title: Voxel-based morphometry of disproportionate cerebrospinal fluid space distribution for the differential diagnosis of idiopathic normal pressure hydrocephalus.
abstract: OBJECTIVE
  To determine whether voxel-based morphometry of the cerebrospinal fluid (CSF) space can accurately differentiate iNPH from other related neurological disorders.
  
  
  METHODS
  Nineteen patients with surgically proven iNPH and 24 patients with Alzheimer's disease (AD), 18 patients with Parkinson's disease (PD), and 14 healthy elderlies were examined. Regions of interest (ROIs) in the ventricular/sylvian (VS) and high convexity/midline (HCM) areas were used in VBM, and differences in CSF volume within these ROIs among the 4 groups were examined.
  
  
  RESULTS
  The relative CSF volume in the VS-ROI in the iNPH group (.64) was significantly higher than that in the AD, PD, and healthy control groups (.26, .29, and .17, respectively; P < .001), whereas the relative CSF volume in the HCM-ROI was significantly reduced in the iNPH (.10) than in the other (.17, .16, and .16, respectively) groups (P < .001). Furthermore, the ratio of the 2 areas (VS/HCM) was markedly higher in the iNPH (6.87) than in the other (1.65, 1.74, .97, respectively) groups (P < .001), with sensitivity and specificity of .89 and 1.00, respectively.
  
  
  CONCLUSIONS
  The VBM-based CSF space analysis can detect disproportionate changes in CSF space and differentiate iNPH patients from those with AD or PD and healthy elderlies accurately.
authors.affiliation: Division of Ultrahigh Field MRI, Institute for Biomedical Sciences, Iwate Medical University, Yahaba, Iwate, Japan.
authors.forename: Fumio
authors.initials: F
authors.lastname: Yamashita
authors.forename: Makoto
authors.initials: M
authors.lastname: Sasaki
authors.forename: Makoto
authors.initials: M
authors.lastname: Saito
authors.forename: Etsuro
authors.initials: E
authors.lastname: Mori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Kudo
authors.forename: Tatsunori
authors.initials: T
authors.lastname: Natori
authors.forename: Ikuko
authors.initials: I
authors.lastname: Uwano
authors.forename: Kenji
authors.initials: K
authors.lastname: Ito
authors.forename: Koichi
authors.initials: K
authors.lastname: Saito
mesh_terms: D000368:Aged; D000465:Algorithms; D002555:Cerebrospinal Fluid / Q000166:cytology*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000473:pathology*; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D019636:Neurodegenerative Diseases / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Alzheimer's disease; Idiopathic normal pressure hydrocephalus; Parkinson's disease; cerebrospinal fluid space; voxel-based morphometry