Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer's dementia and Parkinson's disease, and hydrocephalus versus atrophy in chronic TBI-a narrative review

Sharada Kadaba Sridhar; Jen Dysterheft Robb; Rishabh Gupta; Scarlett Cheong; Rui Kuang; Uzma Samadani

doi:10.3389/fneur.2024.1347200

Structural neuroimaging markers of normal pressure hydrocephalus versus Alzheimer's dementia and Parkinson's disease, and hydrocephalus versus atrophy in chronic TBI-a narrative review

Front Neurol. 2024 Mar 21:15:1347200. doi: 10.3389/fneur.2024.1347200. eCollection 2024.

Authors

Sharada Kadaba Sridhar^{1

2}, Jen Dysterheft Robb², Rishabh Gupta^{2

3}, Scarlett Cheong^{1

2}, Rui Kuang^{1

4}, Uzma Samadani^{1

2

3

4

5}

Affiliations

¹ Department of Bioinformatics and Computational Biology, University of Minnesota, Minneapolis, MN, United States.
² Neurotrauma Research Lab, Center for Veterans Research and Education, Minneapolis, MN, United States.
³ University of Minnesota Twin Cities Medical School, Minneapolis, MN, United States.
⁴ Department of Computer Science and Engineering, University of Minnesota, Minneapolis, MN, United States.
⁵ Division of Neurosurgery, Department of Surgery, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States.

Abstract

Introduction: Normal Pressure Hydrocephalus (NPH) is a prominent type of reversible dementia that may be treated with shunt surgery, and it is crucial to differentiate it from irreversible degeneration caused by its symptomatic mimics like Alzheimer's Dementia (AD) and Parkinson's Disease (PD). Similarly, it is important to distinguish between (normal pressure) hydrocephalus and irreversible atrophy/degeneration which are among the chronic effects of Traumatic Brain Injury (cTBI), as the former may be reversed through shunt placement. The purpose of this review is to elucidate the structural imaging markers which may be foundational to the development of accurate, noninvasive, and accessible solutions to this problem.

Methods: By searching the PubMed database for keywords related to NPH, AD, PD, and cTBI, we reviewed studies that examined the (1) distinct neuroanatomical markers of degeneration in NPH versus AD and PD, and atrophy versus hydrocephalus in cTBI and (2) computational methods for their (semi-) automatic assessment on Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans.

Results: Structural markers of NPH and those that can distinguish it from AD have been well studied, but only a few studies have explored its structural distinction between PD. The structural implications of cTBI over time have been studied. But neuroanatomical markers that can predict shunt response in patients with either symptomatic idiopathic NPH or post-traumatic hydrocephalus have not been reliably established. MRI-based markers dominate this field of investigation as compared to CT, which is also reflected in the disproportionate number of MRI-based computational methods for their automatic assessment.

Conclusion: Along with an up-to-date literature review on the structural neurodegeneration due to NPH versus AD/PD, and hydrocephalus versus atrophy in cTBI, this article sheds light on the potential of structural imaging markers as (differential) diagnostic aids for the timely recognition of patients with reversible (normal pressure) hydrocephalus, and opportunities to develop computational tools for their objective assessment.

Keywords: Alzheimer’s dementia; Parkinson’s disease; chronic traumatic brain injury; computational methods; normal pressure hydrocephalus; structural imaging.

Publication types

Review

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. We thank the MN State Office of Higher Education for supporting this review.