Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus
Background Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investi...
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| Veröffentlicht in: | Journal of neurology 2025-01, Vol.272 (1), p.56, Article 56 |
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| creator | Hasegawa, Shinya Yoshimaru, Daisuke Hayashi, Norio Shibukawa, Shuhei Takagi, Mika Murai, Hisayuki |
| description | Background
Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investigate the relationship among the ALPS index, white matter changes, and clinical symptoms in patients with iNPH.
Methods
We calculated the ALPS index in 30 patients with iNPH, aged 70 and above, using DTI data and correlated it with various clinical and imaging indices, including the Evans index, callosal angle, cognitive tests, gait assessment (timed up-and-go [TUG] test), cerebrospinal fluid (CSF) medullary pressure, and various DTI indices (axial diffusivity [AD], radial diffusivity [RD], mean diffusivity [MD], fractional anisotropy [FA]).
Results
Significant negative correlations were observed between the ALPS index and the rate of change in step count in the TUG test after the tap test (
r
= −0.5014,
p
= 0.0048), as well as CSF medullary pressure (
r
= −0.4651,
p
= 0.0096). Positive correlations were identified between the ALPS index and both AD (
r
= 0.4984,
p
= 0.0051) and MD (
r
= 0.3631,
p
= 0.0486).
Conclusion
A lower ALPS index was associated with gait improvement following the tap test as well as higher CSF medullary pressure. The ALPS index may detect subtle periventricular compression-induced changes in iNPH. Consequently, it could potentially serve as a predictor for tap test effectiveness in patients with iNPH, offering a new perspective on its application in iNPH diagnosis and treatment. |
| doi_str_mv | 10.1007/s00415-024-12850-y |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3146653445</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3143458397</sourcerecordid><originalsourceid>FETCH-LOGICAL-c2073-61fd63df503a1db0b2ee34e3e7bb39c74eefcd1a5ea5fb0391495a33cf5b1fcf3</originalsourceid><addsrcrecordid>eNp9kc1u1DAUhS0EotOfF2CBLLFhE2rHdjJZVhVQpEpsyjpy7OuJq4wdfGMgvBovh5kZQGLBxpZ1vnOPrg8hLzh7wxlrr5ExyVXFalnxeqtYtT4hGy5FXXGpuqdkw4RklRJKnpFzxEfG2LYIz8mZ6JqmYW29IT9ugp7W7z7s6DICTTDpxceAo5_pAMtXgEBxBuOdN3RI2pfnkrJZctITNaMOO0Cqgz3YrXcuY_HTBQLGRP1e76DIJQN94aZ4Cpoh-S8aTZ50KgHaAPXBwrdyUm99nPUylsQQ077kzAkQcwI6rjZFA_Oop4yX5JnTE8LV6b4gn969fbi9q-4_vv9we3NfmZq1omq4s42wTjGhuR3YUAMICQLaYRCdaSWAM5ZrBVq5gYmOy05pIYxTA3fGiQvy-jh3TvFzBlz6vUcD06QDxIy94LJplJBSFfTVP-hjzKmsf6CEVFvRtYWqj5RJETGB6-dUfiqtPWf9r2r7Y7V9qbY_VNuvxfTyNDoPe7B_LL-7LIA4AlikUkv6m_2fsT8BisW2Bg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3143458397</pqid></control><display><type>article</type><title>Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus</title><source>MEDLINE</source><source>Springer Online Journals</source><creator>Hasegawa, Shinya ; Yoshimaru, Daisuke ; Hayashi, Norio ; Shibukawa, Shuhei ; Takagi, Mika ; Murai, Hisayuki</creator><creatorcontrib>Hasegawa, Shinya ; Yoshimaru, Daisuke ; Hayashi, Norio ; Shibukawa, Shuhei ; Takagi, Mika ; Murai, Hisayuki</creatorcontrib><description>Background
Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investigate the relationship among the ALPS index, white matter changes, and clinical symptoms in patients with iNPH.
