Idiopathic normal pressure hydrocephalus-like MRI features in patients with progressive supranuclear palsy: a comparative case-control study

ABSTRACT

Background

The occurrence of neurodegenerative disease in patients with normal pressure hydrocephalus (NPH) is emphasized in recent reports. Based on this common co-occurrence, some of the hydrocephalic disorders appearing in late adulthood have been hypothesized to result from initially unapparent parenchymal abnormalities of neurodegenerative origin. Among these diseases, progressive supranuclear palsy (PSP) has been specifically remarked on. We aimed to comparatively investigate the neuroimaging clues of iNPH in our PSP subjects.

Methods

Eighteen patients with a clinical diagnosis of PSP, 44 with Parkinson’s disease (PD), and 44 healthy control (HC) individuals were enrolled. The disproportionately enlarged subarachnoid space hydrocephalus (DESH) score, the Evans’ index (EI), and the callosal angle (CA) were measured on the conventional magnetic resonance imaging (MRI). The comparative analyses were performed using IBM SPSS Statistics 26.

Results

We found that dilated Sylvian fissures score (p = 0.016) and focal sulcal dilatation score (p = 0.037) were higher in the PSP group in comparison to HC whereas the CA score was higher in PSP subjects in comparison to both PD patients and HC (p = 0.000). Remarkably, the DESH score was also found to be higher in the PSP group in comparison to the age-matched HC group (p = 0.024).

Conclusions

We found that the NPH-like MRI features were more common in PSP subjects in comparison to PD subjects and age-matched HC. These results may provide critical contributions to the literature regarding the overlap between PSP and NPH.

KEYWORDS:

• Progressive supranuclear palsy
• idiopathic normal pressure hydrocephalus
• co-existence
• neurodegeneration

Disclosure statement

No potential conflict of interest was reported by the author(s).

Compliance with ethical standards

The ethical approval has been obtained from the local committee of the Diskapi Yildirim Beyazit Training and Research Hospital.

Informed consent form has been obtained from the patient.

Author contributions

Concept – S.C., H.O.; Design – H.O., B.K.; Supervision – H.O., S.C.; Materials – H.O; Data Collection and/or Processing – H.O, B.K.; Analysis and/or Interpretation – HO., S.C.; Literature Search – H.O, B.K.; Writing Manuscript – H.O., B.K., Critical Review – H.O., S.C.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Halil Onder

Halil Onder is an associate professor working in neurology clinic, diskapi Yildirim beyazit training and research hospital. He is particularly interested in movement disorders.

Bilge Kocer

Bilge Kocer is an associate professor working in neurology clinic, diskapi Yildirim beyazit training and research hospital. Her particular interest is deep brain stimulation of Parkinson's disease.

Selcuk Comoglu

Selcuk Comoglu is a professor working in neurology clinic, diskapi Yildirim beyazit training and research hospital. Her particular interest is deep brain stimulation of Parkinson’s disease.