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. 2023 Aug 24:15:1241237.
doi: 10.3389/fnagi.2023.1241237. eCollection 2023.

Comparison of cerebrospinal fluid space between probable normal pressure hydrocephalus and Alzheimer's disease

Hongliang Li  1 , Chunyan Liu  1 , Hong Tai  2 , Youping Wei  3 , Taizhong Shen  3 , Qiong Yang  1 , Keyang Zheng  4 , Yan Xing  1
Affiliations

Comparison of cerebrospinal fluid space between probable normal pressure hydrocephalus and Alzheimer's disease

Hongliang Li et al. Front Aging Neurosci. .

Erratum in

Abstract

Introduction: Idiopathic normal pressure hydrocephalus (INPH) is a potentially reversible syndrome characterized by complex symptoms, difficulty in diagnosis and a lack of detailed clinical description, and it is difficult to distinguish from Alzheimer's disease (AD). The objective of this study was to design a method for measuring the actual amount of hydrocephalus in patients with INPH and to evaluate INPH.

Methods: All subjects underwent a 3D T1-weighted MRI. Statistical parametric mapping 12 was used for preprocessing images, statistical analysis, and voxel-based morphometric gray matter (GM) volume, white matter (WM) volume, and cerebrospinal fluid (CSF) volume analysis. The demographic and clinical characteristics of the groups were compared using a t-test for continuous variables and a chi-square test for categorical variables. Pearson's correlation analysis and Bonferroni's statistic-corrected one-way ANOVA were used to determine the relationship among demographic variables. Receiver operating characteristic (ROC) curves were used to assess the accuracy of the callosal angle (CA), WM ratio, and CSF ratio in distinguishing probable INPH from AD.

Results: The study included 42 patients with INPH, 32 patients with AD, and 24 healthy control subjects (HCs). There were no differences among the three groups in basic characteristics except for Mini-Mental State Examination (MMSE). There was a correlation between the intracranial CSF ratio and CA. The WM ratio and CSF ratio in patients with INPH and AD were statistically different. Furthermore, the combination of CA, WM ratio, and CSF ratio had a greater differential diagnostic value between INPH and AD patients than CA alone.

Conclusion: INPH can be accurately assessed by measuring intracranial CSF ratio, and the addition of WM ratio and CSF ratio significantly improved the differential diagnostic value of probable INPH from AD compared to CA alone.

Keywords: Alzheimer’s disease; cerebrospinal fluid; differential diagnosis; idiopathic normal pressure hydrocephalus; voxel-based morphometry.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart for enrolling probable INPH patients in this study.
FIGURE 2
FIGURE 2
The average ratio of GM, WM, and CSF in patients with probable INPH, AD, and HCs.
FIGURE 3
FIGURE 3
The relationship between the CSF volume ratio and the callosal angle index of the patients in the indicated groups.
FIGURE 4
FIGURE 4
The receiver operating characteristic graph curves of callosal angle, WM ratio, CSF ratio and combined indicator for the differential diagnosis of probable INPH from AD.
See this image and copyright information in PMC

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