Abstract
The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus (iNPH) is largely unknown. We investigated how ventricular expansion (width of the temporal horns [TH], callosal angle [CA], and Evans’ index [EI]) related to symptom severity in suspected iNPH. Participants (n = 168; 74.9 years ± SD 6.7; 55% females) from the general population underwent neurological examination, computed tomography, and neuropsychological testing. Multiple linear regression analysis revealed that wide TH was independently associated with all examined iNPH symptoms (p < 0.01) except for fine-motor performance, whereas a narrow CA only was associated to specific motor and cognitive functions (p < 0.05). TH and EI correlated significantly with incontinence (rs 0.17 and rs 0.16; p < 0.05). In conclusion, wide TH was significantly associated with most iNPH-symptoms. This finding potentially reflects the complex nature of the hippocampus, however further studies are needed to demonstrate functional connectivity.
Highlights
The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus is largely unknown
The radiological parameter temporal horns (TH) was significantly related to all results of cognition and motor performance (p < 0.01) except for Grooved pegboard test (GPT)
In Alzheimer’s disease (AD), the common finding of wide TH is probably due to atrophy of the hippocampus whereas in hydrocephalus it is more likely that the hippocampus is compressed by the increased cerebrospinal fluid (CSF) volume in the TH
Summary
The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus (iNPH) is largely unknown. Wide TH was significantly associated with most iNPH-symptoms. This finding potentially reflects the complex nature of the hippocampus, further studies are needed to demonstrate functional connectivity. Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome with a debut typically in the 6th and 7th decade 1,2 characterized by balance disturbance and “magnetic shuffling gait” (i.e. decreased step-length and step-height), urinary urgency and cognitive deficiencies such as reduced memory encoding and retrieval, and poor executive function[2,3,4]. Memory encoding and retrieval is consistently associated with the h ippocampus[27], and smaller hippocampi are present in iNPH and probably secondary to an increased CSF-volume in the temporal horns (TH)[28]
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