Advertisement

Neuroradiology

, 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
  • 80 Downloads

Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusion

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

Keywords

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

Notes

Acknowledgements

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

Funding

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)

References

  1. 1.
    Hakim S, Adams RD (1965) The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure: observations on cerebrospinal fluid hydrodynamics. J Neurol Sci 2:307–327CrossRefGoogle Scholar
  2. 2.
    Kazui H, Miyajima M, Mori E, Ishikawa M, Investigators S (2015) Lumboperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (SINPHONI-2): an open-label randomised trial. Lancet Neurol 14:585–594CrossRefGoogle Scholar
  3. 3.
    Hashimoto M, Ishikawa M, Mori E, Kuwana N, Study of I o n i (2010) Diagnosis of idiopathic normal pressure hydrocephalus is supported by MRI-based scheme: a prospective cohort study. Cerebrospinal Fluid Res 7:18CrossRefGoogle Scholar
  4. 4.
    Iseki C, Takahashi Y, Wada M, Kawanami T, Adachi M, Kato T (2014) Incidence of idiopathic normal pressure hydrocephalus (iNPH): a 10-year follow-up study of a rural community in Japan. J Neurol Sci 339:108–112CrossRefGoogle Scholar
  5. 5.
    Larsson A, Bergh AC, Bilting M, Arlig A, Jacobsson L, Stephensen H, Wikkelsö C (1994) Regional cerebral blood flow in normal pressure hydrocephalus: diagnostic and prognostic aspects. Eur J Nucl Med 21:118–123CrossRefGoogle Scholar
  6. 6.
    Kristensen B, Malm J, Fagerland M, Hietala SO, Johansson B, Ekstedt J, Karlsson T (1996) Regional cerebral blood flow, white matter abnormalities, and cerebrospinal fluid hydrodynamics in patients with idiopathic adult hydrocephalus syndrome. J Neurol Neurosurg Psychiatry 60:282–288CrossRefGoogle Scholar
  7. 7.
    Sasaki H, Ishii K, Kono AK, Miyamoto N, Fukuda T, Shimada K, Ohkawa S, Kawaguchi T, Mori E (2007) Cerebral perfusion pattern of idiopathic normal pressure hydrocephalus studied by SPECT and statistical brain mapping. Ann Nucl Med 21:39–45CrossRefGoogle Scholar
  8. 8.
    Jagust WJ, Friedland RP, Budinger TF (1985) Positron emission tomography with [18F]fluorodeoxyglucose differentiates normal pressure hydrocephalus from Alzheimer-type dementia. J Neurol Neurosurg Psychiatry 48:1091–1096CrossRefGoogle Scholar
  9. 9.
    Ohmichi T, Kondo M, Itsukage M, Koizumi H, Matsushima S, Kuriyama N, Ishii K, Mori E, Yamada K, Mizuno T, Tokuda T (2018) Usefulness of the convexity apparent hyperperfusion sign in 123I-iodoamphetamine brain perfusion SPECT for the diagnosis of idiopathic normal pressure hydrocephalus. J Neurosurg Mar 16:1–8.  https://doi.org/10.3171/2017.9.JNS171100 Google Scholar
  10. 10.
    Ishii K, Uemura T, Miyamoto N, Yoshikawa T, Yamaguchi T, Ashihara T, Ohtani Y (2011) Regional cerebral blood flow in healthy volunteers measured by the graph plot method with iodoamphetamine SPECT. Ann Nucl Med 25:255–260CrossRefGoogle Scholar
  11. 11.
    Ashburner J (2007) A fast diffeomorphic image registration algorithm. Neuroimage 38:95–113CrossRefGoogle Scholar
  12. 12.
    Ishii K, Kanda T, Harada A, Miyamoto N, Kawaguchi T, Shimada K, Ohkawa S, Uemura T, Yoshikawa T, Mori E (2008) Clinical impact of the callosal angle in the diagnosis of idiopathic normal pressure hydrocephalus. Eur Radiol 18:2678–2683CrossRefGoogle Scholar
  13. 13.
    Ishii K, Kawaguchi T, Shimada K, Ohkawa S, Miyamoto N, Kanda T, Uemura T, Yoshikawa T, Mori E (2008) Voxel-based analysis of gray matter and CSF space in idiopathic normal pressure hydrocephalus. Dement Geriatr Cogn Disord 25:329–335CrossRefGoogle Scholar
  14. 14.
    Yamashita F, Sasaki M, Saito M, Mori E, Kawaguchi A, Kudo K, Natori T, Uwano I, Ito K, Saito K (2014) Voxel-based morphometry of disproportionate cerebrospinal fluid space distribution for the differential diagnosis of idiopathic normal pressure hydrocephalus. J Neuroimaging 24:359–365CrossRefGoogle Scholar
  15. 15.
    Ishii K, Hashimoto M, Hayashida K, Hashikawa K, Chang CC, Nakagawara J, Nakayama T, Mori S, Sakakibara R (2011) A multicenter brain perfusion SPECT study evaluating idiopathic normal-pressure hydrocephalus on neurological improvement. Dement Geriatr Cogn Disord 32:1–10CrossRefGoogle Scholar
  16. 16.
    Ishii K, Yamaji S, Kitagaki H, Imamura T, Hirono N, Mori E (1999) Regional cerebral blood flow difference between dementia with Lewy bodies and AD. Neurology 53:413–416CrossRefGoogle Scholar

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

Personalised recommendations