusion in NPH patients with improved LUTD after shunt surgery to those without LUTD improvement after surgery, and it demonstrated that the patients with LUTD improvement after surgery showed a significant increase in bilateral mid‐cingulate parietal and left frontal blood flow compared with those without improvement.…”

The effects of hydrocephalus on the periventricular white matter in intracerebral hemorrhage: a diffuser tensor imaging study

“…Many neural tracts from the frontal lobe, such as thalamocortical tracts between the thalamus and the prefrontal cortex, the corticoreticulospinal tract, and the neural tract for urinary control, are known to pass through the anterior CR [28][29][30][31]. Furthermore, several authors have reported that patients with hydrocephalus exhibit clinical manifestations related to frontal lobe dysfunction with respect to cognition, gait, and urinary control [1,2,[32][33][34][35][36]. Accordingly, our finding that the anterior CR was most compressed by hydrocephalus might also be related to these clinical manifestations.…”

Influence of comorbidities in idiopathic normal pressure hydrocephalus — research and clinical care. A report of the ISHCSF task force on comorbidities in INPH

“…Recent perfusion studies with single photon emission tomography revealed that a hypoperfusion was present in the right frontal area in INPH patients with moderate or severe incontinence, compared to those with none or mild incontinence [20]. …”