Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus
Abstract Periventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to p...
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| Format: | Article |
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Nature Portfolio
2021-10-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-98054-0 |
| _version_ | 1818718893649166336 |
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| author | Alexander Rau Marco Reisert Elias Kellner Jonas A. Hosp Horst Urbach Theo Demerath |
| author_facet | Alexander Rau Marco Reisert Elias Kellner Jonas A. Hosp Horst Urbach Theo Demerath |
| author_sort | Alexander Rau |
| collection | DOAJ |
| description | Abstract Periventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to patients without. The hypothesis is that periventricular hyperintensities in patients with presumed iNPH show higher water content than in patients without imaging features of iNPH. 21 patients with iNPH Radscale 7–12 (“high probability of iNPH”) and 10 patients with iNPH Radscale 2–4 (“low probability of iNPH”) were examined with a neurodegeneration imaging protocol including a diffusion microstructure imaging sequence. Periventricular hyperintensities and deep white matter hyperintensities were segmented and diffusion measures were compared. In patients with imaging features of iNPH, the free water content in periventricular hyperintensities was significantly higher compared to the control group (p = 0.005). This effect was also detectable in deep white matter hyperintensities (p = 0.024). Total brain volumes and total gray or white matter volumes did not differ between the groups. Periventricular cap free water fraction was highly discriminative regarding patients with presumed iNPH and controls with an ROC AUC of 0.933. Quantitative diffusion microstructure imaging shows elevated water content in periventricular hyperintensities in patients with imaging features of iNPH, which could be the imaging correlate for pathologic fluid accumulation and may be used as an imaging biomarker in the future. |
| first_indexed | 2024-12-17T19:58:17Z |
| format | Article |
| id | doaj.art-197e8c301fdb4214ab1f0ac303ef072c |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-17T19:58:17Z |
| publishDate | 2021-10-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-197e8c301fdb4214ab1f0ac303ef072c2022-12-21T21:34:32ZengNature PortfolioScientific Reports2045-23222021-10-0111111010.1038/s41598-021-98054-0Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalusAlexander Rau0Marco Reisert1Elias Kellner2Jonas A. Hosp3Horst Urbach4Theo Demerath5Department of Neuroradiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgMedical Physics, Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgMedical Physics, Department of Radiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Neurology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Neuroradiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgDepartment of Neuroradiology, Medical Center – University of Freiburg, Faculty of Medicine, University of FreiburgAbstract Periventricular white matter changes are common in patients with idiopathic normal pressure hydrocephalus (iNPH) and considered to represent focally elevated interstitial fluid. We compared diffusion measures in periventricular hyperintensities in patients with imaging features of iNPH to patients without. The hypothesis is that periventricular hyperintensities in patients with presumed iNPH show higher water content than in patients without imaging features of iNPH. 21 patients with iNPH Radscale 7–12 (“high probability of iNPH”) and 10 patients with iNPH Radscale 2–4 (“low probability of iNPH”) were examined with a neurodegeneration imaging protocol including a diffusion microstructure imaging sequence. Periventricular hyperintensities and deep white matter hyperintensities were segmented and diffusion measures were compared. In patients with imaging features of iNPH, the free water content in periventricular hyperintensities was significantly higher compared to the control group (p = 0.005). This effect was also detectable in deep white matter hyperintensities (p = 0.024). Total brain volumes and total gray or white matter volumes did not differ between the groups. Periventricular cap free water fraction was highly discriminative regarding patients with presumed iNPH and controls with an ROC AUC of 0.933. Quantitative diffusion microstructure imaging shows elevated water content in periventricular hyperintensities in patients with imaging features of iNPH, which could be the imaging correlate for pathologic fluid accumulation and may be used as an imaging biomarker in the future.https://doi.org/10.1038/s41598-021-98054-0 |
| spellingShingle | Alexander Rau Marco Reisert Elias Kellner Jonas A. Hosp Horst Urbach Theo Demerath Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus Scientific Reports |
| title | Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| title_full | Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| title_fullStr | Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| title_full_unstemmed | Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| title_short | Increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| title_sort | increased interstitial fluid in periventricular and deep white matter hyperintensities in patients with suspected idiopathic normal pressure hydrocephalus |
| url | https://doi.org/10.1038/s41598-021-98054-0 |
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