Characteristics of patients with idiopathic normal pressure hydrocephalus for whom neurosurgeons hesitate to perform shunt surgery: a nationwide hospital-based survey in Japan.

Background: There is no consensus regarding the indications for shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH) aged ≥ 85 years or in those with severe physical or mental comorbidities. This nationwide study investigates the current approaches of neurosurgeons regarding iNPH treatment and surgical indications.

Methods: A questionnaire, developed in collaboration with neurosurgeons and dementia specialists, was distributed to 1,220 facilities from October 10, 2023.

Spatiotemporal dynamics of reading Kana (syllabograms) and Kanji (morphograms).

Reading engages complex neural networks integrating visual, phonological, and semantic information. The dual-stream model posits ventral and dorsal pathways for lexical and sublexical processing in the left hemisphere and is well-supported in alphabetic languages. However, its applicability to non-alphabetic scripts remains unclear.

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

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.

Distinct cerebral perfusion patterns and linguistic profiles in Alzheimer's disease-related primary progressive aphasia.

Alzheimer's disease (AD)-related primary progressive aphasia (PPA) exhibits considerable heterogeneity in clinical presentation and neuroimaging patterns. No studies have quantitatively assessed cerebral perfusion patterns or systematically evaluated the internal heterogeneity of linguistic and neuroimaging features in this population. This study aimed to investigate cerebral hypoperfusion patterns and elucidate their correlation with diverse linguistic features in patients with AD-related PPA using a data-driven approach.

Instrumental assessment of INPH: structural and functional neuroimaging.

Introduction: For the accurate diagnosis of idiopathic normal pressure hydrocephalus (iNPH) an accurate neuroimaging is essential. Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) is a key neuroradiological feature and novel imaging techniques, including voxel-based morphometry and AI-assisted analyses are emerging as powerful tools to investigate iNPH pathophysiology. Converging evidence also suggests a role for dopaminergic dysfunction in iNPH.

What is idiopathic in normal pressure hydrocephalus?

Introduction: Normal pressure hydrocephalus (NPH) can be caused by acquired events - e.g. subarachnoid hemorrhage, meningitis, or trauma - or can be "idiopathic" (iNPH) when no clear cause is identifiable.

Oral applause sign in progressive supranuclear palsy.

The applause sign (AS) is a recognized phenomenon observed in progressive supranuclear palsy (PSP) and other neurological conditions where individuals produce over three claps following a request to clap only thrice after a demonstration. In this study, we introduced a novel linguistic phenomenon termed the oral applause sign (OAS) associated with the AS. The OAS is characterized by increased repetition counts of Japanese repetitive onomatopoeic words, such as uttering "pata-pata-pata" instead of the expected "pata-pata.

The utility of customised tissue probability maps and templates for patients with idiopathic normal pressure hydrocephalus: a computational anatomy toolbox (CAT12) study.

Background: Disproportionately enlarged subarachnoid space hydrocephalus (DESH) is one of the neuroradiological characteristics of idiopathic normal pressure hydrocephalus (iNPH), which makes statistical analyses of brain images difficult. This study aimed to develop and validate methods of accurate brain segmentation and spatial normalisation in patients with DESH by using the Computational Anatomy Toolbox (CAT12).

Methods: Two hundred ninety-eight iNPH patients with DESH and 25 healthy controls (HCs) who underwent cranial MRI were enrolled in this study.

A Case of Progressive Multifocal Leukoencephalopathy Caused by Epcoritamab.

A female patient aged in her 50s had presented with the onset of follicular lymphoma (FL) with left mandibular swelling, with a pathological grade of 1 and clinical stage of Ⅳ (Ann Arbor staging). Cyclophosphamide, doxorubicin, vincristine, prednisolone, and rituximab (R-CHOP) resulted in complete molecular remission (CMR). The patient experienced two recurrences, and treatments were successful; however, the side effect of continuous lymphocytopenia existed eight years after the onset.

Development of a Gait Analysis Application for Assessing Upper and Lower Limb Movements to Detect Pathological Gait.

Pathological gait in patients with Hakim's disease (HD, synonymous with idiopathic normal-pressure hydrocephalus; iNPH), Parkinson's disease (PD), and cervical myelopathy (CM) has been subjectively evaluated in this study. We quantified the characteristics of upper and lower limb movements in patients with pathological gait. We analyzed 1491 measurements of 1 m diameter circular walking from 122, 12, and 93 patients with HD, PD, and CM, respectively, and 200 healthy volunteers using the Three-Dimensional Pose Tracker for Gait Test.

Higher cerebral blood flow on four-dimensional flow magnetic resonance imaging in young women.

We investigated the reduction in regional brain volume and cerebral blood flow (CBF) with aging and explored potential sex differences in healthy brains. Three-dimensional (3D) T1-weighted magnetic resonance imaging (MRI), time-of-flight magnetic resonance angiography, and four-dimensional (4D) flow MRI were performed on 129 healthy volunteers aged 22-92 years. The brains of healthy volunteers were segmented into 21 subregions using 3D T1-weighted MRI and CBFs in 16 major intracranial arteries were measured using 4D flow MRI.

