Structural correlates of cognitive impairment in normal pressure hydrocephalus.
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Authors
Mole, Tom B
Keong, Nicole CH
DeVito, Elise E
Savulich, George
Pickard, John D
Sahakian, Barbara J
Publication Date
2019-03Journal Title
Acta Neurol Scand
ISSN
0001-6314
Publisher
Hindawi Limited
Volume
139
Issue
3
Pages
305-312
Language
eng
Type
Article
This Version
VoR
Physical Medium
Print-Electronic
Metadata
Show full item recordCitation
Peterson, K. A., Mole, T. B., Keong, N. C., DeVito, E. E., Savulich, G., Pickard, J. D., & Sahakian, B. J. (2019). Structural correlates of cognitive impairment in normal pressure hydrocephalus.. Acta Neurol Scand, 139 (3), 305-312. https://doi.org/10.1111/ane.13052
Abstract
OBJECTIVES: The pathological bases for the cognitive and neuropsychiatric symptoms in normal pressure hydrocephalus (NPH) have not been elucidated. However, the symptoms may indicate dysfunction of subcortical regions. Previously, volume reductions of subcortical deep grey matter (SDGM) structures have been observed in NPH patients. The present study used automated segmentation methods to investigate whether SDGM structure volumes are associated with cognitive and neuropsychiatric measures. METHODS: Fourteen NPH patients and eight healthy controls were included in the study. Patients completed neuropsychological tests of general cognition, verbal learning and memory, verbal fluency and measures of apathy and depression pre- and postshunt surgery. Additionally, patients underwent 3 Tesla T1-weighted magnetic resonance imaging at baseline and 6 months postoperatively. Controls were scanned once. SDGM structure volumes were estimated using automated segmentation (FSL FIRST). Since displacement of the caudate nuclei occurred for some patients due to ventriculomegaly, patient caudate volumes were also estimated using manual tracing. Group differences in SDGM structure volumes were investigated, as well as associations between volumes and cognitive and neuropsychiatric measures in patients. RESULTS: Volumes of the caudate, thalamus, putamen, pallidum, hippocampus and nucleus accumbens (NAcc) were significantly reduced in the NPH patients compared to controls. In the NPH group, smaller caudate and NAcc volumes were associated with poorer performance on neuropsychological tests and increased severity of neuropsychiatric symptoms, while reduced volume of the pallidum was associated with better performance on the MMSE and reduced apathy. CONCLUSIONS: Striatal volume loss appears to be associated with cognitive and neuropsychiatric changes in NPH.
Keywords
Brain, Humans, Hydrocephalus, Normal Pressure, Magnetic Resonance Imaging, Adult, Middle Aged, Female, Male, Cognitive Dysfunction
Sponsorship
National Institute for Health Research (NIHR) Brain Injury MedTech in vitro Diagnostic Co-operative based at Cambridge University Hospitals NHS Foundation Trust and University of Cambridge.
NIHR Biomedical Research Centre.
Funder references
Medical Research Council (G0001237)
Medical Research Council (G9439390)
Medical Research Council (G0600986)
Medical Research Council (G1000183)
Wellcome Trust (089589/Z/09/Z)
Medical Research Council (G0001354)
Identifiers
External DOI: https://doi.org/10.1111/ane.13052
This record's URL: https://www.repository.cam.ac.uk/handle/1810/286975
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