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Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space
OBJECTIVE: We sought to identify the prevalence of MRI features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH-iNPH) and to describe the clinico-radiological features and outcomes of a community-based investigation (The Vien...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Blackwell Publishing Ltd
2014
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184559/ https://www.ncbi.nlm.nih.gov/pubmed/25356428 http://dx.doi.org/10.1002/acn3.87 |
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author | Akiguchi, Ichiro Shirakashi, Yoshitomo Budka, Herbert Watanabe, Yuko Watanabe, Toshiyuki Shiino, Akihiko Ogita, Mihoko Kawamoto, Yasuhiro Jungwirth, Susanne Krampla, Wolfgang Fischer, Peter |
author_facet | Akiguchi, Ichiro Shirakashi, Yoshitomo Budka, Herbert Watanabe, Yuko Watanabe, Toshiyuki Shiino, Akihiko Ogita, Mihoko Kawamoto, Yasuhiro Jungwirth, Susanne Krampla, Wolfgang Fischer, Peter |
author_sort | Akiguchi, Ichiro |
collection | PubMed |
description | OBJECTIVE: We sought to identify the prevalence of MRI features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH-iNPH) and to describe the clinico-radiological features and outcomes of a community-based investigation (The Vienna Trans-Danube Aging study). METHODS: Of the 697 inhabitants (all 75 years old), 503 completed extensive neurological examinations at baseline and were followed up every 30 months thereafter with MRIs, mini-mental state examination (MMSE), and the Unified Parkinson Disease Rating Scale-Motor Section (UPDRSM). The DESH-iNPH participant data were compared with the data from participants with Evans index ratios >0.3 (ex vacuo hydrocephalus), cerebral small-vessel diseases, and normal MRIs. The widening of perivascular space was also evaluated by MRI in these groups. RESULTS: Eight participants with DESH-iNPH (1.6%) and 76 with ex vacuo hydrocephalus (16.1%) at baseline were identified. The mean MMSE in DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs was 26.4, 27.9, and 28.3, respectively, and the mean UPDRSM was 9.75, 2.96, and 1.87, respectively. After a 90-month follow-up, the mortality rates for DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs were 25.0%, 21.3%, and 10.9%, respectively. The perivascular-space widening scores were significantly smaller in the DESH-iNPH cases, particularly at the centrum semiovale, compared to cerebral small-vessel disease and ex vacuo hydrocephalus cases. INTERPRETATION: The prevalence of DESH-iNPH was 1.6% for participants aged 75 years and revealed significantly lower MMSE and higher UPDRSM scores compared to the ex vacuo hydrocephalus and controls. Moreover, it is suggested that perivascular-space narrowing is a morphological and pathophysiological marker of DESH-iNPH. |
format | Online Article Text |
id | pubmed-4184559 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Blackwell Publishing Ltd |
record_format | MEDLINE/PubMed |
spelling | pubmed-41845592014-10-29 Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space Akiguchi, Ichiro Shirakashi, Yoshitomo Budka, Herbert Watanabe, Yuko Watanabe, Toshiyuki Shiino, Akihiko Ogita, Mihoko Kawamoto, Yasuhiro Jungwirth, Susanne Krampla, Wolfgang Fischer, Peter Ann Clin Transl Neurol Research Articles OBJECTIVE: We sought to identify the prevalence of MRI features of disproportionately enlarged subarachnoid space hydrocephalus in possible idiopathic normal pressure hydrocephalus (DESH-iNPH) and to describe the clinico-radiological features and outcomes of a community-based investigation (The Vienna Trans-Danube Aging study). METHODS: Of the 697 inhabitants (all 75 years old), 503 completed extensive neurological examinations at baseline and were followed up every 30 months thereafter with MRIs, mini-mental state examination (MMSE), and the Unified Parkinson Disease Rating Scale-Motor Section (UPDRSM). The DESH-iNPH participant data were compared with the data from participants with Evans index ratios >0.3 (ex vacuo hydrocephalus), cerebral small-vessel diseases, and normal MRIs. The widening of perivascular space was also evaluated by MRI in these groups. RESULTS: Eight participants with DESH-iNPH (1.6%) and 76 with ex vacuo hydrocephalus (16.1%) at baseline were identified. The mean MMSE in DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs was 26.4, 27.9, and 28.3, respectively, and the mean UPDRSM was 9.75, 2.96, and 1.87, respectively. After a 90-month follow-up, the mortality rates for DESH-iNPH, ex vacuo hydrocephalus, and normal MRIs were 25.0%, 21.3%, and 10.9%, respectively. The perivascular-space widening scores were significantly smaller in the DESH-iNPH cases, particularly at the centrum semiovale, compared to cerebral small-vessel disease and ex vacuo hydrocephalus cases. INTERPRETATION: The prevalence of DESH-iNPH was 1.6% for participants aged 75 years and revealed significantly lower MMSE and higher UPDRSM scores compared to the ex vacuo hydrocephalus and controls. Moreover, it is suggested that perivascular-space narrowing is a morphological and pathophysiological marker of DESH-iNPH. Blackwell Publishing Ltd 2014-08 2014-07-28 /pmc/articles/PMC4184559/ /pubmed/25356428 http://dx.doi.org/10.1002/acn3.87 Text en © 2014 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. http://creativecommons.org/licenses/by-nc-nd/3.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. |
spellingShingle | Research Articles Akiguchi, Ichiro Shirakashi, Yoshitomo Budka, Herbert Watanabe, Yuko Watanabe, Toshiyuki Shiino, Akihiko Ogita, Mihoko Kawamoto, Yasuhiro Jungwirth, Susanne Krampla, Wolfgang Fischer, Peter Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title | Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title_full | Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title_fullStr | Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title_full_unstemmed | Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title_short | Disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
title_sort | disproportionate subarachnoid space hydrocephalus—outcome and perivascular space |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4184559/ https://www.ncbi.nlm.nih.gov/pubmed/25356428 http://dx.doi.org/10.1002/acn3.87 |
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