Abstract
When considering the underlying pathophysiological mechanisms involved in idiopathic
normal pressure hydrocephalus (iNPH), white matter is often the main locus of investigation.
However, when an axon in the brain is damaged, degeneration of the neuron can occur
proximally (dying back) and Alzheimer's disease (AD), associated with cortical thinning,
is a common pathologic comorbidity with iNPH. We investigated differences in cortical
thickness between CSF tap test (CSFTT) responders and non-responders in iNPH patients
and compared patterns of cortical thickness in iNPH patients with that of AD patients.
Thirty-two iNPH patients (16 CSFTT responders and 16 CSFTT non-responders) and 16
AD patients were imaged with MRI, including 3-dimensional volumetric images for cortical
thickness analysis across the entire brain. Among the iNPH patients, CSFTT non-responders,
when compared to responders, had statistically significant cortical thinning in the
left superior frontal gyrus at the level of a false discovery rate (FDR) p < 0.05, and tended to show widespread cortical thinning in most areas of the brain.
Relative to the CSFTT responders, AD patients showed statistically significant cortical
thinning in superior and medial frontal gyrus, left precentral gyrus, postcentral
gyrus, paracentral lobule, precuneus, and superior parietal lobule after FDR correction
(p < 0.05). However, comparing patterns of cortical thinning between AD patients and CSFTT
non-responders revealed no statistically significant differences. Differences in cortical
thickness correlated with CSFTT response for iNPH patients may indicate a possibility
for considering patterns of cortical thinning in patients with ventriculomegaly as
potential brain imaging markers for the prediction of CSFTT responders. And, our findings
suggest that comorbid AD pathology might be related to the cortical thinning patterns
found in CSFTT non-responders. Larger studies, using normal controls and combinations
of other biomarkers associated with AD, would be necessary to evaluate these hypotheses.
Keywords
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Article info
Publication history
Published online: August 12, 2013
Accepted:
July 20,
2013
Received in revised form:
July 7,
2013
Received:
May 6,
2013
Identification
Copyright
© 2013 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