Methods
We calculated the ALPS index in 30 patients with iNPH, aged 70 and above, using DTI data and correlated it with various clinical and imaging indices, including the Evans index, callosal angle, cognitive tests, gait assessment (timed up-and-go [TUG] test), cerebrospinal fluid (CSF) medullary pressure, and various DTI indices (axial diffusivity [AD], radial diffusivity [RD], mean diffusivity [MD], fractional anisotropy [FA]).
Results
Significant negative correlations were observed between the ALPS index and the rate of change in step count in the TUG test after the tap test (
r
= −0.5014,
p
= 0.0048), as well as CSF medullary pressure (
r
= −0.4651,
p
= 0.0096). Positive correlations were identified between the ALPS index and both AD (
r
= 0.4984,
p
= 0.0051) and MD (
r
= 0.3631,
p
= 0.0486).
Conclusion
A lower ALPS index was associated with gait improvement following the tap test as well as higher CSF medullary pressure. The ALPS index may detect subtle periventricular compression-induced changes in iNPH. Consequently, it could potentially serve as a predictor for tap test effectiveness in patients with iNPH, offering a new perspective on its application in iNPH diagnosis and treatment.</description><identifier>ISSN: 0340-5354</identifier><identifier>ISSN: 1432-1459</identifier><identifier>EISSN: 1432-1459</identifier><identifier>DOI: 10.1007/s00415-024-12850-y</identifier><identifier>PMID: 39666072</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Aged ; Aged, 80 and over ; Anisotropy ; Brain - diagnostic imaging ; Brain - pathology ; Brain - physiopathology ; Cerebrospinal fluid ; Compression ; Diffusion Tensor Imaging ; Female ; Gait ; Glymphatic System - diagnostic imaging ; Glymphatic System - physiopathology ; Humans ; Hydrocephalus ; Hydrocephalus, Normal Pressure - diagnostic imaging ; Hydrocephalus, Normal Pressure - physiopathology ; Image processing ; Male ; Medicine ; Medicine & Public Health ; Neuroimaging ; Neurology ; Neuroradiology ; Neurosciences ; Original Communication ; Patients ; Pressure ; Substantia alba ; White Matter - diagnostic imaging ; White Matter - pathology</subject><ispartof>Journal of neurology, 2025-01, Vol.272 (1), p.56, Article 56</ispartof><rights>Springer-Verlag GmbH Germany, part of Springer Nature 2024 Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.</rights><rights>2024. Springer-Verlag GmbH Germany, part of Springer Nature.</rights><rights>Copyright Springer Nature B.V. Jan 2025</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2073-61fd63df503a1db0b2ee34e3e7bb39c74eefcd1a5ea5fb0391495a33cf5b1fcf3</cites><orcidid>0009-0000-1144-6284</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00415-024-12850-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00415-024-12850-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27923,27924,41487,42556,51318</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39666072$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hasegawa, Shinya</creatorcontrib><creatorcontrib>Yoshimaru, Daisuke</creatorcontrib><creatorcontrib>Hayashi, Norio</creatorcontrib><creatorcontrib>Shibukawa, Shuhei</creatorcontrib><creatorcontrib>Takagi, Mika</creatorcontrib><creatorcontrib>Murai, Hisayuki</creatorcontrib><title>Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus</title><title>Journal of neurology</title><addtitle>J Neurol</addtitle><addtitle>J Neurol</addtitle><description>Background
Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investigate the relationship among the ALPS index, white matter changes, and clinical symptoms in patients with iNPH.
Methods
We calculated the ALPS index in 30 patients with iNPH, aged 70 and above, using DTI data and correlated it with various clinical and imaging indices, including the Evans index, callosal angle, cognitive tests, gait assessment (timed up-and-go [TUG] test), cerebrospinal fluid (CSF) medullary pressure, and various DTI indices (axial diffusivity [AD], radial diffusivity [RD], mean diffusivity [MD], fractional anisotropy [FA]).
Results
Significant negative correlations were observed between the ALPS index and the rate of change in step count in the TUG test after the tap test (
r
= −0.5014,
p
= 0.0048), as well as CSF medullary pressure (
r
= −0.4651,
p
= 0.0096). Positive correlations were identified between the ALPS index and both AD (
r
= 0.4984,
p
= 0.0051) and MD (
r
= 0.3631,
p
= 0.0486).
