title: DTI-MRI biomarkers in the search for normal pressure hydrocephalus aetiology: a review.
abstract: Normal pressure hydrocephalus (NPH) is a clinical syndrome characterized by gait disturbances, urinary incontinence and dementia. Clinical presentation overlaps with Alzheimer disease (AD). Early recognition thus early intervention (shunting) is important for successful treatment, but lack of a diagnostic test with sufficient sensitivity and specificity complicates the diagnosis. We performed literature search and composed a structured review of imaging biomarkers of NPH. Morphometric studies are not sufficient to diagnose NPH. Hydrocephalus is a common finding in elderly people due to the symmetric brain atrophy and is even more pronounced in patients with AD. The key MRI biomarker seems to be diffusion tensor imaging (DTI). According to recent studies, the DTI analysis of the splenium corporis callosi, posterior limb of internal capsule, hippocampus and fornix combined with measurement of Evans index is a promising MRI biomarker of NPH and could be used for NPH diagnostics and in the differential diagnosis from AD and other dementias.
authors.affiliation: Department of Neurosurgery, Hospital Dessau, Auenweg 38, 06847, Dessau-Roßlau, Germany, dav.hoza@icloud.com.
authors.forename: David
authors.initials: D
authors.lastname: Hoza
authors.forename: Aleš
authors.initials: A
authors.lastname: Vlasák
authors.forename: Daniel
authors.initials: D
authors.lastname: Hořínek
authors.forename: Martin
authors.initials: M
authors.lastname: Sameš
authors.forename: Alex
authors.initials: A
authors.lastname: Alfieri
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000473:pathology; D000818:Animals; D015415:Biomarkers / Q000032:analysis; D001921:Brain / Q000473:pathology*; D056324:Diffusion Tensor Imaging; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods
chemical_list: D015415:Biomarkers