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Kadaba Sridhar S, Dysterheft Robb J, Gupta R, Cheong S, Kuang R, Samadani U. Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer's dementia and Parkinson's disease, and hydrocephalus versus atrophy in chronic TBI-a narrative review. Front Neurol 2024; 15:1347200. [PMID: 38576534 PMCID: PMC10991762 DOI: 10.3389/fneur.2024.1347200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 02/07/2024] [Indexed: 04/06/2024] Open
Abstract
Introduction Normal Pressure Hydrocephalus (NPH) is a prominent type of reversible dementia that may be treated with shunt surgery, and it is crucial to differentiate it from irreversible degeneration caused by its symptomatic mimics like Alzheimer's Dementia (AD) and Parkinson's Disease (PD). Similarly, it is important to distinguish between (normal pressure) hydrocephalus and irreversible atrophy/degeneration which are among the chronic effects of Traumatic Brain Injury (cTBI), as the former may be reversed through shunt placement. The purpose of this review is to elucidate the structural imaging markers which may be foundational to the development of accurate, noninvasive, and accessible solutions to this problem. Methods By searching the PubMed database for keywords related to NPH, AD, PD, and cTBI, we reviewed studies that examined the (1) distinct neuroanatomical markers of degeneration in NPH versus AD and PD, and atrophy versus hydrocephalus in cTBI and (2) computational methods for their (semi-) automatic assessment on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans. Results Structural markers of NPH and those that can distinguish it from AD have been well studied, but only a few studies have explored its structural distinction between PD. The structural implications of cTBI over time have been studied. But neuroanatomical markers that can predict shunt response in patients with either symptomatic idiopathic NPH or post-traumatic hydrocephalus have not been reliably established. MRI-based markers dominate this field of investigation as compared to CT, which is also reflected in the disproportionate number of MRI-based computational methods for their automatic assessment. Conclusion Along with an up-to-date literature review on the structural neurodegeneration due to NPH versus AD/PD, and hydrocephalus versus atrophy in cTBI, this article sheds light on the potential of structural imaging markers as (differential) diagnostic aids for the timely recognition of patients with reversible (normal pressure) hydrocephalus, and opportunities to develop computational tools for their objective assessment.
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Affiliation(s)
- Sharada Kadaba Sridhar
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
- Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States
| | - Jen Dysterheft Robb
- Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States
| | - Rishabh Gupta
- Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States
- University of Minnesota Twin Cities Medical School, Minneapolis, MN, United States
| | - Scarlett Cheong
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
- Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States
| | - Rui Kuang
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, United States
| | - Uzma Samadani
- Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States
- Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States
- University of Minnesota Twin Cities Medical School, Minneapolis, MN, United States
- Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, United States
- Division of Neurosurgery, Department of Surgery, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
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Tanaka T, Iwashita H, Liu X, Momozaki N, Honda E, Matsuno A, Morimoto T. Prevalence of idiopathic normal pressure hydrocephalus in patients with vertebral compression fractures. Surg Neurol Int 2023; 14:429. [PMID: 38213459 PMCID: PMC10783668 DOI: 10.25259/sni_818_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 11/21/2023] [Indexed: 01/13/2024] Open
Abstract
Background Patients with idiopathic normal pressure hydrocephalus (iNPH) may be more prone to all fracture types due to falls. Vertebral compression fractures (VCFs) are a global burden that temporarily or permanently affects millions of elderly people. This study aimed to investigate the prevalence of iNPH in patients with VCFs. Methods We retrospectively reviewed 128 patients aged 60-102 years who underwent balloon kyphoplasty (BKP) for VCFs between November 1, 2017, and March 31, 2020. We also assessed the presence of the iNPH triad (i.e., gait disturbance, cognitive impairment, and urinary incontinence). Patients with Evans' index (EI) >0.3 and the iNPH triad were defined as having possible iNPH, those with clinical improvement after a cerebrospinal fluid tap test were defined as having probable iNPH, and those with clinical improvement after a shunt surgery were defined as having definite iNPH. Results Of the 128 patients, seven were excluded due to a history of intracranial disease that could cause ventricular enlargement or gait disturbance. Another 70 patients who did not undergo head computed tomography or magnetic resonance imaging one year before or after BKP were excluded from the study. Finally, 51 patients with a mean age of 78.9 years were enrolled. The mean EI value of these 51 patients was 0.28, with 18 patients showing EI >0.3. Moreover, 18 had possible iNPH, one had probable iNPH, and one had definite iNPH. Conclusion Screening for iNPH in elderly patients with VCFs can allow early diagnosis of iNPH and benefit them more from surgical treatment.
