, Volume 61, Issue 1, pp 37–42 | Cite as

Regional dissociation between the cerebral blood flow and gray matter density alterations in idiopathic normal pressure hydrocephalous: results from SINPHONI-2 study

  • Ryuichi Takahashi
  • Kazunari IshiiEmail author
  • Takahiko Tokuda
  • Madoka Nakajima
  • Takaharu Okada
  • SINPHONI-2 Investigators
Diagnostic Neuroradiology



The purpose of this study was to elucidate the specific regional cerebral blood flow (rCBF) alterations for idiopathic normal pressure hydrocephalus (iNPH) by comparing the proportional rCBF and gray matter change from those of a normal database at the same point of SPECT and MRI examinations.


Thirty subjects with iNPH underwent both CBF SPECT and MRI. After normalization, voxel-wise two-sample t tests between patients and 11 normal controls were conducted to compare the regional alteration in the gray matter density and rCBF.


The rCBF reduction and the gray matter decrease were seen in almost similar regions surrounding Sylvian fissure, the left parietotemporal region and frontal lobes, whereas we did not find rCBF increase at the top of the high convexity, where the increase of the gray matter density was the highest (p < 0.05).


Our study showed regional associations and dissociations between the relative gray matter density and rCBF in patients with iNPH.


Idiopathic normal pressure hydrocephalus Cerebral blood flow Gray matter density Regional difference 



This study is a sub-study of the multi-center study “SINPHONI-2.” SINPHONI-2 investigators are listed on the appendix. We thank Nihon Medi-Physics Corp for providing a graphic user interface program for constructing CBF image with the graph plot method.

Compliance with ethical standards


No funding was received for this study; however, this study is a sub-study of multi-center study “SINPHONI-2” and funding was partly provided by Johnson & Johnson and Nihon Medi-Physics Corp.

Conflict of interest

KI receives lecture fees from Nihon Medi-Physics Corp.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

234_2018_2106_MOESM1_ESM.doc (64 kb)
ESM 1 (DOC 64 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyHyogo Prefectural Rehabilitation Hospital at Nishi-HarimaTatsunoJapan
  2. 2.Department of RadiologyKindai University Faculty of MedicineOsakasayamaJapan
  3. 3.Department of RadiologyHyogo Brain and Heart CenterHimejiJapan
  4. 4.Department of Molecular Pathobiology of Brain DiseasesKyoto Prefectural University of MedicineKyotoJapan
  5. 5.Department of NeurosurgeryJuntendo University School of MedicineTokyoJapan
  6. 6.Department of Neurosurgery, Tama-Hokubu Medical CenterHealth and Medical Treatment CorporationHigashimurayamashiJapan

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