White Matter Changes in Normal Pressure Hydrocephalus, a Possible Marker for the White Matter Damage
Abstrakt
Objective: The etiology of normal pressure hydrocephalus (NPH) remains enigmatic. The search for reliable markers of the disease for non invasive diagnostics and for the etiology of the disease is constantly needed.
One of the hypotheses for gait impairment in NPH is the affection of periventricular white matter. Methods: In this study 18 patients were investigated for possible NPH.
All patients underwent diagnostic testing including the lumbar infusion test and 5 days of external lumbar drainage for diagnosis of normal pressure hydrocephalus. Eleven healthy individuals were examined with the same technique.
Following parameters were then manually measured: fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in fornix, genu of the internal capsule, and optic radiation. The ROI was placed two slices above the slice where anterior comissure could be detected.
A Mann Whitney U test was used for the analysis of the results. Conclusion: The DTI measurements may reveal the white matter structural imparirment in patients with normal pressure hydrocephalus.
As a possible non-invasive diagnostic marker it deserves further attention and investigation. Our patients will be also imaged 3 months after the shunting procedure to assess any possible restructuralisation.