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White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination

2002; Wiley; Volume: 105; Issue: 6 Linguagem: Inglês

10.1034/j.1600-0404.2002.01189.x

1600-0404

Mats Tullberg, L. Hultin, Sven Ekholm, Jan‐Eric Månsson, Pam Fredman, Carsten Wikkelsö,

Fetal and Pediatric Neurological Disorders

Acta Neurologica ScandinavicaVolume 105, Issue 6 p. 417-426 White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination M. Tullberg, M. Tullberg Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorL. Hultin, L. Hultin Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorS. Ekholm, S. Ekholm Department of Radiology, Sahlgrenska University Hospital, Göteborg University, Göteborg, SwedenSearch for more papers by this authorJ.-E. Månsson, J.-E. Månsson Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorP. Fredman, P. Fredman Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorC. Wikkelsø, C. Wikkelsø Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this author M. Tullberg, M. Tullberg Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorL. Hultin, L. Hultin Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorS. Ekholm, S. Ekholm Department of Radiology, Sahlgrenska University Hospital, Göteborg University, Göteborg, SwedenSearch for more papers by this authorJ.-E. Månsson, J.-E. Månsson Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorP. Fredman, P. Fredman Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this authorC. Wikkelsø, C. Wikkelsø Institute of Clinical Neuroscience, Göteborg University, Göteborg, Sweden,Search for more papers by this author First published: 20 May 2002 https://doi.org/10.1034/j.1600-0404.2002.01189.xCitations: 96 Mats Tullberg Institute of Clinical Neuroscience, Sahlgrenska University Hospital, Göteborg University, SE 413 45 Göteborg, Sweden Tel.: +46 31 342 10 00 Fax: +46 31 342 24 67 e-mail: mats.tullberg@neuro.gu.se Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Abstract Objectives– To analyse the diagnostic and prognostic value of periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH) magnetic resonance imaging (MRI) changes and their relation to symptoms and cerebrospinal fluid (CSF) markers of demyelination (sulphatide) and axonal degeneration [neurofilament triplet protein (NFL)] in a large series of patients with normal pressure hydrocephalus (NPH) and Binswanger disease (BD). Materials and methods– PVH and DWMH were determined by a semi-automatic segmentation method on T2-weighted images in 29 patients with NPH and 17 patients with BD. CSF analyses, psychometric testing and quantification of balance, gait and continence were performed in all patients and also postoperatively in NPH patients. Results– No MRI variable could identify NPH or BD patients. Abundant PVH and DWMH preoperatively correlated with improvement in gait, balance and psychometric performance after shunt surgery (P < 0.05). CSF sulphatide correlated positively with the amount of DWMH (P < 0.05) while NFL was correlated to both PVH and DWMH (P < 0.05). Abundant PVH correlated with poor psychometric performance while DWMH correlated with gait disturbance (P < 0.05). Postoperative reduction in PVH correlated with improvement in gait, balance and psychometric performance. Conclusion– In spite of a refined quantification method, NPH and BD patients exhibited similar MRI changes. MRI had a predictive value in NPH patients. DWMH might relate to demyelination and PVH to neuronal axonal dysfunction. NPH and BD share the major part of symptoms and MRI changes, indicating a common pathophysiological pattern, and we raise the question of how to treat BD patients. Citing Literature Volume105, Issue6June 2002Pages 417-426 RelatedInformation