Voxel‐Based Morphometry of Disproportionate Cerebrospinal Fluid Space Distribution for the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus

Yamashita, Fumio; Sasaki, Makoto; Saitô, Makoto; Mori, Etsuro; Kawaguchi, Atsushı; Kudo, Kohsuke; Natori, Tatsunori; Uwano, Ikuko; Ito, Kenji; Saito, Ko

doi:10.1111/jon.12049

Cited by 23 publications

(17 citation statements)

References 38 publications

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“…Some researchers attributed decreased intracranial compliance to the increased flow in ventricular. 18 In this occasion, brain expansion toward the ventricles more than normal and increased the intracranial pulse pressure, causing a hyperdynamic CSF flow in aqueduct both in systole and diastole. 16 The relatively specific intracranial CSF distribution supports this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

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Reversed aqueductal cerebrospinal fluid net flow in idiopathic normal pressure hydrocephalus

et al. 2017

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Section: Discussionmentioning

confidence: 99%

“…16 The relatively specific intracranial CSF distribution supports this hypothesis. 18 In this occasion, brain expansion toward the ventricles more than normal and increased the intracranial pulse pressure, causing a hyperdynamic CSF flow in aqueduct both in systole and diastole.…”

Section: Discussionmentioning

confidence: 99%

Reversed aqueductal cerebrospinal fluid net flow in idiopathic normal pressure hydrocephalus

et al. 2017

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“…Additionally, a multicenter randomized trial showed significantly higher improvement rates after CSF shunting in patients with DESH accompanied by one or more symptoms of the triad [6]. Furthermore, the value of DESH in differentiating iNPH from other neurologic diseases such as brain atrophy and AD has been confirmed by several studies [7,8]. Hence, DESH appears to be a predictive and diagnostic neuroimaging biomarker of iNPH.…”

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confidence: 89%

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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“…26 The value of DESH in differentiating iNPH from other neurologic diseases has been confirmed by several studies. [27][28][29][30] Several diagnostic criteria for iNPH have recently been proposed. 1,8 One recent study reported that the effectiveness of shunt surgery for patients who were diagnosed according to one of these guidelines remained at 62.7% in terms of the mRS. 31 The incorporation of neuroimaging features that are predictive of surgical outcomes into the diagnostic criteria would thus improve the efficacy of shunt surgery.…”

Section: Discussionmentioning

confidence: 99%

High-Convexity Tightness Predicts the Shunt Response in Idiopathic Normal Pressure Hydrocephalus

Narita

Nishio

Baba

et al. 2016

AJNR Am J Neuroradiol

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Voxel‐Based Morphometry of Disproportionate Cerebrospinal Fluid Space Distribution for the Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus

Abstract: The VBM-based CSF space analysis can detect disproportionate changes in CSF space and differentiate iNPH patients from those with AD or PD and healthy elderlies accurately.

Cited by 23 publications

References 38 publications

Reversed aqueductal cerebrospinal fluid net flow in idiopathic normal pressure hydrocephalus

Reversed aqueductal cerebrospinal fluid net flow in idiopathic normal pressure hydrocephalus

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

High-Convexity Tightness Predicts the Shunt Response in Idiopathic Normal Pressure Hydrocephalus

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