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Front Aging Neurosci 2022 30;14:904194. Epub 2022 May 30.

Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden.

Two of the main features of idiopathic normal pressure hydrocephalus (iNPH) are disturbed gait and cognition. These features are typically investigated separately, but here we combined walking with a cognitive task to investigate if older adults with iNPH were more susceptible to dual-task interference on walking than those without iNPH. In total, 95 individuals from the general population participated in our study. Read More

Front Neurol 2022 27;13:810116. Epub 2022 May 27.

Midorigaoka Hoyoen Hospital, Oita, Japan.

Objective: Treatment of idiopathic normal-pressure hydrocephalus (iNPH) requires collaboration between dementia specialists and neurosurgeons. The role of dementia specialists is to differentiate patients with iNPH from patients with other dementia diseases and to determine if other dementia diseases are comorbid with iNPH. We conducted a nationwide hospital-based questionnaire survey on iNPH in medical centers for dementia (MCDs). Read More

Neurobiol Dis 2022 Aug 25;170:105776. Epub 2022 May 25.

Brain Health Imaging Institute, Department of Radiology, Weill Cornell Medicine, New York, NY, USA. Electronic address:

Cerebrospinal fluid (CSF), predominantly produced in the ventricles and circulating throughout the brain and spinal cord, is a key protective mechanism of the central nervous system (CNS). Physical cushioning, nutrient delivery, metabolic waste, including protein clearance, are key functions of the CSF in humans. CSF volume and flow dynamics regulate intracranial pressure and are fundamental to diagnosing disorders including normal pressure hydrocephalus, intracranial hypotension, CSF leaks, and possibly Alzheimer's disease (AD). Read More

J Clin Med 2022 May 20;11(10). Epub 2022 May 20.

1st Department of Neurology, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, 74 Vass. Sophias Ave., 11528 Athens, Greece.

The aim of the present study was the implementation of the composite imaging "Radscale" in patients with idiopathic normal pressure hydrocephalus (iNPH) and the evaluation of its score, as well as absolute stroke volume and peak flow velocity of cerebrospinal fluid (CSF) in aqueduct as indicators of a positive response following a tap test. Forty-five patients with iNPH were included. Clinical evaluation involved the 10 m timed walk test before and every 24 h for 3 consecutive days after evacuative lumbar puncture (LP). Read More

Fluids Barriers CNS 2022 May 23;19(1):35. Epub 2022 May 23.

Department of Medical Sciences, Neurology, Uppsala University, Uppsala, Sweden.

Introduction: White matter changes (WMC) on brain imaging can be classified as deep white matter hyperintensities (DWMH) or periventricular hyperintensities (PVH) and are frequently seen in patients with idiopathic normal pressure hydrocephalus (iNPH). Contradictory results have been reported on whether preoperative WMC are associated with outcome after shunt surgery in iNPH patients. The aim of this study was to investigate any association between DWMH and PVH and shunt outcome in patients with iNPH, using magnetic resonance volumetry. Read More

J Neurol 2022 May 22. Epub 2022 May 22.

Leenaards Memory Center, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Objective: To assess whether gait, neuropsychological, and multimodal MRI parameters predict short-term symptom reversal after cerebrospinal fluid (CSF) tap test in idiopathic normal pressure hydrocephalus (iNPH).

Methods: Thirty patients (79.3 ± 5. Read More

Cleft Palate Craniofac J 2022 May 20:10556656221100675. Epub 2022 May 20.

6595University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

Introduction: The squamosal suture (SQS) joins the temporal to the parietal bones bilaterally and is a poorly described site of craniosynostosis. SQS fusion is thought to occur as late as the fourth decade of life and beyond; however, we have incidentally noted its presence among our pediatric patients and hypothesize that it may occur earlier in life and more frequently than previously believed.

Methods: A retrospective review of imaging performed on pediatric patients was completed to identify patients with SQS synostosis. Read More

Clin Neurol Neurosurg 2022 Jul 4;218:107278. Epub 2022 May 4.

Division of Neuroradiology, Department of Radiology, University of Michigan, 1500 E Medical Center Dr, UH B2, Ann Arbor, MI 48109, USA.

