Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 3 Issue 12

Novel Brain Linear Measurements to Differentiate between Alzheimer Disease and Normal Pressure Hydrocephalus

Marcos Escosa Bage1*, Saleh S Baeesa2, Mohammed Binmahfoodh3 and Youssef Al-Said3

1MD, PhD, Neurosurgery Department University/Organization: CHIP Hospital Complex. Avda. Carlos Haya, Málaga, Spain
2MD, FRCSC, FAANS Neurosurgery Division, Faculty of Medicine, King Abdulaziz University, Jeddah, SAUDI ARABIA
3MD, FRCSC, Neurosciences Department, King Faisal Specialist Hospital & Research Centre, Jeddah, SAUDI ARABIA

*Corresponding Author: Marcos Escosa Bagé, MD, PhD, Neurosurgery Department University/Organization: CHIP Hospital Complex. Avda. Carlos Haya, Málaga, Spain.

Received: October 17, 2020; Published: November 18, 2020

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Abstract

Background: An Evans’ index (EI) greater than 0.3 has been associated with a diagnosis of idiopathic normal pressure hydrocephalus (iNPH). However, ventricular enlargement is also present in Alzheimer's disease (AD) in the elderly. To assess the differences between ventricular enlargement in AD and iNPH, we developed a geometric model that incorporated different linear brain measurements and compared it with EI.

Materials and Methods: Different ventricular linear measurements were obtained from 124 brain CT scans of normal participants, AD and iNPH patients. We developed a geometric model that yielded a linear measurement proportional to the skull shape.

The maximum frontal horn distance was divided by this new tool and compared with EI to identify a cutoff point that can allow radiological differentiation between AD and iNPH.

Results: The area under the receiver operating characteristic curve (ROC) when EI was used was 0.803, and the corresponding value with the geometric model (VW_N) was 0.802, i.e. almost identical. The cutoff EI to differentiate between AD and iNPH was 0.36, and the cutoff VW_N to distinguish between AD and iNPH was 1.6.

Conclusion: We show that our novel geometrical method is similar to EI for identifying AD and iNPH. Further research and validation of other ventriculomegaly pathologies are required to increase the usage of the geometrical method. Different patterns of ventricular dilatation with size differences in the dilated frontal ventricular horn are observed in AD and iNPH; linear brain measurements can characterize these differences.

Keywords: Normal Pressure Hydrocephalus; MRI; Dementia; Alzheimer Disease

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References

  1. AI Holodny., et al. “MR differential diagnosis of normal-pressure hydrocephalus and Alzheimer's disease: the significance of parahippocampal fissures”. American Journal of Neuroradiology 19 (1998): 813-819.
  2. M Hashimoto., et al. “Study of INPH on neurological improvement (SINPHONI). Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study”. Cerebrospinal Fluid Research 7 (2010): 18.
  3. N Relkin., et al. “Diagnosing idiopathic normal-pressure hydrocephalus”. Neurosurgery 57 (2005): S4-S16.
  4. A Tarnaris., et al. “Noninvasive biomarkers in normal pressure hydrocephalus: evidence for the role of neuroimaging”. Journal of Neurosurgery 110 (2009): 837-851.
  5. E Mori., et al. “Japanese Society of Normal Pressure Hydrocephalus. Guidelines for management of idiopathic normal pressure hydrocephalus: second edition”. Neurologia Medico-Chirurgica 52 (2012): 775-809.
  6. GM McKhann., et al. “The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease”. Alzheimer's Dement 7 (2011): 263-269.
  7. AK Toma., et al. “Watkins, Evans' index revisited: the need for an alternative in normal pressure hydrocephalus”. Neurosurgery 68 (2011): 939-944.
  8. A Tsunoda., et al. “A quantitative index of intracranial cerebrospinal fluid distribution in normal pressure hydrocephalus using an MRI-based processing technique”. Neuroradiology 42 (2000): 424-429.
  9. M Yoshihara., et al. “Differential diagnosis of NPH and brain atrophy assessed by measurement of intracranial and ventricular CSF volume with 3D FASE MRI”. Acta Neurochirurgica 71 (1998): 371-374.
  10. A Tsunoda., et al. “Intracranial cerebrospinal fluid distribution and its postoperative changes in normal pressure hydrocephalus”. Acta Neurochirurgica 143 (2001): 493-499.
  11. WM Palm., et al. “Ventricular dilation: association with gait and cognition”. Annals of Neurology 66 (2009): 485-493.
  12. H Kitagaki., et al. “Imamura, CSF spaces in idiopathic normal pressure hydrocephalus: Morphology and volumetry”. American Journal of Neuroradiology 19 (1998): 1277-1284.
  13. WM Palm., et al. “Intracranial compartment volumes in normal pressure hydrocephalus: Volumetric assessment versus outcome”. American Journal of Neuroradiology 27 (2006): 76-79.
  14. WG Bradley., et al. “Increased intracranial volume: A clue to the etiology of idiopathic normal-pressure hydrocephalus?” American Journal of Neuroradiology25 (2004): 1479-1484.
  15. M Matsumae., et al. “Intracranial compartment volumes in patients with enlarged ventricles assessed by magnetic resonance-based image processing”. Journal of Neurosurgery 84 (1996): 972-981.
  16. K Ishii., et al. “Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus”. European Radiology 18 (2008): 2678-2683.
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Citation

Citation: Marcos Escosa Bage., et al. “Novel Brain Linear Measurements to Differentiate between Alzheimer Disease and Normal Pressure Hydrocephalus". Acta Scientific Neurology 3.12 (2020): 32-38.




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Acceptance rate32%
Acceptance to publication20-30 days
Impact Factor0.844

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