Abstract
Purpose: Idiopathic normal pressure hydrocephalus (iNPH) is known as a treatable form of dementia. Network analysis is emerging as a useful method to study neurological disorder diseases. No study has examined changes of structural brain networks of iNPH patients. We aimed to investigate alterations in the gray matter (GM) structural network of iNPH patients compared with normal elderly volunteers.Materials and Methods: Structural networks were reconstructed using covariance between regional GM volumes extracted from three-dimensional T1-weighted images of 29 possible iNPH patients and 30 demographically similar normal-control (NC) participants and compared with each other.Results: Global network modularity was significantly larger in the iNPH network (P < 0.05). Global network measures were not significantly different between the two networks (P > 0.05). Regional network analysis demonstrated eight nodes with significantly decreased betweenness located in the bilateral frontal, right temporal, right insula and right posterior cingulate regions, whereas only the left anterior cingulate was detected with significantly larger betweenness. The hubs of the iNPH network were mostly located in temporal areas and the limbic lobe, those of the NC network were mainly located in frontal areas.Conclusions: Network analysis was a promising method to study iNPH. Increased network modularity of the iNPH group was detected here, and modularity analysis should be paid much attention to explore the biomarker to select shunting-responsive patients.
Highlights
Idiopathic normal pressure hydrocephalus is a chronic communicating hydrocephalus with a characteristic triad of gait disturbance, dementia and incontinence
Global network modularity was significantly larger in the Idiopathic normal pressure hydrocephalus (iNPH) network compared with the NC network at all densities ranging from 0.28 to 0.5, except for 0.3 (Figure 4)
Earlier work indicated that the altered cerebrospinal fluid (CSF) flow dynamic may be the reason for ventriculomegaly present in the iNPH patients, and speculated that the real root may lie in brain parenchyma (Yin et al, 2017)
Summary
Idiopathic normal pressure hydrocephalus (iNPH) is a chronic communicating hydrocephalus with a characteristic triad of gait disturbance, dementia and incontinence. Many chronic brain disorders with cognitive, emotional, perceptual, and motor symptoms are associated with abnormalities in the brain network organization (Bullmore and Sporns, 2012). Previous studies have demonstrated changes in neuronal connectivity between different brain regions in several diseases associated with cognitive impairment, such as Alzheimer’s disease (Stam et al, 2007) and multiple sclerosis (He et al, 2009). This method provides a new insight into the mechanisms of neuropsychiatric disorders and helps us to find new imaging biomarkers to diagnose and monitor neurological diseases. A hypothesis was that abnormalities exist in the brain structural network of iNPH patients
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