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Structural volumetry in NPH diagnostics and treatment—future or dead end?

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Abstract

To assess automated volumetric analysis as a potential presurgical diagnostic tool or as a method to potentially shed light on normal pressure hydrocephalus (NPH) pathophysiology. MRI imaging according to our protocol was performed in 29 NPH patients, 45 non-NPH (but suspected) patients and 15 controls. Twenty patients underwent a second MRI 3 months after ventriculoperitoneal (VP) shunt surgery. All structures relevant to NPH diagnosis were automatically segmented using commercial software. The results were subsequently tested using ANOVA analysis. Significant differences in the volumes of the corpus callosum, left hippocampus, internal globus pallidus, grey and white matter and ventricular volumes were observed between NPH group and healthy controls. However, the differences between NPH and non-NPH groups were non-significant. Three months after, VP shunt insertion decreased ventricular volume was the only clearly significant result (p value 0.0001). Even though a detailed volumetric study shows several significant differences, volumetric analysis as a standalone method does not provide a simple diagnostic biomarker, nor does it shed a light on an unknown NPH aetiology.

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Funding

Supported by institutional grant Czech Ministry of Defence MO1012.

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Authors and Affiliations

  1. Department of Neurosurgery and Neurooncology, Military University Hospital and Charles University, First Medical Faculty, U Vojenské nemocnice 1200/1, 162 00, Prague 6, Czech Republic

    Aleš Vlasák, Petr Skalický, Arnošt Mládek, Vladimír Beneš & Ondřej Bradáč

  2. Department of Cognitive Systems and Neurosciences, Czech Institute of Informatics, Robotics, and Cybernetics, Czech Technical University, Prague, Czech Republic

    Arnošt Mládek

  3. Department of Radiology, Military University Hospital, Prague, Czech Republic

    Jiří Vrána

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  1. Aleš Vlasák
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Correspondence to Ondřej Bradáč.

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Vlasák, A., Skalický, P., Mládek, A. et al. Structural volumetry in NPH diagnostics and treatment—future or dead end?. Neurosurg Rev 44, 503–514 (2021). https://doi.org/10.1007/s10143-020-01245-y

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