Clinical management of patients with fragile X-associated tremor/ataxia syndrome (FXTAS) is a challenge, and there has been not an established treatment for FXTAS, which is now treated symptomatically. Diagnosis of coexistent idiopathic normal pressure hydrocephalus (iNPH) with FXTAS is also hard because clinical and imaging features can overlap between the FXTAS patients coexistent with and without iNPH. We present a 79-year-old male genetically diagnosed with FXTAS who was successfully treated by a shunt surgery and consequently diagnosed with iNPH, and suggest the management of coexistent iNPH with FXTAS when it is clinically suspicious. Read More

Eur Radiol 2022 Apr 30. Epub 2022 Apr 30.

Department of Radiology, The First Affiliated Hospital of Shenzhen University, Shenzhen University, Shenzhen Second People's Hospital, 3002 SunGang Road West, Shenzhen, 518035, Guangdong Province, China.

Objectives: To explore the value of structural neuroimaging in predicting the prognosis of shunt surgery for idiopathic normal-pressure hydrocephalus (iNPH) using two different standard semi-quantitative imaging scales.

Methods: A total of 47 patients with iNPH who underwent shunt surgery at our hospital between 2018 and 2020 were included in this study. The modified Rankin Scale (mRS) and iNPH grading scale (iNPHGS) were used to evaluate and quantify the clinical symptoms before and after shunt surgery. Read More

J Clin Neurosci 2022 Jul 29;101:16-20. Epub 2022 Apr 29.

Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea. Electronic address:

To investigate alterations in the periventricular gray-white matter ratio (GWR) on computed tomography (CT) in patients with idiopathic normal pressure hydrocephalus (INPH), a total of 140 patients with INPH and 52 age-and sex-matched controls were included by using Japanese guidelines published in 2021: possible, probable, and definite INPH for a retrospective case-control study. The non-enhanced brain CT was reviewed, and the Hounsfield unit (HU) was semi-quantitatively measured using the region of interest (ROI). The size (40 mm) and location of the ROI were standardized within the periventricular white matter (WM) and thalamus. Read More

J Neurol Sci 2022 Jun 20;437:120266. Epub 2022 Apr 20.

Division of Neurology and Clinical Neuroscience, Department of Internal Medicine III, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata 990-9585, Japan. Electronic address:

Background: Idiopathic normal pressure hydrocephalus (iNPH) is primarily characterized by cognitive impairment and gait disturbance. Our objective was to evaluate the clinical characteristics of iNPH and the association between cerebral blood flow (CBF), measured using single-photon emission computed tomography (SPECT), and both cognitive and gait disturbances in iNPH patients.

Methods: We compared cognitive and motor functions and neuroimaging findings between 29 iNPH patients and 35 age-matched Parkinson's disease (PD) patients. Read More

Eur Radiol 2022 Apr 29. Epub 2022 Apr 29.

CIMC - Centre d'Imagerie Médicale de Cornavin, Geneva, Switzerland.

Objectives: Established visual brain MRI markers for dementia include hippocampal atrophy (mesio-temporal atrophy MTA), white matter lesions (Fazekas score), and number of cerebral microbleeds (CMBs). We assessed whether novel quantitative, artificial intelligence (AI)-based volumetric scores provide additional value in predicting subsequent cognitive decline in elderly controls.

Methods: A prospective study including 80 individuals (46 females, mean age 73. Read More

Front Neurol 2022 6;13:857328. Epub 2022 Apr 6.

Department of Radiology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.

Idiopathic normal pressure hydrocephalus (iNPH) is a neurodegenerative disease, characterized by cerebrospinal fluid (CSF) flow disturbance. Today, the only available treatment is CSF diversion surgery (shunt surgery). While traditional imaging biomarkers typically assess CSF space anatomy, recently introduced imaging biomarkers of CSF dynamics and glymphatic enhancement, provide imaging of CSF dynamics and thereby more specifically reveal elements of the underlying pathophysiology. Read More

No Shinkei Geka 2022 Mar;50(2):319-330

Department of Neurology, Kyoto Prefectural University of Medicine.

There are a variety of neurodegenerative diseases that require differentiation from idiopathic normal pressure hydrocephalus(iNPH), including Alzheimer's disease, Parkinson's disease, dementia with Lewy bodies, frontotemporal dementia, progressive supranuclear palsy, and corticobasal degeneration. As the clinical features and structural imaging findings of these diseases may overlap with iNPH, biomarkers reflecting disease-specific pathology are necessary for differential diagnosis. In addition, these diseases often coexist with iNPH in elderly patients, and it is important to confirm the coexistence of their pathology even in cases clinically diagnosed as iNPH. Read More

No Shinkei Geka 2022 Mar;50(2):309-317

Department of Neurology and Clinical Neuroscience, Faculty of Medicine, Yamagata University.

