Diffusion Tensor Imaging of the Superior Thalamic Radiation and Cerebrospinal Fluid Distribution in Idiopathic Normal Pressure Hydrocephalus

Younes, Kyan; Hasan, Khader M.; Kamali, Arash; McGough, Christine; Keser, Zafer; Hasan, Omar; Melicher, Tomáš; Kramer, Larry A.; Schulz, Paul E.; Researchers, Alzheimer's Disease Neuroimaging Initiative

doi:10.1111/jon.12581

Cited by 15 publications

(18 citation statements)

References 34 publications

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“…As the displacement of fluid in compartments is critical within the NPH spectrum, studies have shown that DTI has been able to demonstrate different patterns of white matter injury consistent with the symptomatology of the NPH disorder (16). DTI has also been found to differentiate NPH from other cohorts such as those with other types of ventriculomegaly, chronic hydrocephalus as well as Alzheimer's disease, Parkinson's disease, and other dementias (17–19). However, there are challenges in DTI acquisition and interpretation that prevent its more widespread uptake at the clinical-research interface.…”

Section: Introductionmentioning

confidence: 99%

DTI Profiles for Rapid Description of Cohorts at the Clinical-Research Interface

et al. 2019

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Normal pressure hydrocephalus (NPH) is a syndrome comprising gait disturbance, cognitive decline and urinary incontinence that is an unique model of reversible brain injury, but it presents as a challenging spectrum of disease cohorts. Diffusion Tensor Imaging (DTI), with its ability to interrogate structural white matter patterns at a microarchitectural level, is a potentially useful tool for the confirmation and characterization of disease cohorts at the clinical-research interface. However, obstacles to its widespread use involve the need for consistent DTI analysis and interpretation tools across collaborator sites. We present the use of DTI profiles, a simplistic methodology to interpret white matter injury patterns based on the morphology of diffusivity parameters. We examined 13 patients with complex NPH, i.e., patients with NPH and overlay from multiple comorbidities, including vascular risk burden and neurodegenerative disease, undergoing extended CSF drainage, clinical assessments, and multi-modal MR imaging. Following appropriate exclusions, we compared the morphology of DTI profiles in such complex NPH patients (n = 12, comprising 4 responders and 8 non-responders) to exemplar DTI profiles from a cohort of classic NPH patients (n = 16) demonstrating responsiveness of white matter injury to ventriculo-peritoneal shunting. In the cohort of complex NPH patients, mean age was 71.3 ± 7.6 years (10 males, 2 females) with a mean MMSE score of 21.1. There were 5 age-matched healthy controls, mean age was 73.4 ± 7.2 years (1 male, 4 females) and mean MMSE score was 26.8. In the exemplar cohort of classic NPH patients, mean age was 74.7 ± 5.9 years (10 males, 6 females) and mean MMSE score was 24.1. There were 9 age-matched healthy controls, mean age was 69.4 ± 9.7 years (4 males, 5 females) and mean MMSE score was 28.6. We found that, despite the challenges of acquiring DTI metrics from differing scanners across collaborator sites and NPH patients presenting as differing cohorts along the spectrum of disease, DTI profiles for responsiveness to interventions were comparable. Distinct DTI characteristics were demonstrated for complex NPH responders vs. non-responders. The morphology of DTI profiles for complex NPH responders mimicked DTI patterns found in predominantly shunt-responsive patients undergoing intervention for classic NPH. However, DTI profiles for complex NPH non-responders was suggestive of atrophy. Our findings suggest that it is possible to use DTI profiles to provide a methodology for rapid description of differing cohorts of disease at the clinical-research interface. By describing DTI measures morphologically, it was possible to consistently compare white matter injury patterns across international collaborator datasets.

