A Simplified Callosal Angle Measure Best Differentiates Idiopathic-Normal Pressure Hydrocephalus from Neurodegenerative Dementia

Annachiara Cagnin, Mariachiara Simioni, Matteo Tagliapietra, Valentina Citton, Sara Pompanin, Alessandro Della Puppa, Mario Ermani, Renzo Manara

Research output: Contribution to journalArticle

Abstract

Background: Idiopathic normal-pressure hydrocephalus (iNPH) can resemble or occur in combination with other brain disorders frequently present in the elderly such as Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). Objective: To study the accuracy of a simplified callosal angle measure in differentiating iNPH from DLB and AD using conventional brain MRI. Methods:76 patients (24 iNPH, 30 DLB, 22 AD) and 40 healthy controls served as discovering cohort. The callosal angle measure was obtained on standard coronal brain MRI images crossing the corpus callosum midpoint. 41 patients (21 iNPH and 20 DLB/AD) were used as independent validation cohort. A set of other conventional MRI markers of iNPH was also evaluated. Results: iNPH showed a significantly decreased mean callosal angle value compared to both disease groups and controls (iNPH = 109 ± 9; DLB = 136.9 ± 8.2; AD = 135.4 ± 11.3; Controls = 138.5 ± 5.2; p <0.00001). Using a cut off angle of 123, derived by the mean -3SD of the control group, an accuracy of 96% (sensitivity 100%, specificity 95.4%) was obtained. By ROC analysis, the area under the curve was 0.99 (95% CI: 0.97-1). The measure was consistent (intra-rater: r = 0.94) and reproducible (inter-rater: r = 0.89). In the validation cohort, this cut off angle value discriminated iNPH from DLB/AD with 97.5% accuracy. None of the conventional MRI signs reached the same accuracy. Conclusions: This simplified callosal angle measure represents an accurate, reproducible, and easy marker of iNPH.

Original languageEnglish
Pages (from-to)1033-1038
Number of pages6
JournalJournal of Alzheimer's Disease
Volume46
Issue number4
DOIs
Publication statusPublished - Jun 26 2015

Keywords

  • Alzheimer's disease
  • dementia with Lewy bodies
  • idiopathic normal-pressure hydrocephalus
  • MRI marker

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology
  • Clinical Psychology

Fingerprint Dive into the research topics of 'A Simplified Callosal Angle Measure Best Differentiates Idiopathic-Normal Pressure Hydrocephalus from Neurodegenerative Dementia'. Together they form a unique fingerprint.

  • Cite this

    Cagnin, A., Simioni, M., Tagliapietra, M., Citton, V., Pompanin, S., Della Puppa, A., Ermani, M., & Manara, R. (2015). A Simplified Callosal Angle Measure Best Differentiates Idiopathic-Normal Pressure Hydrocephalus from Neurodegenerative Dementia. Journal of Alzheimer's Disease, 46(4), 1033-1038. https://doi.org/10.3233/JAD-150107