Several cohort studies in Japan have revealed that the prevalence of idiopathic normal pressure hydrocephalus(iNPH)is around 1.6% among the elderly population(≧ 50 years old). The incidence of iNPH from the Yamagata(Takahata)cohort was 1. Read More

No Shinkei Geka 2022 Mar;50(2):298-308

Department of Neurosurgery, Faculty of Medicine, Juntendo University.

In aging societies, idiopathic normal-pressure hydrocephalus(iNPH)has emerged as an important disease that can negatively affect the activities of daily living among the elderly. Evidence supporting diagnosis and treatment has accumulated and, in Japan, the third edition of the iNPH treatment guideline was published in 2020. Through the promotion of multi-facility research efforts in Japan, diagnosis of iNPH has been based on characteristic phenomena including gait disturbance, overactive bladder, cognitive impairment, and disproportionately enlarged subarachnoid space hydrocephalus(DESH). Read More

Front Vet Sci 2022 23;9:828083. Epub 2022 Mar 23.

Department of Neurology and Neurosurgery, Southfields Veterinary Specialists, Essex, United Kingdom.

A 14-year-old male neutered domestic short-hair cat was presented for a history of behavioral changes and episodes of urinary retention. Neurological examination was consistent with a multifocal intracranial neuroanatomical localization, with suspected right sided lateralisation and suspected raised intracranial pressure (ICP). Brain magnetic resonance imaging (MRI) revealed an intraventricular multilobulated well-defined T2W-hyperintense and T1W-isointense, markedly contrast enhancing mass lesion within the dorsal aspect of the III ventricle extending into the left lateral ventricle, causing hypertensive obstructive hydrocephalus. Read More

Clin Neuroradiol 2022 Apr 7. Epub 2022 Apr 7.

Department of Neurology, University Medical Center Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Germany.

Purpose: The diagnosis of idiopathic normal pressure hydrocephalus (iNPH) can be challenging. Aim of this study was to use a novel T1 mapping method to enrich the diagnostic work-up of patients with suspected iNPH.

Methods: Using 3T magnetic resonance imaging (MRI) we prospectively evaluated rapid high-resolution T1 mapping at 0. Read More

Neurosurg Focus 2022 04;52(4):E6

1Department of Neurosurgery, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague.

Objective: Phase-contrast MRI allows detailed measurements of various parameters of CSF motion. This examination is technically demanding and machine dependent. The literature on this topic is ambiguous. Read More

J Cereb Blood Flow Metab 2022 Mar 29:271678X221090747. Epub 2022 Mar 29.

Department of Neurosurgery, Oslo University Hospital - Rikshospitalet, Oslo, Norway.

Chronic sleep disturbance is a risk factor for dementia disease, possibly due to impaired sleep-dependent clearance of toxic metabolic by-products. We compared enrichment of a cerebrospinal fluid (CSF) tracer within brain of patients reporting good or poor sleep quality, assessed by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Tracer enrichment in a selection of brain regions was assessed using multiphase magnetic resonance imaging up to 48 hours after intrathecal administration of the contrast agent gadobutrol (0. Read More

Zhonghua Yi Xue Za Zhi 2022 Mar;102(11):774-780

Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China.

To explore the relationship between white matter lesions and clinical features and response of cerebral spinal fluid (CSF) tap test in patients with idiopathic normal pressure hydrocephalus(iNPH). Possible iNPH patients were enrolled from outpatients and inpatients in Peking Union Medical College Hospital between 2014 and 2019. All patients underwent detailed neuropsychological and walking assessments, CSF tap test, as well as head magnetic resonance imaging. Read More

Neurol Res 2022 Mar 17:1-7. Epub 2022 Mar 17.

Neurology Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.

Background: The occurrence of neurodegenerative disease in patients with normal pressure hydrocephalus (NPH) is emphasized in recent reports. Based on this common co-occurrence, some of the hydrocephalic disorders appearing in late adulthood have been hypothesized to result from initially unapparent parenchymal abnormalities of neurodegenerative origin. Among these diseases, progressive supranuclear palsy (PSP) has been specifically remarked on. Read More

Front Neurol 2022 28;13:843883. Epub 2022 Feb 28.

Department of Radiology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan.

