Relationship between cognitive profile and neuroradiographic parameters in patients with idiopathic normal pressure hydrocephalus

Shahrzad Mortazavi; Ghazaleh Jamalipour Soufi; Fatemeh Rajabi; Sahar Akbaripour; Mohammad Reza Maracy; Majid Barekatain

doi:10.18502/cjn.v21i3.11111

Shahrzad Mortazavi Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Ghazaleh Jamalipour Soufi Department of Radiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Fatemeh Rajabi Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
Sahar Akbaripour Kashani Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
Mohammad Reza Maracy Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
Majid Barekatain Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

DOI: https://doi.org/10.18502/cjn.v21i3.11111

Keywords: Hydrocephalus; Normal Pressure; Cognition; Linear Model; Magnetic Resonance Imaging

Abstract

Background: Normal pressure hydrocephalus (NPH) is a reversible type of dementia, which affects 0.2 to 5.9 percent of elders. It manifests with triad of gait disturbances, urinary incontinence, and cognitive decline. In this study, association between cognitive and neuroradiographic parameters of idiopathic NPH (iNPH) was appraised to find out possible biomarkers for preventive intervention.

Methods: In a cross-sectional study, 16 patients with iNPH were evaluated for third and fourth ventricle diameter, diameter of temporal horn of lateral ventricle, Evans index (EI), callosal angle (CA), callosal bowing, and ballooning of frontal horn. The Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) was used to take cognitive profile. Relation between brain magnetic resonance imaging (MRI) indices and cognitive domains was extracted, using generalized linear model (GLM).

Results: Patients with mild callosal bowing had better function in memory (P = 0.050) and language (P = 0.001) than those with moderate to severe callosal bowing. Negative or mild ballooning of frontal horn was also associated with higher scores in memory (P = 0.010), executive function (EF) (P = 0.029), and language (P = 0.036) than moderate to severe ballooning of frontal horn. Increased 3^rd ventricle diameter was associated with decline in total cognition (P = 0.008), memory (P = 0.019), EF (P = 0.012), and language (P = 0.001). Relation between other radiographic indices and cognitive function was not significant.

Conclusion: Third ventricular diameter, rounding of frontal horn of lateral ventricle, and callosal bowing are more accurate neuroradiographic parameters to predict cognitive decline in iNPH.