Conclusion
A lower ALPS index was associated with gait improvement following the tap test as well as higher CSF medullary pressure. The ALPS index may detect subtle periventricular compression-induced changes in iNPH. Consequently, it could potentially serve as a predictor for tap test effectiveness in patients with iNPH, offering a new perspective on its application in iNPH diagnosis and treatment.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Anisotropy</subject><subject>Brain - diagnostic imaging</subject><subject>Brain - pathology</subject><subject>Brain - physiopathology</subject><subject>Cerebrospinal fluid</subject><subject>Compression</subject><subject>Diffusion Tensor Imaging</subject><subject>Female</subject><subject>Gait</subject><subject>Glymphatic System - diagnostic imaging</subject><subject>Glymphatic System - physiopathology</subject><subject>Humans</subject><subject>Hydrocephalus</subject><subject>Hydrocephalus, Normal Pressure - diagnostic imaging</subject><subject>Hydrocephalus, Normal Pressure - physiopathology</subject><subject>Image processing</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Neuroimaging</subject><subject>Neurology</subject><subject>Neuroradiology</subject><subject>Neurosciences</subject><subject>Original Communication</subject><subject>Patients</subject><subject>Pressure</subject><subject>Substantia alba</subject><subject>White Matter - diagnostic imaging</subject><subject>White Matter - pathology</subject><issn>0340-5354</issn><issn>1432-1459</issn><issn>1432-1459</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc1u1DAUhS0EotOfF2CBLLFhE2rHdjJZVhVQpEpsyjpy7OuJq4wdfGMgvBovh5kZQGLBxpZ1vnOPrg8hLzh7wxlrr5ExyVXFalnxeqtYtT4hGy5FXXGpuqdkw4RklRJKnpFzxEfG2LYIz8mZ6JqmYW29IT9ugp7W7z7s6DICTTDpxceAo5_pAMtXgEBxBuOdN3RI2pfnkrJZctITNaMOO0Cqgz3YrXcuY_HTBQLGRP1e76DIJQN94aZ4Cpoh-S8aTZ50KgHaAPXBwrdyUm99nPUylsQQ077kzAkQcwI6rjZFA_Oop4yX5JnTE8LV6b4gn969fbi9q-4_vv9we3NfmZq1omq4s42wTjGhuR3YUAMICQLaYRCdaSWAM5ZrBVq5gYmOy05pIYxTA3fGiQvy-jh3TvFzBlz6vUcD06QDxIy94LJplJBSFfTVP-hjzKmsf6CEVFvRtYWqj5RJETGB6-dUfiqtPWf9r2r7Y7V9qbY_VNuvxfTyNDoPe7B_LL-7LIA4AlikUkv6m_2fsT8BisW2Bg</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Hasegawa, Shinya</creator><creator>Yoshimaru, Daisuke</creator><creator>Hayashi, Norio</creator><creator>Shibukawa, Shuhei</creator><creator>Takagi, Mika</creator><creator>Murai, Hisayuki</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0000-1144-6284</orcidid></search><sort><creationdate>20250101</creationdate><title>Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus</title><author>Hasegawa, Shinya ; Yoshimaru, Daisuke ; Hayashi, Norio ; Shibukawa, Shuhei ; Takagi, Mika ; Murai, Hisayuki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2073-61fd63df503a1db0b2ee34e3e7bb39c74eefcd1a5ea5fb0391495a33cf5b1fcf3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Anisotropy</topic><topic>Brain - diagnostic imaging</topic><topic>Brain - pathology</topic><topic>Brain - physiopathology</topic><topic>Cerebrospinal fluid</topic><topic>Compression</topic><topic>Diffusion Tensor Imaging</topic><topic>Female</topic><topic>Gait</topic><topic>Glymphatic System - diagnostic imaging</topic><topic>Glymphatic System - physiopathology</topic><topic>Humans</topic><topic>Hydrocephalus</topic><topic>Hydrocephalus, Normal Pressure - diagnostic imaging</topic><topic>Hydrocephalus, Normal Pressure - physiopathology</topic><topic>Image processing</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Neuroimaging</topic><topic>Neurology</topic><topic>Neuroradiology</topic><topic>Neurosciences</topic><topic>Original Communication</topic><topic>Patients</topic><topic>Pressure</topic><topic>Substantia