Intracranial volume, cranial thickness, and hyperostosis frontalis interna in the elderly

May, Hila; Mali, Yael; Dar, Gali; Abbas, Janan; Hershkovitz, Israel; Peled, Nir

doi:10.1002/ajhb.22325

Cited by 30 publications

(25 citation statements)

References 48 publications

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“…Previous studies have hypothesized that with age, the cranial bones thicken as a result of decreased ICV (May et al 2012;Royle et al 2013). The hypothesized mechanism is that the skull compensates for the ICV loss and increases CSF to maintain a relatively constant ICP.…”

Section: Discussionmentioning

confidence: 99%

“…The significant shape change of the inner frontal region for females may be attributed to a benign physiological condition known as hyperostosis frontalis interna (HFI), which causes a thickening of the skull frontal region. HFI patients are considered to be anatomically normal and are noted as unremarkable in radiology reports (May et al 2010(May et al , 2012Raikos et al 2011). Upon visual inspection of the scans analyzed, 11% of the subjects had changes compatible with HFI, in parallel with estimations of the incidence of HFI in the population (She & Szakacs, 2004).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of morphological changes in the adult skull with age and sex

et al. 2014

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The morphology of the brain and skull are important in the evaluation of the aging human; however, little is known about how the skull may change with age. The objective of this study was to evaluate the morphological changes of the adult skull using three-dimensional geometric morphometric analysis of thousands of landmarks with the focus on anatomic regions that may be correlated with brain atrophy and head injury. Computed tomography data were collected between ages 20 and 100. Each scan was segmented using thresholding techniques. An atlas image of a 50th percentile skull was registered to each subject scan by computing a series of rigid, affine, and non-linear transformations between atlas space and subject space. Landmarks on the atlas skull were transformed to each subject and partitioned into the inner and outer cranial vault and the cranial fossae. A generalized Procrustes analysis was completed for the landmark sets. The coordinate locations describing the shape of each region were regressed with age to generate a model predicting the landmark location with age. Permutation testing was performed to assess significant changes with age. For the males, all anatomic regions reveal significant changes in shape with age except for the posterior cranial fossa. For the females, only the middle cranial fossa and anterior cranial fossa were found to change significantly in shape. Results of this study are important for understanding the adult skull and how shape changes may pertain to brain atrophy, aging, and injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of morphological changes in the adult skull with age and sex

et al. 2014

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“…On the other hand, changes in the ICV must be compensated by parallel changes in other tissues. Interestingly, thickening of the skull was detected in several cases [58,42]. Thus, it is plausible that skull bone thickening is responsible for all, part of, or correlates with, the ICV changes.…”

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confidence: 99%

Changes in the intracranial volume from early adulthood to the sixth decade of life: A longitudinal study

Caspi

Brouwer

Schnack

et al. 2019

Preprint

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AbstractNormal brain-aging occurs at all structural levels. Excessive pathophysiological changes in the brain, beyond the normal one, are implicated in the etiology of brain disorders such as severe forms of the schizophrenia spectrum and dementia. To account for brain-aging in health and disease, it is critical to study the age-dependent trajectories of brain biomarkers at various levels and among different age groups.The intracranial volume (ICV) is a key biological marker, and changes in the ICV during the lifespan can teach us about the biology of development, aging, and gene X environment interactions. However, whether ICV changes with age in adulthood is not resolved.Applying a semi-automatic in-house-built algorithm for ICV extraction on T1w MR brain scans in the Dutch longitudinal cohort (GROUP), we measured ICV changes. Individuals between the ages of 16 and 55 years were scanned up to three consecutive times with 3.32±0.32 years between consecutive scans (N=482, 359, 302). Using the extracted ICVs, we calculated ICV longitudinal aging-trajectories based on three analysis methods; direct calculation of ICV differences between the first and the last scan, fitting all ICV measurements of individuals to a straight line and applying a global linear mixed model fitting. We report statistically significant increases in the ICV in adulthood until the fourth decade of life (average change +0.03%/y, or about 0.5 ml/y, at age 20), and decreases in the ICV afterward (−0.09%/y, or about −1.2 ml/y, at age 55). To account for previous cross-sectional reports of ICV changes, we analyzed the same data using a cross-sectional approach. Our cross-sectional analysis detected ICV changes consistent with the previously reported cross-sectional effect. However, the reported amount of cross-sectional changes within this age range was significantly larger than the longitudinal changes. We attribute the cross-sectional results to a generational effect.In conclusion, the human intracranial volume does not stay constant during adulthood but instead shows a small increase during young adulthood and a decrease thereafter from the fourth decade of life. The age-related changes in the longitudinal setup are smaller than those reported using cross-sectional approaches and unlikely to affect structural brain imaging studies correcting for intracranial volume considerably. As to the possible mechanisms involved, this awaits further study, although thickening of the meninges and skull bones have been proposed, as well as a smaller amount of brain fluids addition above the overall loss of brain tissue.

