Higher prevalence of idiopathic normal pressure hydrocephalus‐like MRI features in progressive supranuclear palsy: An imaging reminder of atypical parkinsonism

Abstract

Objectives:The classic triad of idiopathic normal pressure hydrocephalus (NPH) encompass gait disturbance, cognitive impairment, and urinary incontinence. These symptoms overlap with parkinsonism but with distinct treatment. Lacking applicable differentiation also hampers the prediction to therapeutic response. Here, we try to clarify this issue among different Parkinsonian syndromes and propose some innovative thinking while approaching a patient with parkinsonism and hydrocephalus concomitantly.Methods: Twenty-four patients with clinical probable multiple system atrophy (MSA), 34 with probable progressive supranuclear palsy (PSP), and 58 with sex-and agematched Parkinson's disease (PD) were enrolled. Evans' index (EI), callosal angle (CA), antero-posterior (AP) diameter of the midbrain, length of the midbrain tegmentum diameter (MB Tegm ), and disproportionately enlarged subarachnoid space hydrocephalus (DESH) were evaluated using the conventional MRI. Logistic regression was applied to identify the independent variables in hydrocephalus.Results: Patients with PSP had higher mean EI than those with MSA and PD. Around 38.2% of patients with PSP had accompanied hydrocephalus (EI > 0.3). Parkinsonism subtypes (PD, MSA, or PSP), AP diameter of the midbrain, and MB Tegm were significantly different among patients with and without hydrocephalus. After regression This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Planimetric and Volumetric Brainstem MRI Markers in Progressive Supranuclear Palsy, Multiple System Atrophy, and Corticobasal Syndrome. A Systematic Review and Meta-Analysis

“…After duplicate record elimination, 1096 records were screened by reviewing the title and abstract, eliminating 702 further studies. For the 337 remaining records, full texts were reviewed, eliminating 315 records (unrelated content: n = 280; patient or control group consisting of <10 subjects: n = 22 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]; full text unavailable: n = 1 [38]; non-extractable data: n = 1 [39]; data in median/quartiles: n = 4 [40][41][42][43]; identical study cohorts or study cohorts with significant overlap: n = 2 [8,44]; data on PSP/MSA cohorts without distinction of RS/MSA-P phenotypes: n = 5 [45][46][47][48][49]). Five studies were identified via manual search of related papers, references, and citing papers [13,[50][51][52][53].…”

The effects that secondary parkinsonian syndromes have on health status

“…The triad of symptoms for idiopathic normal pressure hydrocephalus (iNPH) includes 1) urinary incontinence, 2) gait disturbances, and 3) cognitive impairment along with ventriculomegaly (21). There is evidence suggesting similarities between progressive supranuclear palsy (PSP) and normal pressure hydrocephalus (NPH) (21).…”

Neuroimaging in Parkinsonism: Insights and Challenges

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