The time-course augmentation of perivascular space enlargement in the basal ganglia among a community-dwelling elder population.

Purpose: We examined whether time-course augmentation of perivascular space enlargement in the basal ganglia (BG-PVS) reflected cerebral small vessel disease (CSVD) severity by considering white matter hyperintensity lesion (WMHL) as an indicator for CSVD.

Materials And Methods: This study population included 416 older participants from a community-based cohort. They participated in magnetic resonance imaging (MRI) studies more than once during the study period.

Modeling cerebrospinal fluid dynamics across the entire intracranial space through integration of four-dimensional flow and intravoxel incoherent motion magnetic resonance imaging.

Background: Bidirectional reciprocal motion of cerebrospinal fluid (CSF) was quantified using four-dimensional (4D) flow magnetic resonance imaging (MRI) and intravoxel incoherent motion (IVIM) MRI. To estimate various CSF motions in the entire intracranial region, we attempted to integrate the flow parameters calculated using the two MRI sequences. To elucidate how CSF dynamics deteriorate in Hakim's disease, an age-dependent chronic hydrocephalus, flow parameters were estimated from the two MRI sequences to assess CSF motion in the entire intracranial region.

The grasp reflex in patients with idiopathic normal pressure hydrocephalus.

Objective: To investigate the prevalence and intensity of grasp reflexes and to examine changes in these reflexes after shunt surgery in patients with idiopathic normal pressure hydrocephalus (iNPH).

Methods: We enrolled 147 patients with probable iNPH. A standard procedure was used to determine the presence of grasp reflexes, and the intensity of these reflexes was assessed using a four-category classification.

Automatic assessment of disproportionately enlarged subarachnoid-space hydrocephalus from 3D MRI using two deep learning models.

Background: Disproportionately enlarged subarachnoid-space hydrocephalus (DESH) is a key feature for Hakim disease (idiopathic normal pressure hydrocephalus: iNPH), but subjectively evaluated. To develop automatic quantitative assessment of DESH with automatic segmentation using combined deep learning models.

Methods: This study included 180 participants (42 Hakim patients, 138 healthy volunteers; 78 males, 102 females).

[Epidemiology, Natural History, and Genetic Factors of Idiopathic Normal Pressure Hydrocephalus].

According to a cohort study in a Japanese rural area, the prevalence of idiopathic normal pressure hydrocephalus (iNPH) in the 80s was 7.7% among the older inhabitants, despite only a small percentage of the population seeking consultation. The 16-year observation of the cohort revealed that people were in the state of asymptomatic ventriculomegaly with features of iNPH on magnetic resonance imaging or asymptomatic ventricular enlargement several years before presenting symptoms and intracranial changes of iNPH.

Aging and Sex Differences in Brain Volume and Cerebral Blood Flow.

How do regional brain volume ratios and cerebral blood flow (CBF, mL/min) change with aging, and are there sex differences? This study aimed to comprehensively evaluate the relationships between regional brain volume ratios and CBF in healthy brains. The study participants were healthy volunteers who underwent three-dimensional T1-weighted MRI, time-of-flight MR angiography, and four-dimensional (4D) flow MRI between 2020 and 2022. The brain was automatically segmented into 21 brain subregions from 3D T1-weighted MRI, and CBF in 16 major intracranial arteries were measured by 4D flow MRI.

Paraneoplastic Cerebellar Degeneration Accompanied by Seropositivity for Anti-GAD65, Anti-SOX-1 and Anti-VGCC Antibodies Due to Small-cell Lung Cancer.

Paraneoplastic cerebellar degeneration (PCD) is a paraneoplastic neurological syndrome that is rarely accompanied by seropositivity with a combination of multiple antibodies. We herein report a 50-year-old man with PCD accompanied by small-cell lung cancer (SCLC). This patient was seropositive for anti-glutamic acid decarboxylase 65, anti-SRY-related HMG-box gene 1 and anti-voltage-gated calcium channel antibodies.

Effect of cerebrospinal fluid area mask correction on I-FP-CIT SPECT images in idiopathic normal pressure hydrocephalus.

Background: Cerebrospinal fluid (CSF) area mask correction reduces the influence of low [I]-N-fluoropropyl-2b-carbomethoxy-3b-(4-iodophenyl) nortropane (I-FP-CIT) accumulation in the volume of interest (VOI) by CSF area dilatation on the specific binding ratio (SBR) calculated using the Southampton method. We assessed the effect of CSF area mask correction on the SBR for idiopathic normal pressure hydrocephalus (iNPH) characterized by CSF area dilatation.

Methods: We enrolled 25 patients with iNPH who were assessed using I-FP-CIT single-photon emission computed tomography (SPECT) before shunt surgery or the tap test.