Restricted accessResearch articleFirst published online 2014-10
Relationship between cerebrospinal fluid flow,ventricles morphology,and DTI properties in internal capsules: differences between Alzheimer's disease and normal-pressure hydrocephalus
Normal-pressure hydrocephalus (NPH) and Alzheimer's disease (AD) have some similar clinical features and both involve white matter and cerebrospinal fluid (CSF) disorders.
Purpose
To compare putative relationships between ventricular morphology, CSF flow, and white matter diffusion in AD and NPH.
Material and Methods
Thirty patients (18 with AD and 12 with suspected NPH) were included in the study. All patients underwent a 3-Tesla MRI scan, which included phase-contrast MRI of the aqueduct (to assess the aqueductal CSF stroke volume) and a DTI session (to calculate the fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) in the internal capsules).
Results
FA was correlated with ventricular volume in the suspected NPH population (P < 0.001; rs = 0.88), whereas the ADC was highly correlated with the aqueductal CSF stroke volume in AD (P < 0.001; rs = 0.79).
Conclusion
Although AD and NPH both involve CSF disorders, the two diseases do not have the same impact on the internal capsules. The magnitude of the ADC is related to the aqueductal CSF stroke volume in AD, whereas FA is related to ventricular volume in NPH.
KuczynskiBTarganEMadisonC. White matter integrity and cortical metabolic associations in aging and dementia. Alzheimers Dement2010; 6: 54–62.
2.
ZhangY-ZChangCWeiX-E. Comparison of diffusion tensor image study in association fiber tracts among normal, amnestic mild cognitive impairment, and Alzheimer's patients. Neurol India2011; 59: 168–173.
3.
HattoriTYuasaTAokiS. Altered microstructure in corticospinal tract in idiopathic normal pressure hydrocephalus: comparison with Alzheimer disease and Parkinson disease with dementia. Am J Neuroradiol2011; 32: 1681–1687.
4.
SilverbergGDMayoMSaulT. Alzheimer's disease, normal-pressure hydrocephalus, and senescent changes in CSF circulatory physiology: a hypothesis. Lancet Neurol2003; 2: 506–511.
5.
DeCarliCHaxbyJVGilletteJA. Longitudinal changes in lateral ventricular volume in Datients with dementia of the Alzheimer type. Neurology1992; 42: 2029–2029.
6.
NestorSMRupsinghRBorrieM. Ventricular enlargement as a possible measure of Alzheimer's disease progression validated using the Alzheimer's disease neuroimaging initiative database. Brain2008; 131: 2443–2454.
7.
TarnarisAKitchenNDWatkinsLD. Noninvasive biomarkers in normal pressure hydrocephalus: evidence for the role of neuroimaging. J Neurosurg2009; 110: 837–851.
8.
SchottJMPriceSLFrostC. Measuring atrophy in Alzheimer disease. Neurology 122005; 65: 119–124.
9.
HattingenEJurcoaneAMelberJ. Diffusion tensor imaging in patients with adult chronic idiopathic hydrocephalus. Neurosurgery2010; 66: 917–924.
10.
EnzmannDRPelcNJ. Cerebrospinal fluid flow measured by phase-contrast cine MR. Am J Neuroradiol1993; 14: 1301–1310.
11.
El SankariSGondry-JouetCFichtenA. Cerebrospinal fluid and blood flow in mild cognitive impairment and Alzheimer's disease: a differential diagnosis from idiopathic normal pressure hydrocephalus. Fluids Barriers CNS2011; 8: 12–12.
12.
ParenteDBGasparettoELDa CruzLCHJr. Potential role of diffusion tensor MRI in the differential diagnosis of mild cognitive impairment and Alzheimer's disease. Am J Roentgenol2008; 190: 1369–1374.
13.
EbisuTNaruseSHorikawaY. Discrimination between different types of white matter edema with diffusion-weighted MR imaging. J Magn Reson Imaging1993; 3: 863–868.
14.
TourdiasTDragonuIFushimiY. Aquaporin 4 correlates with apparent diffusion coefficient and hydrocephalus severity in the rat brain: A combined MRI–histological study. NeuroImage2009; 47: 659–666.
15.
UluğAMTruongTNFilippiCG. Diffusion Imaging in Obstructive Hydrocephalus. Am J Neuroradiol2003; 24: 1171–1176.
16.
McKhannGDrachmanDFolsteinM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology1984; 34: 939–444.
17.
FolsteinMFFolsteinSEMcHughPR. ‘‘Mini-mental state’’. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res1975; 12: 189–198.
HakimSAdamsRD. The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics. J. Neurol. Sci1965; 2: 307–327.
20.
BazinP-LCuzzocreoJLYassaMA. Volumetric neuroimage analysis extensions for the MIPAV software package. J Neurosci Methods2007; 165: 111–121.
21.
BalédentOHenry-FeugeasMCIdy-PerettiI. Cerebrospinal fluid dynamics and relation with blood flow: a magnetic resonance study with semiautomated cerebrospinal fluid segmentation. Invest Radiol2001; 36: 368–377.
SauerbreiW. The use of resampling methods to simplify regression models in medical statistics. J Roy Stat Soc C Appl Stat1999; 48: 313–329.
24.
BatemanGALeviCRSchofieldP. The pathophysiology of the aqueduct stroke volume in normal pressure hydrocephalus: can co-morbidity with other forms of dementia be excluded?Neuroradiology2005; 47: 741–748.
25.
AssafYBen-SiraLConstantiniS. Diffusion tensor imaging in hydrocephalus: initial experience. Am J Neuroradiol2006; 27: 1717–1724.
26.
AnikYDemirciAAnikI. Apparent diffusion coefficient and cerebrospinal fluid flow measurements in patients with hydrocephalus. J Comput Assist Tomogr2008; 32: 392–396.
SimonTJDingLBishJP. Volumetric, connective, and morphologic changes in the brains of children with chromosome 22q11.2 deletion syndrome: an integrative study. NeuroImage2005; 25: 169–180.
