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. 2022 Mar;43(3):1783-1790.
doi: 10.1007/s10072-021-05594-4. Epub 2021 Sep 9.

Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus

Andrea Quattrone  1 , Alessia Sarica  2 , Domenico La Torre  3 , Maurizio Morelli  1 , Alessandro Mechelli  1 , Pier Paolo Arcuri  4 , Aldo Quattrone  5   6   7
Affiliations

Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus

Andrea Quattrone et al. Neurol Sci. 2022 Mar.

Abstract

Background: Progressive supranuclear palsy (PSP) patients can show ventricular enlargement mimicking normal pressure hydrocephalus (NPH). The aim of this study was to distinguish PSP patients with marked ventricular dilatation (PSP-vd) from those with normal ventricular system and to evaluate the coexistence of NPH in PSP-vd patients.

Methods: One hundred three probable PSP patients, 18 definite NPH patients, and 41 control subjects were enrolled in the study. Evans index (EI) > 0.32 associated with callosal angle (CA) < 100° was used to identify PSP-vd patients. Automated ventricular volumetry (AVV) and Magnetic Resonance Hydrocephalic Index (MRHI) were performed on T1-weighted MR images to evaluate the presence of NPH in PSP-vd patients.

Results: Twelve (11.6%) out of 103 PSP patients had both abnormal EI and CA values (PSP-vd). In two of these 12 patients, AVV and MRHI values suggested PSP + NPH. In the remaining 10 PSP-vd patients, AVV and MRHI values were higher than PSP patients with normal ventricular system and controls, but lower than PSP + NPH and NPH patients, suggesting a non-hydrocephalic ventricular enlargement.

Discussion: Our study provides evidence that the combination of EI and CA biomarkers allowed to identify PSP patients with marked ventricular dilatation mimicking NPH. Only a few of these patients had PSP + NPH. Recognition of these PSP patients with enlarged ventricles can positively impact the care of this disease, helping clinicians to identify patients with PSP + NPH who could benefit from shunt procedure and avoid surgery in those with enlarged ventricles without NPH.

Keywords: Automated volumetry; Callosal angle; Normal pressure hydrocephalus; Progressive supranuclear palsy; Ventricular dilatation.

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References

    1. Höglinger GU, Respondek G, Stamelou M, Kurz C, Josephs KA, Lang AE, Mollenhauer B, Müller U, Nilsson C, Whitwell JL, Arzberger T, Englund E, Gelpi E, Giese A, Irwin DJ, Meissner WG, Pantelyat A, Rajput A, van Swieten JC, Troakes C, Antonini A, Bhatia KP, Bordelon Y, Compta Y, Corvol JC, Colosimo C, Dickson DW, Dodel R, Ferguson L, Grossman M, Kassubek J, Krismer F, Levin J, Lorenzl S, Morris HR, Nestor P, Oertel WH, Poewe W, Rabinovici G, Rowe JB, Schellenberg GD, Seppi K, van Eimeren T, Wenning GK, Boxer AL, Golbe LI, Litvan I, for the Movement Disorder Society- endorsed PSP study group (2017) Clinical diagnosis of progressive supranuclear palsy: the Movement Disorder Society criteria. Mov Disord 6:853–864 - DOI
    1. Kato N, Arai K, Hattori T (2003) Study of the rostral midbrain atrophy in progressive supranuclear palsy. J Neurol Sci 210:57–60 - DOI
    1. Quattrone A, Antonini A, Vaillancourt DE, Seppi K, Ceravolo R, Strafella AP, Morelli M, Nigro S, Vescio B, Bianco MG, Vasta R, Arcuri PP, Weis L, Fiorenzato E, Biundo R, Burciu RG, Krismer F, McFarland NR, Mueller C, Gizewski ER, Cosottini M, Del Prete E, Mazzucchi S, Quattrone A (2020) A new MRI measure to early differentiate progressive supranuclear palsy from de novo Parkinson’s disease in clinical practice: an international study. Mov Disord 36(3):681–689. https://doi.org/10.1002/mds.28364 - DOI - PubMed - PMC
    1. Ohara M, Hattori T, Yokota T (2020) Progressive supranuclear palsy often develops idiopathic normal pressure hydrocephalus-like MRI features. Eur J Neurol 27:1930–1936 - DOI
    1. Quattrone A, Sarica A, La Torre D, Morelli M, Vescio B, Nigro S, Barbagallo G, Nisticò R, Salsone M, Arcuri PP, Novellino F, Bianco MG, Arabia G, Cascini G, Quattrone A (2020) Magnetic resonance imaging biomarkers distinguish normal pressure hydrocephalus from progressive supranuclear palsy. Mov Disord 35:1406–1415 - DOI

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