Mortazavi Shahrzad, Jamalipour Soufi Ghazaleh, Rajabi Fatemeh, Akbaripour Sahar, Maracy Mohammad Reza, Barekatain Majid
Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Curr J Neurol. 2022 Jul 6;21(3):178-182. doi: 10.18502/cjn.v21i3.11111.
Normal pressure hydrocephalus (NPH) is a reversible type of dementia, which affects 0.2 to 5.9 percent of elders. It manifests with triad of gait disturbances, urinary incontinence, and cognitive decline. In this study, association between cognitive and neuroradiographic parameters of idiopathic NPH (iNPH) was appraised to find out possible biomarkers for preventive intervention. In a cross-sectional study, 16 patients with iNPH were evaluated for third and fourth ventricle diameter, diameter of temporal horn of lateral ventricle, Evans index (EI), callosal angle (CA), callosal bowing, and ballooning of frontal horn. The Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) was used to take cognitive profile. Relation between brain magnetic resonance imaging (MRI) indices and cognitive domains was extracted, using generalized linear model (GLM). Patients with mild callosal bowing had better function in memory (P = 0.050) and language (P = 0.001) than those with moderate to severe callosal bowing. Negative or mild ballooning of frontal horn was also associated with higher scores in memory (P = 0.010), executive function (EF) (P = 0.029), and language (P = 0.036) than moderate to severe ballooning of frontal horn. Increased 3 ventricle diameter was associated with decline in total cognition (P = 0.008), memory (P = 0.019), EF (P = 0.012), and language (P = 0.001). Relation between other radiographic indices and cognitive function was not significant. Third ventricular diameter, rounding of frontal horn of lateral ventricle, and callosal bowing are more accurate neuroradiographic parameters to predict cognitive decline in iNPH.
正常压力脑积水（NPH）是一种可逆性痴呆类型，影响0.2%至5.9%的老年人。其表现为步态障碍、尿失禁和认知衰退三联征。在本研究中，对特发性正常压力脑积水（iNPH）的认知和神经影像学参数之间的关联进行评估，以找出可能用于预防性干预的生物标志物。在一项横断面研究中，对16例iNPH患者评估了第三和第四脑室直径、侧脑室颞角直径、埃文斯指数（EI）、胼胝体角（CA）、胼胝体弯曲度和额角膨隆情况。使用神经精神病学单元认知评估工具（NUCOG）获取认知概况。采用广义线性模型（GLM）提取脑磁共振成像（MRI）指标与认知领域之间的关系。胼胝体轻度弯曲的患者在记忆（P = 0.050）和语言（P = 0.001）方面的功能优于中度至重度胼胝体弯曲的患者。额角阴性或轻度膨隆与记忆（P = 0.010）、执行功能（EF）（P = 0.029）和语言（P = 0.036）方面的较高得分也相关，而中度至重度额角膨隆则不然。第三脑室直径增加与总体认知（P = 0.008）、记忆（P = 0.019）、EF（P = 0.012）和语言（P = 0.001）下降相关。其他影像学指标与认知功能之间的关系不显著。第三脑室直径、侧脑室额角圆钝度和胼胝体弯曲度是预测iNPH认知衰退更准确的神经影像学参数。