Background: The aim of this study was to evaluate the water diffusivity changes along the perivascular space after lumboperitoneal shunt (LPS) surgery in idiopathic normal pressure hydrocephalus.

Methods: Nine patients diagnosed with idiopathic normal pressure hydrocephalus (iNPH; three men and six women, mean age ± SD = 75.22 ± 5. Read More

Front Aging Neurosci 2022 23;14:797803. Epub 2022 Feb 23.

Department of Radiology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.

This study investigated the relationship between preoperative cerebral blood flow (CBF) in patients with idiopathic normal pressure hydrocephalus (INPH) and preoperative clinical symptoms and changes of clinical symptoms after shunt surgery. A total of 32 patients with diagnosed INPH and 18 age-matched healthy controls (HCs) were involved in this study. All subjects underwent magnetic resonance imaging (MRI), including 3D pulsed arterial-spin labeling (PASL) for non-invasive perfusion imaging, and clinical symptom evaluation at baseline, and all patients with INPH were reexamined with clinical tests 1 month postoperatively. Read More

Neurol India 2022 Jan-Feb;70(1):377-379

Department of Neurology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India.

Neurosyphilis, a chronic infection of the nervous system by Treponema pallidum can present in all stages of syphilis. Recently, it is found that neurosyphilis presents with novel manifestations. Here, we report a young patient who had neurosyphilis presenting as Normal Pressure Hydrocephalus (NPH) with bilateral optic atrophy. Read More

Fluids Barriers CNS 2022 Mar 5;19(1):20. Epub 2022 Mar 5.

Department of Anesthesiology, Yale School of Medicine, New Haven, CT, USA.

Background: Hydrocephalus (increased ventricular size due to CSF accumulation) is a common finding in human ciliopathies and in mouse models with genetic depletion of the multiciliated cell (MCC) cilia machinery. However, the contribution of MCC to CSF dynamics and, the mechanism by which impaired MCC function leads to hydrocephalus remains poorly understood. The aim of our study was to examine if defects in MCC ciliogenesis and cilia-generated CSF flow impact central nervous system (CNS) fluid homeostasis including glymphatic transport and solute waste drainage. Read More

BMC Infect Dis 2022 Mar 3;22(1):216. Epub 2022 Mar 3.

Hospital Universitário Walter Cantídio, Universidade Federal do Ceará, Fortaleza, Brazil.

Background: COVID-19 is a pandemic disease responsible for many deaths worldwide. Many neurological manifestations have been described. We report a case of normal pressure hydrocephalus (NPH) 2 months after acute COVID19 infection, in a patient without other risk factors. Read More

Tzu Chi Med J 2022 Jan-Mar;34(1):35-43. Epub 2021 Apr 19.

Department of Neurosurgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation and Tzu Chi University, Hualien, Taiwan.

Idiopathic normal pressure hydrocephalus (iNPH), albeit characterized by gait impairment, cognitive decline, and urinary incontinence, in clinical diagnosis is poorly defined and is usually coexistent with other neurodegenerative diseases. Surgical operation with shunt implantation is the primary treatment but leads to variable outcomes. Recent studies demonstrated that the pathophysiology of iNPH may include both preceding cerebrovascular events and concomitant Alzheimer's dementia or dopaminergic degenerative neuropathology in patients' brain. Read More

Neural Comput Appl 2022 Feb 24:1-10. Epub 2022 Feb 24.

Royal Brompton Hospital, London, UK.

Based on CT and MRI images acquired from normal pressure hydrocephalus (NPH) patients, using machine learning methods, we aim to establish a multimodal and high-performance automatic ventricle segmentation method to achieve an efficient and accurate automatic measurement of the ventricular volume. First, we extract the brain CT and MRI images of 143 definite NPH patients. Second, we manually label the ventricular volume (VV) and intracranial volume (ICV). Read More

PLoS One 2022 28;17(2):e0264395. Epub 2022 Feb 28.

Lavrentyev Institute of Hydrodynamics of the Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia.

This paper describes the effects of the interaction of cerebral fluids (arterial, capillary and venous blood, cerebrospinal fluid) on ventricular wall displacement and periventricular pressure using a mathematical multiphase poroelasticity model for the cerebral parenchyma. The interaction of cerebral fluids is given by a set of four numerical coefficients. A multiple linear regression with interaction is constructed that allows us to quantify the effect of these coefficients on the average ventricular wall displacement. Read More