Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease

Daniel Hořínek, Irena Štěpán-Buksakowska, Nikoletta Szabó, Bradley J. Erickson, Eszter Tóth, Vlastimil Šulc, Vladimir Beneš, Jiří Vrána, Jakub Hort, Christopher Nimsky, Milan Mohapl, Miloslav Roček, L. Vécsei, Zsigmond Tamás Kincses

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. Patients and methods Diffusion tensor images were obtained from 17 patients with NPH, 14 with AD, and 17 healthy controls. White matter integrity was quantified by fractional anisotropy (FA), mean (MD), axial (λ1) and radial diffusivity (RD). The diffusion parameters were compared between the groups in 'skeletonised' tracts representing the core of the fibre bundles. Results Reduced FA was found in NPH patients throughout the corpus callosum, particularly in the splenium, along with increased RD. On the other hand, FA, MD and RD were higher in NPH in the cortico-fugal fibres arising from the frontal and parietal cortex. While no FA changes were detected in AD patients compared to controls, widespread increased RD was observed. When comparing NPH and AD patients, higher FA, MD and RD was observed in the corona radiata in the periventricular fibres arising from the frontal and parietal cortex in NPH patients. The ventricular volumes were correlated with diffusivity parameters in the tracts next to the ventricles in AD and NPH patients. Conclusion Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.

Original languageEnglish
Pages (from-to)52-59
Number of pages8
JournalClinical Neurology and Neurosurgery
Volume140
DOIs
Publication statusPublished - Jan 1 2016

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Normal Pressure Hydrocephalus
Alzheimer Disease
Differential Diagnosis
Anisotropy
Parietal Lobe
Frontal Lobe
White Matter
Diffusion Tensor Imaging
Corpus Callosum

Keywords

  • Alzheimer's disease
  • DTI
  • MRI
  • Normal pressure hydrocephalus
  • TBSS
  • White matter

ASJC Scopus subject areas

  • Clinical Neurology
  • Surgery

Cite this

Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease. / Hořínek, Daniel; Štěpán-Buksakowska, Irena; Szabó, Nikoletta; Erickson, Bradley J.; Tóth, Eszter; Šulc, Vlastimil; Beneš, Vladimir; Vrána, Jiří; Hort, Jakub; Nimsky, Christopher; Mohapl, Milan; Roček, Miloslav; Vécsei, L.; Kincses, Zsigmond Tamás.

In: Clinical Neurology and Neurosurgery, Vol. 140, 01.01.2016, p. 52-59.

Research output: Contribution to journalArticle

Hořínek, D, Štěpán-Buksakowska, I, Szabó, N, Erickson, BJ, Tóth, E, Šulc, V, Beneš, V, Vrána, J, Hort, J, Nimsky, C, Mohapl, M, Roček, M, Vécsei, L & Kincses, ZT 2016, 'Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease', Clinical Neurology and Neurosurgery, vol. 140, pp. 52-59. https://doi.org/10.1016/j.clineuro.2015.11.010
Hořínek, Daniel ; Štěpán-Buksakowska, Irena ; Szabó, Nikoletta ; Erickson, Bradley J. ; Tóth, Eszter ; Šulc, Vlastimil ; Beneš, Vladimir ; Vrána, Jiří ; Hort, Jakub ; Nimsky, Christopher ; Mohapl, Milan ; Roček, Miloslav ; Vécsei, L. ; Kincses, Zsigmond Tamás. / Difference in white matter microstructure in differential diagnosis of normal pressure hydrocephalus and Alzheimer's disease. In: Clinical Neurology and Neurosurgery. 2016 ; Vol. 140. pp. 52-59.
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abstract = "Objectives Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. Patients and methods Diffusion tensor images were obtained from 17 patients with NPH, 14 with AD, and 17 healthy controls. White matter integrity was quantified by fractional anisotropy (FA), mean (MD), axial (λ1) and radial diffusivity (RD). The diffusion parameters were compared between the groups in 'skeletonised' tracts representing the core of the fibre bundles. Results Reduced FA was found in NPH patients throughout the corpus callosum, particularly in the splenium, along with increased RD. On the other hand, FA, MD and RD were higher in NPH in the cortico-fugal fibres arising from the frontal and parietal cortex. While no FA changes were detected in AD patients compared to controls, widespread increased RD was observed. When comparing NPH and AD patients, higher FA, MD and RD was observed in the corona radiata in the periventricular fibres arising from the frontal and parietal cortex in NPH patients. The ventricular volumes were correlated with diffusivity parameters in the tracts next to the ventricles in AD and NPH patients. Conclusion Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.",
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AU - Štěpán-Buksakowska, Irena

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AU - Erickson, Bradley J.

AU - Tóth, Eszter

AU - Šulc, Vlastimil

AU - Beneš, Vladimir

AU - Vrána, Jiří

AU - Hort, Jakub

AU - Nimsky, Christopher

AU - Mohapl, Milan

AU - Roček, Miloslav

AU - Vécsei, L.

AU - Kincses, Zsigmond Tamás

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N2 - Objectives Alzheimer's disease (AD) and normal pressure hydrocephalus (NPH) are both associated with cognitive decline and ventriculomegaly. While promising approach in differentiating between the two diseases, only a few diffusion tensor imaging (DTI) studies compared directly NPH and AD patients. The current study compares global whitematter (WM) alterations in AD and NPH addressing some of the methodological issues of previous studies. Patients and methods Diffusion tensor images were obtained from 17 patients with NPH, 14 with AD, and 17 healthy controls. White matter integrity was quantified by fractional anisotropy (FA), mean (MD), axial (λ1) and radial diffusivity (RD). The diffusion parameters were compared between the groups in 'skeletonised' tracts representing the core of the fibre bundles. Results Reduced FA was found in NPH patients throughout the corpus callosum, particularly in the splenium, along with increased RD. On the other hand, FA, MD and RD were higher in NPH in the cortico-fugal fibres arising from the frontal and parietal cortex. While no FA changes were detected in AD patients compared to controls, widespread increased RD was observed. When comparing NPH and AD patients, higher FA, MD and RD was observed in the corona radiata in the periventricular fibres arising from the frontal and parietal cortex in NPH patients. The ventricular volumes were correlated with diffusivity parameters in the tracts next to the ventricles in AD and NPH patients. Conclusion Our analysis identified a pattern of WM diffusion alterations that can differentiate NPH patients from controls and AD patients.

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