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“…Recent research has suggested that various symptoms may occur as a consequence of HFI, independent of these syndromes (Attanasio et al 2013;Djonic et al 2016). Specifically, intrusive bone growth in patients with HFI may reduce intracranial volume or compress the cerebral cortex, resulting in various neurological symptoms (May et al 2012). HFI is associated with cognitive slowing, mood disturbance, epilepsy, dementia, schizoaffective disorders, headache and intracranial hypertension (Hershkovitz et al 1999;Devriendt et al 2005;Djonic et al 2016).…”

Section: Introductionmentioning

confidence: 99%

“…HFI is associated with cognitive slowing, mood disturbance, epilepsy, dementia, schizoaffective disorders, headache and intracranial hypertension (Hershkovitz et al 1999;Devriendt et al 2005;Djonic et al 2016). In addition there are studies that correlate HFI with Alzheimer's and Parkinson's diseases (May et al 2012;Cetiner Batun et al 2015).…”

Section: Introductionmentioning

confidence: 99%

3D‐Microarchitectural patterns of Hyperostosis frontalis interna: a micro‐computed tomography study in aged women

et al. 2016

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Although seen frequently during dissections and autopsies, Hyperostosis frontalis interna (HFI) - a morphological pattern of the frontal bone thickening - is often ignored and its nature and development are not yet understood sufficiently. Current macroscopic classification defines four grades/stages of HFI based on the morphological appearance and size of the affected area; however, it is unclear if these stages also depict the successive phases in the HFI development. Here we assessed 3D-microarchitecture of the frontal bone in women with various degrees of HFI expression and in an age- and sex-matched control group, hypothesizing that the bone microarchitecture bears imprints of the pathogenesis of HFI and may clarify the phases of its development. Frontal bone samples were collected during routine autopsies from 20 women with HFI (age: 69.9 ± 11.1 years) and 14 women without HFI (age: 74.1 ± 9.7 years). We classified the HFI samples into four groups, each group demonstrating different macroscopic type or stage of HFI. All samples were scanned by micro-computed tomography to evaluate 3D bone microarchitecture in the following regions of interest: total sample, outer table, diploe and inner table. Our results revealed that, compared to the control group, the women with HFI showed a significantly increased bone volume fraction in the region of diploe, along with significantly thicker and more plate-like shaped trabeculae and reduced trabecular separation and connectivity density. Moreover, the inner table of the frontal bone in women with HFI displayed significantly increased total porosity and mean pore diameter compared to controls. Microstructural reorganization of the frontal bone in women with HFI was also reflected in significantly higher porosity and lower bone volume fraction in the inner vs. outer table due to an increased number of pores larger than 100 μm. The individual comparisons between the control group and different macroscopic stages of HFI revealed significant differences only between the control group and the morphologically most pronounced type of HFI. Our microarchitectural findings demonstrated clear differences between the HFI and the control group in the region of diploe and the inner table. Macroscopic grades of HFI could not be distinguished at the level of bone microarchitecture and their consecutive nature cannot be supported. Rather, our study suggests that only two different types of HFI (moderate and severe HFI) have microstructural justification and should be considered further. It is essential to record HFI systematically in human postmortem subjects to provide more data on the mechanisms of its development.

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Intracranial volume, cranial thickness, and hyperostosis frontalis interna in the elderly

Cited by 30 publications

References 48 publications

Evaluation of morphological changes in the adult skull with age and sex

Evaluation of morphological changes in the adult skull with age and sex

Changes in the intracranial volume from early adulthood to the sixth decade of life: A longitudinal study

3D‐Microarchitectural patterns of Hyperostosis frontalis interna: a micro‐computed tomography study in aged women

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