Abstract
Background
Progressive supranuclear palsy (PSP) patients can show ventricular enlargement mimicking normal pressure hydrocephalus (NPH). The aim of this study was to distinguish PSP patients with marked ventricular dilatation (PSP-vd) from those with normal ventricular system and to evaluate the coexistence of NPH in PSP-vd patients.
Methods
One hundred three probable PSP patients, 18 definite NPH patients, and 41 control subjects were enrolled in the study. Evans index (EI) > 0.32 associated with callosal angle (CA) < 100° was used to identify PSP-vd patients. Automated ventricular volumetry (AVV) and Magnetic Resonance Hydrocephalic Index (MRHI) were performed on T1-weighted MR images to evaluate the presence of NPH in PSP-vd patients.
Results
Twelve (11.6%) out of 103 PSP patients had both abnormal EI and CA values (PSP-vd). In two of these 12 patients, AVV and MRHI values suggested PSP + NPH. In the remaining 10 PSP-vd patients, AVV and MRHI values were higher than PSP patients with normal ventricular system and controls, but lower than PSP + NPH and NPH patients, suggesting a non-hydrocephalic ventricular enlargement.
Discussion
Our study provides evidence that the combination of EI and CA biomarkers allowed to identify PSP patients with marked ventricular dilatation mimicking NPH. Only a few of these patients had PSP + NPH. Recognition of these PSP patients with enlarged ventricles can positively impact the care of this disease, helping clinicians to identify patients with PSP + NPH who could benefit from shunt procedure and avoid surgery in those with enlarged ventricles without NPH.
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Data availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
Code availability
Not applicable.
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Andrea Quattrone and Aldo Quattrone contributed to the study conception and design. All authors contributed to the data collection and analysis. The first draft of the manuscript was written by Andrea Quattrone. All authors revised the article critically for intellectual content and approved the final version of the manuscript to be submitted.
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This study was performed in line with the principles of the Declaration of Helsinki. All study procedures and ethical aspects were approved by the institutional review board of Magna Graecia University, Catanzaro, Italy.
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Quattrone, A., Sarica, A., La Torre, D. et al. Progressive supranuclear palsy with marked ventricular dilatation mimicking normal pressure hydrocephalus. Neurol Sci 43, 1783–1790 (2022). https://doi.org/10.1007/s10072-021-05594-4
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DOI: https://doi.org/10.1007/s10072-021-05594-4