Article Figures & Data
Figures
- Fig 1.
Regions of interest in a healthy control subject and a patient with INPH. A, Three representative images of color-coded FA maps in a healthy subject. Regions of interest for the periventricular white matter tracts are shown. B, The same methods are used for a patient with INPH. C, Superimposed polygons on color-coded maps in the healthy subject identify the 6 representative tracts: the anterior limb of the internal capsule and the posterior limb of the internal capsule (left), the genu and splenium of the corpus callosum (middle), and the superior longitudinal fasciculus and the inferior longitudinal fasciculus (right). D, The same methods are used for a patient with INPH. Fibers crossing from left to right are visualized in red; those crossing posteroanteriorly, in green; and those crossing inferosuperiorly, in blue.
- Fig 2.
Differences among groups and postshunting changes in the posterior limb of the internal capsule. FA (A) and MD (B) are compared among the 4 groups: healthy control, INPH, AD, and subcortical vascular dementia in the posterior limb of the internal capsule. Postshunting changes of FA (C) and MD (D) in the posterior limb of the internal capsule in 9 patients with INPH (patient 3, 4, 6, 7, 8, 10, 11, 12, and 14 in Table 1) are also demonstrated. Error bars represent ±1 SD. The asterisk indicates P < .05.
- Fig 3.
Diagnostic value of FA in the posterior limb of the internal capsule. A, ROC plot of FA in the posterior limb of the internal capsule. B, Scatterplots of the Evans index and FA in the posterior limb of the internal capsule in healthy control subjects and patients with INPH, AD, and subcortical vascular dementia. The dashed line indicates the cutoff value of FA in the posterior limb of the internal capsule (0.613), and the dotted line indicates the standard cutoff value of the Evans index (0.30).
Tables
No. (Sex/Age, Yr) Duration of Symptoms White Matter Hyperintensities (Cap or Band/Deep White Matter Lesion) (mm)a Shunt Outcomeb Availability of Postshunt DTI Preshunt Evans Indexc Postshunt Evans Indexc 1 (F/68) 5 Years 5.0/0.0 Good Unavailable 0.35 – 2 (M/77) 2.5 Years 7.4/0.0 Excellent Unavailable 0.34 – 3 (F/65) 2 Years 3.3/0.0 Excellent Available 0.41 0.33 4 (M/71) 5 Months 2.6/0.0 Excellent Available 0.33 0.35 5 (F/70) 6.5 Years 0.0/0.0 Fair Unavailable 0.36 – 6 (M/70) 3 Years 0.0/0.0 Good Available 0.33 0.34 7 (F/66) 7 Years 6.2/0.0 Excellent Available 0.34 0.30 8 (M/65) 6 Months 5.5/0.0 Excellent Available 0.36 0.29 9 (M/67) 5 Months 2.0/0.0 Good Unavailable 0.35 – 10 (M/83) 7 Months 4.1/0.0 Good Available 0.32 0.30 11 (M/71) 6 Months 3.5/0.0 Good Available 0.30 0.31 12 (M/56) 6 Months 0.0/0.0 Excellent Available 0.33 0.29 13 (M/71) 1.5 Years 0.0/0.0 Fair Unavailable 0.39 – 14 (F/73) 7 Months 1.7/0.0 Excellent Available 0.34 0.35 15 (F/71) 1 Years 3.4/0.0 Excellent Unavailable 0.38 – 16 (F/74) 2 Years 4.1/0.0 Good Unavailable 0.37 – -
a Modified criteria of Fazekas et al on MR imaging.15
-
b From the scale of Black for assessment of shunt outcome.14
-
c The ratio of the maximal width of the frontal horns to the maximal width of the inner skull.18
-
Parameters HC (n=20) INPH (n=16) AD (n=10) SVaD (n=10) ANOVA, F or χ2 Age (yr) 69.8 (3.5) 69.9 (5.9) 70.3 (4.0) 69.3 (5.3) 0.08 Male sex (No.) (%) 8 (40.0) 9 (56.3) 4 (40.0) 4 (40.0) χ2=1.22 MMSE 28.5 (1.6) 23.9 (4.3) 21.8 (3.1) 21.5 (2.2) 16.56b Evans indexc 0.25 (0.03) 0.35 (0.03) 0.29 (0.03) 0.28 (0.02) 34.67b -
a Variables are mean (±SD) or No. (%).
-
b P < .001.
-
c The ratio of the maximal width of the frontal horns to the maximal width of the inner skull.18
-
Parameters HC (n=20) INPH (n=16) AD (n=10) SVaD (n=10) ANOVA, F or H Value Anterior PVWM FA 0.53 (0.02) 0.54 (0.03)b 0.54 (0.02) 0.49 (0.03) 8.83c MD 0.50 (0.02) 0.55 (0.03)b,d,e 0.52 (0.02) 0.61 (0.03) 40.15c Posterior PVWM FAf 0.55 (0.54–0.55) 0.57 (0.56–0.57)b,d 0.56 (0.55–0.56) 0.51 (0.50–0.53) 24.58c MD 0.53 (0.02) 0.55 (0.03)b 0.53 (0.02) 0.61 (0.03) 25.20c aIC FA 0.55 (0.02) 0.59 (0.04)b,d 0.57 (0.03) 0.50 (0.04) 16.64c MD 0.49 (0.02) 0.53 (0.04)b,d,e 0.50 (0.03) 0.60 (0.04) 33.32c pIC FA 0.59 (0.02) 0.63 (0.03)b,d,e 0.60 (0.02) 0.57 (0.02) 18.67c MDf 0.48 (0.47–0.48) 0.50 (0.49–0.52)d 0.48 (0.47–0.49) 0.56 (0.54–0.57) 31.03c Genu, CC FAf 0.70 (0.64–0.71) 0.66 (0.60–0.70) 0.66 (0.64–0.70) 0.64 (0.62–0.67) 5.45 MDf 0.58 (0.55–0.61) 0.67 (0.63–0.75)d 0.62 (0.67–0.65) 0.69 (0.61–0.75) 20.67g Splenium, CC FAf 0.64 (0.62–0.66) 0.64 (0.60–0.68)b 0.66 (0.63–0.68) 0.56 (0.52–0.63) 11.59g MD 0.85 (0.17) 0.82 (0.14)b 0.88 (0.12) 1.03 (0.16) 4.26g SLF FA 0.47 (0.02) 0.50 (0.03)b,d 0.48 (0.02) 0.44 (0.03) 11.86c MD 0.48 (0.02) 0.51 (0.02)b,d,e 0.49 (0.02) 0.56 (0.02) 36.00c ILF FA 0.49 (0.02) 0.47 (0.03)d 0.49 (0.03) 0.46 (0.02) 4.72g MDf 0.57 (0.55–0.65) 0.57 (0.54–0.62)b 0.59 (0.57–0.64) 0.64 (0.60–0.67) 7.85g -
a Variables are mean (±SD) or median (interquartile range).
-
b P < .05, compared with the SVaD group.
-
c P < .001.
-
d P < .05, compared with the HC group.
-
e P < .05, compared with the AD group.
-
f The Dunn method was used to correct multiple comparisons. In other cases, the Holm-Sidak method was used.
-
g P < .05.
-
