Hippocampal atrophy correlates with severe cognitive impairment in elderly patients with suspected normal pressure hydrocephalus

Measurements of hippocampal formation atrophy using MRI have been useful in distinguishing demented patients with a diagnosis of probable Alzheimer's disease from cognitively normal controls. To determine whether there is a similar relationship between hippocampal size and dementia in elderly p...

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Bibliographic Details
Published in:Journal of neurology, neurosurgery and psychiatry neurosurgery and psychiatry, 1994-05, Vol.57 (5), p.590-593
Main Authors: Golomb, J, de Leon, M J, George, A E, Kluger, A, Convit, A, Rusinek, H, de Santi, S, Litt, A, Foo, S H, Ferris, S H
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer Disease - pathology
Atrophy - pathology
Biological and medical sciences
Cerebrospinal fluid. Meninges. Spinal cord
Female
Hippocampus - pathology
Humans
Hydrocephalus, Normal Pressure - pathology
Magnetic Resonance Imaging
Male
Medical sciences
Nervous system (semeiology, syndromes)
Neurology
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Summary:Measurements of hippocampal formation atrophy using MRI have been useful in distinguishing demented patients with a diagnosis of probable Alzheimer's disease from cognitively normal controls. To determine whether there is a similar relationship between hippocampal size and dementia in elderly patients suspected of normal pressure hydrocephalus (NPH), the authors obtained mini-mental status examination (MMSE) scores and MRI measurements of hippocampal size and CSF volume on 16 elderly patients whose severe ventriculomegaly and unexplained gait impairment made NPH a probable diagnosis. Hippocampal size correlated strongly with MMSE score (r = 0.75, p < 0.001); no significant MMSE correlation was found for ventricular CSF volume or extra-ventricular/ventricular CSF ratio. It was concluded that hippocampal atrophy is associated with severe cognitive dysfunction in many elderly patients with a diagnosis of NPH. As a hypothesis for further investigation, the detection of such atrophy may help identify cases where the presence of a pathology of Alzheimer's disease complicates the diagnosis of NPH.
ISSN:0022-3050
1468-330X
DOI:10.1136/jnnp.57.5.590