Correlation of midbrain diameter and gait disturbance in patients with idiopathic normal pressure hydrocephalus

philhyu Lee, Woo Yong Suk, Hwan Ahn Young, K. Huh

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been suggested that the mesencephalic locomotor region is the anatomical substrate for the development of the hypokinetic NPH gait. To investigate this possibility, we evaluated the correlation between gait disturbance and midbrain diameter. Methods: We enrolled 21 patients with NPH and 20 age-matched control subjects for the study. The maximal diameter of the midbrain and pons, and the width of the lateral and third ventricles were measured using midsagittal T1-weighted MRI and axial T2-weighted MRI, respectively. Gait disturbance, cognitive dysfunction, and incontinence were semiquantified. Results: The maximal midbrain diameter was significantly smaller in the NPH group than in the controls (14.8 ± 0.9 vs. 17.1 ± 0.7mm, p < 0.001). There were inverse correlations between the midbrain diameter and the widths of the two ventricles (r = -0.562, p = 0.008 for the third ventricle, and r = -0.510, p = 0.018 for the lateral ventricle). The severity of gait disturbance was negatively correlated with the midbrain diameter (r = -0.598, p = 0.004), but the degree of cognitive dysfunction and incontinence showed no significant correlation with midbrain diameter or ventricular width. Conclusions: This study suggests that midbrain atrophy is significantly associated with gait disturbance in NPH.

Original languageEnglish
Pages (from-to)958-963
Number of pages6
JournalJournal of Neurology
Volume252
Issue number8
DOIs
Publication statusPublished - 2005 Aug 1

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Normal Pressure Hydrocephalus
Mesencephalon
Gait
Third Ventricle
Lateral Ventricles
Pons
Atrophy
Control Groups

All Science Journal Classification (ASJC) codes

  • Clinical Neurology
  • Neurology

Cite this

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abstract = "Background and purpose: Although gait disturbance is an important feature of idiopathic normal pressure hydrocephalus (NPH), only tentative theories have been offered to explain its pathophysiology. It has been suggested that the mesencephalic locomotor region is the anatomical substrate for the development of the hypokinetic NPH gait. To investigate this possibility, we evaluated the correlation between gait disturbance and midbrain diameter. Methods: We enrolled 21 patients with NPH and 20 age-matched control subjects for the study. The maximal diameter of the midbrain and pons, and the width of the lateral and third ventricles were measured using midsagittal T1-weighted MRI and axial T2-weighted MRI, respectively. Gait disturbance, cognitive dysfunction, and incontinence were semiquantified. Results: The maximal midbrain diameter was significantly smaller in the NPH group than in the controls (14.8 ± 0.9 vs. 17.1 ± 0.7mm, p < 0.001). There were inverse correlations between the midbrain diameter and the widths of the two ventricles (r = -0.562, p = 0.008 for the third ventricle, and r = -0.510, p = 0.018 for the lateral ventricle). The severity of gait disturbance was negatively correlated with the midbrain diameter (r = -0.598, p = 0.004), but the degree of cognitive dysfunction and incontinence showed no significant correlation with midbrain diameter or ventricular width. Conclusions: This study suggests that midbrain atrophy is significantly associated with gait disturbance in NPH.",
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Correlation of midbrain diameter and gait disturbance in patients with idiopathic normal pressure hydrocephalus. / Lee, philhyu; Suk, Woo Yong; Young, Hwan Ahn; Huh, K.

In: Journal of Neurology, Vol. 252, No. 8, 01.08.2005, p. 958-963.

Research output: Contribution to journalArticle

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