Structural correlates of cognitive impairment in normal pressure hydrocephalus.

Autor: Peterson KA; Department of Psychiatry, University of Cambridge, Cambridge, UK.; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK., Mole TB; Department of Psychiatry, University of Cambridge, Cambridge, UK., Keong NCH; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK., DeVito EE; Department of Psychiatry, University of Cambridge, Cambridge, UK.; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK., Savulich G; Department of Psychiatry, University of Cambridge, Cambridge, UK., Pickard JD; Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK., Sahakian BJ; Department of Psychiatry, University of Cambridge, Cambridge, UK.; MRC/ Wellcome Trust Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK.
Jazyk: angličtina
Zdroj: Acta neurologica Scandinavica [Acta Neurol Scand] 2019 Mar; Vol. 139 (3), pp. 305-312. Date of Electronic Publication: 2018 Dec 03.
DOI: 10.1111/ane.13052
Abstrakt: 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.
(© 2018 The Authors. Acta Neurologica Scandinavica Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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