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Distinct cerebral cortical perfusion patterns in idiopathic normal-pressure hydrocephalus.

Kyunghun Kang1, Shin Young Jeong2, Ki-Su Park3

  • 1Department of Neurology, School of Medicine, Kyungpook National University, Daegu, South Korea.

Human Brain Mapping
|September 14, 2022
PubMed
Summary

Idiopathic normal-pressure hydrocephalus (INPH) patients show altered cerebral blood flow (CBF) and cortical thickness. Hyperperfusion in INPH correlates with cortical thickening, suggesting unique disease mechanisms.

Keywords:
cerebral blood flowidiopathic normal-pressure hydrocephalusmagnetic resonance imagingpositron emission tomography

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Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Medicine

Background:

  • Idiopathic normal-pressure hydrocephalus (INPH) is a neurological disorder characterized by gait disturbance, cognitive decline, and urinary dysfunction.
  • Cerebral blood flow (CBF) and cortical thickness alterations are implicated in INPH pathophysiology, but their precise relationship remains unclear.

Purpose of the Study:

  • To evaluate cerebral blood flow (CBF) abnormalities in INPH patients.
  • To investigate the relationship between CBF and cortical thickness in INPH.
  • To explore distinct pathophysiologic mechanisms in INPH.

Main Methods:

  • Surface-based early-phase 18F-florbetaben (E-FBB) PET analysis was used to assess cortical CBF in 39 INPH patients and 20 healthy controls.
  • MRI-based automated surface-based cortical thickness analysis was performed on all participants.
  • A subgroup also underwent 18F-fluorodeoxyglucose (FDG) PET imaging for metabolic correlation.

Main Results:

  • INPH patients exhibited significant hyperperfusion in frontal and parietal cortical regions compared to controls.
  • Increased perfusion in INPH correlated with cortical thickening in these hyperperfused areas.
  • Hypoperfusion was observed in ventrolateral frontal, supramarginal, and temporal regions, but without associated cortical thinning.

Conclusions:

  • Distinct regional relationships between cerebral cortical perfusion and thickness exist in INPH patients.
  • Findings suggest separate pathophysiologic mechanisms underlie hyperperfusion and hypoperfusion in INPH.
  • Altered CBF patterns and their association with cortical morphology offer insights into INPH.