• Fumio Yamashita, Makoto Sasaki, Satoshi Takahashi, Hiroshi Matsuda, Kohsuke Kudo, Shinsuke Narumi, Yasuo Terayama, and Takashi Asada.
• Clinical Neuroscience, Medical Sciences for Control of Pathological Process, Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tenno-dai, Tsukuba-shi, Ibaraki-ken, 305-8577, Japan. fumio@ncnp.go.jp
• Neuroradiology. 2010 May 1;52(5):381-6.

IntroductionWe attempted to detect alterations in the cerebrospinal fluid (CSF) space in patients with idiopathic normal pressure hydrocephalus (iNPH) using voxel-based morphometry (VBM).MethodsWe obtained sagittal volume images of the entire head by three-dimensional T1-weighted magnetic resonance imaging and compared the regional distribution of CSF in 12 patients with iNPH, 14 patients with Alzheimer's disease (AD), and 17 healthy individuals using VBM with automatically extracted CSF objects.ResultsVBM demonstrated significant widening at the lateral ventricles and Sylvian fissures and narrowing of the CSF space at the high convexity/midline areas in iNPH patients, compared to the AD patients and healthy controls (p < 0.05, after correction with a false-discovery rate). In addition, the ratio of the CSF volume in the lateral ventricle/Sylvian fissure area to that in the high convexity/midline area in iNPH patients (3.9 +/- 1.2) was remarkably greater than that in AD patients (1.2 +/- 0.3) and controls (0.9 +/- 0.3; one-way ANOVA, p < 0.001; post hoc Tukey's test, p < 0.001); we could discriminate iNPH patients from those in the other two groups without any overlap, when using a cutoff level of 1.9.ConclusionVBM using CSF objects can be used to delineate the characteristic alteration of the CSF space in iNPH patients, which has been evaluated by visual interpretation.

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