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Wide temporal horns are associated with cognitive dysfunction, as well as impaired gait and incontinence
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.ORCID-id: 0000-0001-5857-9287
Umeå universitet, Medicinska fakulteten, Institutionen för klinisk vetenskap, Neurovetenskaper.ORCID-id: 0000-0002-4686-0941
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2020 (Engelska)Ingår i: Scientific Reports, E-ISSN 2045-2322, Vol. 10, nr 1, artikel-id 18203Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus (iNPH) is largely unknown. We investigated how ventricular expansion (width of the temporal horns [TH], callosal angle [CA], and Evans' index [EI]) related to symptom severity in suspected iNPH. Participants (n=168; 74.9 years +/- SD 6.7; 55% females) from the general population underwent neurological examination, computed tomography, and neuropsychological testing. Multiple linear regression analysis revealed that wide TH was independently associated with all examined iNPH symptoms (p<0.01) except for fine-motor performance, whereas a narrow CA only was associated to specific motor and cognitive functions (p<0.05). TH and EI correlated significantly with incontinence (r(s) 0.17 and r(s) 0.16; p<0.05). In conclusion, wide TH was significantly associated with most iNPH-symptoms. This finding potentially reflects the complex nature of the hippocampus, however further studies are needed to demonstrate functional connectivity.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2020. Vol. 10, nr 1, artikel-id 18203
Nationell ämneskategori
Neurologi
Identifikatorer
URN: urn:nbn:se:umu:diva-177175DOI: 10.1038/s41598-020-75381-2ISI: 000586495800004PubMedID: 33097796Scopus ID: 2-s2.0-85093977166OAI: oai:DiVA.org:umu-177175DiVA, id: diva2:1505619
Tillgänglig från: 2020-12-01 Skapad: 2020-12-01 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Ingår i avhandling
1. A population-based study on neuropsychological and morphological signs of idiopathic normal pressure hydrocephalus
Öppna denna publikation i ny flik eller fönster >>A population-based study on neuropsychological and morphological signs of idiopathic normal pressure hydrocephalus
2022 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) is typically manifested in people over 65 years. The condition of gait disturbances, incontinence, and cognitive dysfunction can be reversed in up to 80% of the cases by ventricular shunting. Neuropsychological testing and standardized brain imaging of signs of iNPH are essential to detect and define the progression. The aims of this thesis were to develop a radiological iNPH scale, examine how morphological features relate to symptoms of iNPH, investigate if dual-task testing (e.g., walking and talking) is helpful in detecting iNPH, and monitor developing symptoms over two years.

METHOD: The studies include 168 participants (median [range] age 73 [66–92]) at baseline (2014/2015) and 104 participants (age 75 [68–91]) at follow-up (2016/2017) from the general population. Neuropsychological tests of executive functions, memory, and motor performance, and computed tomography (CT) for brain imaging were used.

RESULTS: Seven morphological features were combined into a scoring scale for iNPH. The total score correlated with clinical symptoms (r = -0.40, p <.001). All core symptoms were associated to wider temporal horns (TH) (p <.01). Participants with iNPH stopped walking to talk more frequently (p = .044). Participants who developed iNPH during the study worsened more on declarative memory (ES -0.37).

DISCUSSION: The Radscale was related to symptoms of iNPH and the TH to all main clinical features. Difficulties walking while recalling a previous event, worsened declarative memory, and expanding ventricular space surrounding the hippocampus were noticeable signs of iNPH. Memory functions are important to recognize in iNPH.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå University, 2022. s. 86
Serie
Umeå University medical dissertations, ISSN 0346-6612 ; 2200
Nyckelord
idiopathic normal pressure hydrocephalus, cognition, dual-task, ageing, temporal horns, morphology, memory, executive function
Nationell ämneskategori
Neurologi
Forskningsämne
neurologi
Identifikatorer
urn:nbn:se:umu:diva-201142 (URN)978-91-7855-889-6 (ISBN)978-91-7855-890-2 (ISBN)
Disputation
2022-12-15, Hörsalen Snäckan, Östersund sjukhus, Östersund, 09:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2022-11-24 Skapad: 2022-11-21 Senast uppdaterad: 2022-12-02Bibliografiskt granskad

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Lilja-Lund, OttoKockum, KarinNyberg, Lars

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Lilja-Lund, OttoKockum, KarinHellström, PerSöderström, LarsNyberg, LarsLaurell, Katarina
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