alba</topic><topic>White Matter - diagnostic imaging</topic><topic>White Matter - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hasegawa, Shinya</creatorcontrib><creatorcontrib>Yoshimaru, Daisuke</creatorcontrib><creatorcontrib>Hayashi, Norio</creatorcontrib><creatorcontrib>Shibukawa, Shuhei</creatorcontrib><creatorcontrib>Takagi, Mika</creatorcontrib><creatorcontrib>Murai, Hisayuki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hasegawa, Shinya</au><au>Yoshimaru, Daisuke</au><au>Hayashi, Norio</au><au>Shibukawa, Shuhei</au><au>Takagi, Mika</au><au>Murai, Hisayuki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus</atitle><jtitle>Journal of neurology</jtitle><stitle>J Neurol</stitle><addtitle>J Neurol</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>272</volume><issue>1</issue><spage>56</spage><pages>56-</pages><artnum>56</artnum><issn>0340-5354</issn><issn>1432-1459</issn><eissn>1432-1459</eissn><abstract>Background
Diffusion Tensor Image Analysis Along the Perivascular Space (DTI-ALPS) evaluates the glymphatic system in patients with idiopathic normal-pressure hydrocephalus (iNPH). However, white matter compression due to ventricular enlargement may affect the ALPS index. This study aimed to investigate the relationship among the ALPS index, white matter changes, and clinical symptoms in patients with iNPH.
Methods
We calculated the ALPS index in 30 patients with iNPH, aged 70 and above, using DTI data and correlated it with various clinical and imaging indices, including the Evans index, callosal angle, cognitive tests, gait assessment (timed up-and-go [TUG] test), cerebrospinal fluid (CSF) medullary pressure, and various DTI indices (axial diffusivity [AD], radial diffusivity [RD], mean diffusivity [MD], fractional anisotropy [FA]).
Results
Significant negative correlations were observed between the ALPS index and the rate of change in step count in the TUG test after the tap test (
r
= −0.5014,
p
= 0.0048), as well as CSF medullary pressure (
r
= −0.4651,
p
= 0.0096). Positive correlations were identified between the ALPS index and both AD (
r
= 0.4984,
p
= 0.0051) and MD (
r
= 0.3631,
p
= 0.0486).
Conclusion
A lower ALPS index was associated with gait improvement following the tap test as well as higher CSF medullary pressure. The ALPS index may detect subtle periventricular compression-induced changes in iNPH. Consequently, it could potentially serve as a predictor for tap test effectiveness in patients with iNPH, offering a new perspective on its application in iNPH diagnosis and treatment.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39666072</pmid><doi>10.1007/s00415-024-12850-y</doi><orcidid>https://orcid.org/0009-0000-1144-6284</orcidid></addata></record> |
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| source | MEDLINE; Springer Online Journals |
| subjects | Aged Aged, 80 and over Anisotropy Brain - diagnostic imaging Brain - pathology Brain - physiopathology Cerebrospinal fluid Compression Diffusion Tensor Imaging Female Gait Glymphatic System - diagnostic imaging Glymphatic System - physiopathology Humans Hydrocephalus Hydrocephalus, Normal Pressure - diagnostic imaging Hydrocephalus, Normal Pressure - physiopathology Image processing Male Medicine Medicine & Public Health Neuroimaging Neurology Neuroradiology Neurosciences Original Communication Patients Pressure Substantia alba White Matter - diagnostic imaging White Matter - pathology |
| title | Analyzing the relationship between specific brain structural changes and the diffusion tensor image analysis along the perivascular space index in idiopathic normal pressure hydrocephalus |
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