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Section: Introductionmentioning

confidence: 99%

DTI Profiles for Rapid Description of Cohorts at the Clinical-Research Interface

et al. 2019

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“…Many measures were used as assessments of cognitive function (Mini Mental State Examination (MMSE), 21–29,31,32,35–37,43–45,48,49 trail making test A (TMT-A), 23,32,33,35,36,43,49 DemTect test, 25 , 32 Montreal Cognitive Assessment (MOCA) 54 ; learning and memory (Hopkins Verbal Learning Task-Revised (HVLT-R) 39 ); verbal fluency and executive function (COWAT), 20 , 39 Wechsler Memory Scale III (WMS-WL), 20 Rey complex figure test (RCFT), 20 according to Deckersbach et al. 71 ); conceptualization, mental flexibility, motor programming, sensitivity to interference, inhibitory control and environmental autonomy due to frontal lobe dysfunction (frontal assessment battery (FAB) 22,24,33,36,37,41,45,49 ); grade of dementia (Clinical Dementia Rating Scale (CDR), 29,35,36 , Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) 29 ); motor impairment and gait (gait velocity, 43 Timed Up and Go (TUG) test, 22,23,30,35–38,41,…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, ventricular to sulcal CSF ratio was greater in the iNPH patients compared to AD and healthy controls. 54…”

Section: Discussionmentioning

confidence: 99%

“…16–17 in 1994, and recently, many papers investigated its role in analyzing white matter (WM) alterations in patients with iNPH. 12 , 18–54 DTI is a non-invasive MR technique that provides information about the orientation and anisotropy of the WM tracts, and may delineate microstructural changes in cerebral WM; high-resolution, multitensor imaging (more than six diffusion directions) is currently combined with various other advanced MR techniques to study connectivity within the brain. In fact, illnesses that disrupt the normal organization or integrity of cerebral WM have a qualitative and quantitative impact on DTI measures.…”

Section: Introductionmentioning

confidence: 99%

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The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review

2020

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Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that comprises a triad of gait disturbance, dementia and urinary incontinence, associated with ventriculomegaly in the absence of elevated intraventricular cerebrospinal fluid (CSF) pressure. It is important to identify patients with iNPH because some of its clinical features may be reversed by the insertion of a CSF shunt. The diagnosis is based on clinical history, physical examination and brain imaging, especially magnetic resonance imaging (MRI). Recently, some papers have investigated the role of diffusion tensor imaging (DTI) in evaluating white matter alterations in patients with iNPH. DTI analysis in specific anatomical regions seems to be a promising MR biomarker of iNPH and could also be used in the differential diagnosis from other dementias. However, there is a substantial lack of structured reviews on this topic. Thus, we performed a literature search and analyzed the most recent and pivotal articles that investigated the role of DTI in iNPH in order to provide an up-to-date overview of the application of DTI in this setting. We reviewed studies published between January 2000 and June 2020. Thirty-eight studies and four reviews were included. Despite heterogeneity in analysis approaches, the majority of studies reported significant correlations between DTI and clinical symptoms in iNPH patients, as well as different DTI patterns in patients with iNPH compared to those with Alzheimer or Parkinson diseases. It remains to be determined whether DTI could predict the success after CSF shunting.

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“…Верхняя таламическая лучистость (superior thalamic radiation) -содержит волокна, связывающие вентральную группу ядер с пре-и постцентральными извилинами, вторичной моторной и сенсорной корой [32].…”

Section: теменно-мостовые затылочномос товые височно-мостовые волокнаunclassified

The Normal Anatomy of the Brain Pathways: What the Neuroradiologist Needs to Know (Literature Review)

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Diffusion Tensor Imaging of the Superior Thalamic Radiation and Cerebrospinal Fluid Distribution in Idiopathic Normal Pressure Hydrocephalus

Cited by 15 publications

References 34 publications

DTI Profiles for Rapid Description of Cohorts at the Clinical-Research Interface

DTI Profiles for Rapid Description of Cohorts at the Clinical-Research Interface

The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review

The Normal Anatomy of the Brain Pathways: What the Neuroradiologist Needs to Know (Literature Review)

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