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Distinct cerebral cortical microstructural changes in idiopathic normal-pressure hydrocephalus.
Myong Hun Hahm1, Shin Young Jeong2, Suhyun Kim3
1Department of Radiology, Daekyung Imaging Center, Daegu, Republic of Korea.
Frontiers in Neurology
|August 29, 2025
Summary
Idiopathic normal-pressure hydrocephalus (INPH) patients show distinct cortical mean diffusivity (MD) patterns compared to Alzheimer
Area of Science:
- Neuroimaging
- Neurology
- Medical Diagnostics
Background:
- Idiopathic normal-pressure hydrocephalus (INPH) and Alzheimer's disease (AD) are common neurodegenerative conditions in the elderly.
- Distinguishing between INPH and AD is crucial for appropriate treatment and patient management.
- Cortical microstructural changes, detectable via diffusion tensor imaging (DTI), may offer differential diagnostic markers.
Purpose of the Study:
- To investigate differences in cortical mean diffusivity (MD) between INPH patients, AD patients, and healthy controls.
- To identify specific cortical regions with altered MD in INPH that can differentiate it from AD.
- To evaluate the diagnostic performance of these MD changes in distinguishing INPH from AD.
Main Methods:
- MRI including DTI was performed on 42 INPH patients, 51 AD patients, and 23 healthy controls.
- Surface-based analysis was used to examine cortical MD across the entire brain.
- Specific regions of interest (ROIs) were defined based on observed MD alterations in INPH patients.
Main Results:
- INPH patients exhibited reduced MD in frontal, parietal, and occipital convexity regions (INPH MD LOW ROI) compared to controls.
- INPH patients showed increased MD in frontal and temporal cortical regions (INPH MD HIGH ROI) compared to controls.
- Mean MD in the INPH MD LOW ROI effectively differentiated INPH from AD with an AUC of 0.857.
Conclusions:
- Distinct patterns of cortical MD changes are present in INPH patients.
- Cortical regions with reduced MD can distinguish INPH from AD with good accuracy.
- Assessing microstructural integrity through cortical MD may aid in differentiating INPH and AD in elderly individuals.
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