Lateral Ventricle Enlargement and Cortical Thinning in Idiopathic Normal-pressure Hydrocephalus Patients

Kyunghun Kang,Jong-Min Lee,Uicheul Yoon,Kichang Kwak

doi:10.1038/s41598-018-31399-1

Abstract

We utilized three-dimensional, surface-based, morphometric analysis to investigate ventricle shape between 2 groups: (1) idiopathic normal-pressure hydrocephalus (INPH) patients who had a positive response to the cerebrospinal fluid tap test (CSFTT) and (2) healthy controls. The aims were (1) to evaluate the location of INPH-related structural abnormalities of the lateral ventricles and (2) to investigate relationships between lateral ventricular enlargement and cortical thinning in INPH patients. Thirty-three INPH patients and 23 healthy controls were included in this study. We used sparse canonical correlation analysis to show correlated regions of ventricular surface expansion and cortical thinning. Significant surface expansion in the INPH group was observed mainly in clusters bilaterally located in the superior portion of the lateral ventricles, adjacent to the high convexity of the frontal and parietal regions. INPH patients showed a significant bilateral expansion of both the temporal horns of the lateral ventricles and the medial aspects of the frontal horns of the lateral ventricles to surrounding brain regions, including the medial frontal lobe. Ventricular surface expansion was associated with cortical thinning in the bilateral orbitofrontal cortex, bilateral rostral anterior cingulate cortex, left parahippocampal cortex, left temporal pole, right insula, right inferior temporal cortex, and right fusiform gyrus. These results suggest that patients with INPH have unique patterns of ventricular surface expansion. Our findings encourage future studies to elucidate the underlying mechanism of lateral ventricular morphometric abnormalities in INPH patients.

Highlights

Specific neuropathologies and neurological conditions such as Alzheimer’s disease (AD)[14]
We investigated the shape of the lateral ventricles utilizing a three-dimensional, surface-based, morphometric approach in 2 groups: (1) idiopathic normal-pressure hydrocephalus (INPH) patients who had a positive response to the CSF tap test (CSFTT) and (2) healthy controls
Compared with age- and gender-matched healthy controls, INPH patients showed a significant surface expansion mainly in areas located in the medial aspects of the frontal horns and the superior portion of the bilateral lateral ventricles, which are surrounded by the high convexity of the frontal and parietal regions and the medial frontal lobe

Summary

Introduction

Specific neuropathologies and neurological conditions such as Alzheimer’s disease (AD)[14]. The INPH group in a study, when compared to controls, exhibited cortical thinning in the middle temporal lobe[18]. Hydrocephalus is characterized by enlargement of the cerebral ventricles and in animal studies, an increasing degree of ventriculomegaly is associated with more marked thinning of the cerebral cortex[15,17]. An investigation of the relationship between lateral ventricular enlargement and cortical thinning in INPH patients has not been reported. We investigated the shape of the lateral ventricles utilizing a three-dimensional, surface-based, morphometric approach in 2 groups: (1) INPH patients who had a positive response to the CSFTT and (2) healthy controls. The aims of the study are (1) to evaluate the location of INPH-related structural abnormalities of the lateral ventricles and (2) to investigate relationships between lateral ventricular enlargement and cortical thinning in INPH patients. We hypothesized that INPH patients might show a characteristic pattern of lateral ventricular enlargement and that there may be unique relationships between lateral ventricular enlargement and cortical thinning in INPH patients

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