Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea.
Sci Rep. 2020 Dec 3;10(1):21213. doi: 10.1038/s41598-020-78067-x.
We investigated differences in cortical thickness between idiopathic normal-pressure hydrocephalus (INPH) patients and healthy controls. We also explored whether a relationship exists between cortical thinning and gait disturbance in INPH patients. Forty-nine INPH patients and 26 healthy controls were imaged with MRI, including 3-dimensional volumetric images, for automated surface-based cortical thickness analysis across the entire brain. Compared with age- and gender-matched healthy controls, unexpectedly, INPH patients showed statistically significant cortical thickening mainly in areas located in the high convexity of the frontal, parietal, and occipital regions. Additionally, cortical thinning mainly in temporal and orbitofrontal regions was observed in the INPH group relative to the control group. The Gait Status Scale (GSS) scores were negatively correlated with cortical thickness in the medial orbital part of the superior frontal gyrus, gyrus rectus, superior temporal gyrus, temporal pole, and insula. A distinctive pattern of cortical thickness changes was found in INPH patients. We cautiously suggest that cortical thickening in INPH can result from reactive gliosis. Further, our results support the hypothesis that cortical thinning in INPH can result from neuronal degeneration. In addition, cortical thinning can play an important role in gait disturbances in INPH patients.
我们研究了特发性正常压力脑积水（INPH）患者与健康对照者之间皮质厚度的差异。我们还探讨了 INPH 患者皮质变薄与步态障碍之间是否存在关系。对 49 例 INPH 患者和 26 例健康对照者进行了 MRI 成像，包括三维容积图像，用于对整个大脑进行基于自动表面的皮质厚度分析。出乎意料的是，与年龄和性别匹配的健康对照组相比，INPH 患者主要在前额、顶叶和枕叶的高凸区显示出统计学上显著的皮质增厚。此外，与对照组相比，INPH 组在颞叶和眶额区域观察到皮质变薄。步态状态量表（GSS）评分与额上回、直回、颞上回、颞极和脑岛的内侧眶部皮质厚度呈负相关。在 INPH 患者中发现了一种独特的皮质厚度变化模式。我们谨慎地提出，INPH 中的皮质增厚可能是反应性神经胶质增生的结果。此外，我们的结果支持 INPH 中皮质变薄可能是神经元变性的假说。此外，皮质变薄可能在 INPH 患者的步态障碍中发挥重要作用。