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Affiliation(s)
- Tatsuya Tanaka
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Hideki Iwashita
- Department of Neurosurgery, Imari Arita Kyoritsu Hospital, Arita, Japan
| | - Xuan Liu
- Department of Neurosurgery, Shiroishi Kyoritsu Hospital, Shiroishi, Japan
| | - Nobuaki Momozaki
- Department of Neurosurgery, Imari Arita Kyoritsu Hospital, Arita, Japan
| | - Eiichiro Honda
- Department of Neurosurgery, Shiroishi Kyoritsu Hospital, Shiroishi, Japan
| | - Akira Matsuno
- Department of Neurosurgery, International University of Health and Welfare, School of Medicine, Narita, Japan
| | - Tadatsugu Morimoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Saga University, Saga, Japan
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Zhang X, Liu Y, Guo S, Song Z. EG-Unet: Edge-Guided cascaded networks for automated frontal brain segmentation in MR images. Comput Biol Med 2023; 158:106891. [PMID: 37044048 DOI: 10.1016/j.compbiomed.2023.106891] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/07/2023] [Accepted: 04/01/2023] [Indexed: 04/05/2023]
Abstract
Accurate segmentation of frontal lobe areas on magnetic resonance imaging (MRI) can assist in diagnosing and managing idiopathic normal-pressure hydrocephalus. However, frontal lobe segmentation is challenging due to the complexity of the degree and shape of damage and the ambiguity of the boundaries of frontal lobe sites. Therefore, to extract the rich edge information and feature representation of the frontal lobe, this paper designs an edge guidance (EG) module to enhance the representation of edge features. Accordingly, an edge-guided cascade network framework (EG-Net) is proposed to segment frontal lobe parts automatically. Two-dimensional MRI slice images are fed into the edge generation and segmentation networks. First, the edge generation network extracts the edge information from the input image. Then, the edge information is sent to the EG module to generate an edge attention map for feature representation enhancement. Meanwhile, multi-scale attentional convolution (MSA) is utilized in the feature coding stage of the segmentation network to obtain feature responses from different perceptual fields in the coding stage and enrich the spatial context information. Besides, the feature fusion module is employed to selectively aggregate the multi-scale features in the coding stage with the edge features output by the EG module. Finally, the two components are fused, and a decoder recovers the spatial information to generate the final prediction results. An extensive quantitative comparison is performed on a publicly available brain MRI dataset (MICCAI 2012) to evaluate the effectiveness of the proposed algorithm. The experimental results indicate that the proposed method achieves an average DICE score of 95.77% compared to some advanced methods, which is 4.96% better than the classical U-Net. The results demonstrate the potential of the proposed EG-Net in improving the accuracy of frontal edge pixel classification through edge guidance.
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Affiliation(s)
- Xiufeng Zhang
- Mechanical and Electrical Engineering, Dalian Minzu University, Liaohe West Road 18, Dalian, China
| | - Yansong Liu
- Mechanical and Electrical Engineering, Dalian Minzu University, Liaohe West Road 18, Dalian, China.
| | - Shengjin Guo
- Mechanical and Electrical Engineering, Dalian Minzu University, Liaohe West Road 18, Dalian, China
| | - Zhao Song
- Shenzhen Hospital, Southern Medical University, Xinhu Road 1333, Shenzhen, China
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White H, Webb R, McKnight I, Legg K, Lee C, Lee PH, Spicer OS, Shim JW. TRPV4 mRNA is elevated in the caudate nucleus with NPH but not in Alzheimer's disease. Front Genet 2022; 13:936151. [PMID: 36406122 PMCID: PMC9670164 DOI: 10.3389/fgene.2022.936151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/17/2022] [Indexed: 01/04/2023] Open
Abstract
Symptoms of normal pressure hydrocephalus (NPH) and Alzheimer's disease (AD) are somewhat similar, and it is common to misdiagnose these two conditions. Although there are fluid markers detectable in humans with NPH and AD, determining which biomarker is optimal in representing genetic characteristics consistent throughout species is poorly understood. Here, we hypothesize that NPH can be differentiated from AD with mRNA biomarkers of unvaried proximity to telomeres. We examined human caudate nucleus tissue samples for the expression of transient receptor potential cation channel subfamily V member 4 (TRPV4) and amyloid precursor protein (APP). Using the genome data viewer, we analyzed the mutability of TRPV4 and other genes in mice, rats, and humans through matching nucleotides of six genes of interest and one house keeping gene with two factors associated with high mutation rate: 1) proximity to telomeres or 2) high adenine and thymine (A + T) content. We found that TRPV4 and microtubule associated protein tau (MAPT) mRNA were elevated in NPH. In AD, mRNA expression of TRPV4 was unaltered unlike APP and other genes. In mice, rats, and humans, the nucleotide size of TRPV4 did not vary, while in other genes, the sizes were inconsistent. Proximity to telomeres in TRPV4 was <50 Mb across species. Our analyses reveal that TRPV4 gene size and mutability are conserved across three species, suggesting that TRPV4 can be a potential link in the pathophysiology of chronic hydrocephalus in aged humans (>65 years) and laboratory rodents at comparable ages.
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Affiliation(s)
- Hunter White
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Ryan Webb
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Ian McKnight
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Kaitlyn Legg
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Chan Lee
- Department of Anesthesia, Indiana University Health Arnett Hospital, Lafayette, IN, United States
| | - Peter H.U. Lee
- Department of Cardiothoracic Surgery, Southcoast Health, Fall River, MA, United States,Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, United States
| | - Olivia Smith Spicer
- National Institute of Mental Health, National Institute of Health, Bethesda, MD, United States
| | - Joon W. Shim
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States,*Correspondence: Joon W. Shim,
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