Regional brain volume changes in Hakim's disease versus Alzheimer's and mild cognitive impairment.

IF 4.1 Q1 CLINICAL NEUROLOGY
Brain communications Pub Date : 2025-03-26 eCollection Date: 2025-01-01 DOI:10.1093/braincomms/fcaf122
Shigeki Yamada, Takuya Yuzawa, Hirotaka Ito, Chifumi Iseki, Toshiyuki Kondo, Tomoyasu Yamanaka, Motoki Tanikawa, Tomohiro Otani, Satoshi Ii, Yasuyuki Ohta, Yoshiyuki Watanabe, Shigeo Wada, Marie Oshima, Mitsuhito Mase
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Abstract

Idiopathic normal-pressure hydrocephalus (Hakim's disease) is characterized by ventricular enlargement and disproportionately enlarged subarachnoid space hydrocephalus, leading to localized brain deformation. Differentiating regional brain volume changes in Hakim's disease from those in Alzheimer's disease, Hakim's disease with Alzheimer's disease, and mild cognitive impairment provides insights into disease-specific mechanisms. This study aimed to identify disease-specific patterns of brain volume changes in Hakim's disease, Alzheimer's disease, Hakim's disease with Alzheimer's disease, and mild cognitive impairment and compare them with those in cognitively healthy individuals using an advanced artificial intelligence-based brain segmentation tool. The study included 970 participants, comprising 52 patients with Hakim's disease, 256 with Alzheimer's disease, 25 with Hakim's disease with Alzheimer's disease, 163 with mild cognitive impairment, and 474 healthy controls. The intracranial spaces were segmented into 100 brain and 7 CSF subregions from 3D T1-weighted MRIs using brain subregion analysis. The volume ratios of these regions were compared among the groups using Glass's Δ, referencing 400 healthy controls aged ≥50 years. Hakim's disease exhibited significant volume reduction in the supramarginal gyrus of the parietal lobe and the paracentral gyrus of the frontal lobe. Alzheimer's disease exhibited prominent volume loss in the hippocampus and temporal lobe, particularly in the entorhinal cortex, fusiform gyrus, and inferior temporal gyrus. Hakim's disease with Alzheimer's disease showed significant volume reductions in the supramarginal gyrus of the parietal lobe, similar to Hakim's disease, whereas temporal lobe volumes were relatively preserved compared with those in Alzheimer's disease. Patients with mild cognitive impairment aged ≥70 years had comparable regional brain volume ratios with healthy controls in the same age group. The Hakim's disease and Hakim's disease with Alzheimer's disease groups were characterized by volume reductions in the frontal and parietal lobes caused by disproportionately enlarged subarachnoid space hydrocephalus-related compression compared with temporal lobe atrophy observed in the Alzheimer's disease group. These disease-specific morphological changes highlight the need for longitudinal studies to clarify the causes of compression and atrophy.

哈基姆氏病与阿尔茨海默病和轻度认知障碍的局部脑容量变化。
特发性常压脑积水(哈基姆病)以脑室增大和蛛网膜下腔不成比例增大脑积水为特征,导致局部脑变形。区分哈基姆氏病与阿尔茨海默病、哈基姆氏病与阿尔茨海默病以及轻度认知障碍患者的区域脑容量变化,有助于了解疾病特异性机制。本研究旨在确定哈基姆病、阿尔茨海默病、哈基姆病合并阿尔茨海默病和轻度认知障碍患者的脑容量变化的疾病特异性模式,并使用先进的基于人工智能的大脑分割工具将其与认知健康个体的脑容量变化进行比较。该研究包括970名参与者,包括52名哈基姆氏病患者,256名阿尔茨海默氏病患者,25名哈基姆氏病合并阿尔茨海默氏病患者,163名轻度认知障碍患者,以及474名健康对照。利用脑亚区分析,将三维t1加权mri的颅内间隙分割为100个脑区和7个脑脊液亚区。使用Glass的Δ比较各组之间这些区域的体积比,参考400名年龄≥50岁的健康对照。哈基姆氏病在顶叶边缘上回和额叶中央旁回中表现出明显的体积减少。阿尔茨海默病在海马和颞叶中表现出明显的体积损失,特别是在内嗅皮层、梭状回和颞下回。哈基姆氏病合并阿尔茨海默病显示顶叶边缘上回的体积明显减少,与哈基姆氏病相似,而颞叶体积与阿尔茨海默病相比相对保留。年龄≥70岁的轻度认知障碍患者与同一年龄组健康对照者的区域脑容量比相当。与阿尔茨海默病组观察到的颞叶萎缩相比,哈基姆病组和哈基姆病合并阿尔茨海默病组的特征是,由于蛛网膜下腔不成比例地扩大,脑积水相关的压迫导致额叶和顶叶体积减少。这些疾病特有的形态学变化强调了纵向研究的必要性,以阐明压迫和萎缩的原因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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