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01-10-2014 | Original Communication

Differentiating shunt-responsive normal pressure hydrocephalus from Alzheimer disease and normal aging: pilot study using automated MRI brain tissue segmentation

Authors: Yafell Serulle, Henry Rusinek, Ivan I. Kirov, Hannah Milch, Els Fieremans, Alexander B. Baxter, John McMenamy, Rajan Jain, Jeffrey Wisoff, James Golomb, Oded Gonen, Ajax E. George

Published in: Journal of Neurology | Issue 10/2014

Abstract

Evidence suggests that normal pressure hydrocephalus (NPH) is underdiagnosed in day to day radiologic practice, and differentiating NPH from cerebral atrophy due to other neurodegenerative diseases and normal aging remains a challenge. To better characterize NPH, we test the hypothesis that a prediction model based on automated MRI brain tissue segmentation can help differentiate shunt-responsive NPH patients from cerebral atrophy due to Alzheimer disease (AD) and normal aging. Brain segmentation into gray and white matter (GM, WM), and intracranial cerebrospinal fluid was derived from pre-shunt T1-weighted MRI of 15 shunt-responsive NPH patients (9 men, 72.6 ± 8.0 years-old), 17 AD patients (10 men, 72.1 ± 11.0 years-old) chosen as a representative of cerebral atrophy in this age group; and 18 matched healthy elderly controls (HC, 7 men, 69.7 ± 7.0 years old). A multinomial prediction model was generated based on brain tissue volume distributions. GM decrease of 33 % relative to HC characterized AD (P < 0.005). High preoperative ventricular and near normal GM volumes characterized NPH. A multinomial regression model based on gender, GM and ventricular volume had 96.3 % accuracy differentiating NPH from AD and HC. In conclusion, automated MRI brain tissue segmentation differentiates shunt-responsive NPH with high accuracy from atrophy due to AD and normal aging. This method may improve diagnosis of NPH and improve our ability to distinguish normal from pathologic aging.

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Title: Differentiating shunt-responsive normal pressure hydrocephalus from Alzheimer disease and normal aging: pilot study using automated MRI brain tissue segmentation
Authors: Yafell Serulle
Henry Rusinek
Ivan I. Kirov
Hannah Milch
Els Fieremans
Alexander B. Baxter
John McMenamy
Rajan Jain
Jeffrey Wisoff
James Golomb
Oded Gonen
Ajax E. George
Publication date: 01-10-2014
Publisher: Springer Berlin Heidelberg
Published in: Journal of Neurology / Issue 10/2014
Print ISSN: 0340-5354
Electronic ISSN: 1432-1459
DOI: https://doi.org/10.1007/s00415-014-7454-0

At a glance: The STEP trials

Springer Medicine

Differentiating shunt-responsive normal pressure hydrocephalus from Alzheimer disease and normal aging: pilot study using automated MRI brain tissue segmentation

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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