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Correlation of ventricular diameter and cognitive dysfunction in patients with IPD – Comparison of transcranial sonography and MRI: STUDY




















Image source: NEURORADIOLOGYCASES

Background:
In the course of idiopathic Parkinson’s disease (IPD) 30% of patients develop dementia yielding to new challenges in diagnosis and therapy. Several studies in multiple sclerosis or HIV patients indicated a correlation of ventricular diameter as a marker of brain atrophy and a decline of cognitive function.

Objective:
The aim of this study was to evaluate if ventricular diameter measured by TCS and MR-imaging is a marker of brain atrophy and if it is correlated with severity of disease and cognitive dysfunction.

Methods:
In this study 108 PD patients (64% male, 36% female; mean age: 63,64 ± 8,24 years (yrs)) and 39 controls (36% male, 64% female; mean age: 51,7 ± 15,6 yrs) underwent a T1/T2-weighted MR Imaging and TCS. The transverse diameter of the third ventricle (3v) and the frontal horns of right (rv) and left (lv) lateral ventricles were measured. Furthermore, neurological examinations, standardized motor functional (UPDRS, Webster) and cognitive (MMST, PANDA, ZVT) tests were performed. 31 individuals underwent a follow up examination after 5 yrs.

Results:
The TCS measurement of ventricular diameter significantly correlated with the MRI measurement (Spearman rank correlation, 3v: r = 0.8, lv: r = 0.4; p < 0.01, rv: r = 0.2; p < 0.05) with a high interobserver reliability. In the PD-group the diameter of the third ventricle was 0.54 ± 0.02 cm and of the lateral ventricles 1.49 ± 0.36 cm. Group membership did not influence ventricular diameter in TCS or MRI. Age had a significant impact on ventricular diameter (3v: r = 0.49; p < 0.01; rv: r = 0.389; p < 0.01; lv: r = 0.421; p < 0.01). Above all, MRI and TCS data were correlated significantly with cognitive tests: MMST (3v: r = −0.3; p = n. s.; lv: r = −0.5; p < 0.01; rv: r = −0.5; p < 0.05), PANDA-Test (Spearman rank correlation, 3v: r = −0.457; p < 0.05; lv: r = −0.417; p < 0.05; rv: r = −0.261; p = n.s.). No correlation between motor function and ventricular diameter was found. In 5-year follow-up all individuals showed a significant increase of lateral ventricular diameter (rv+lv: p < 0.0005) particularly in IPD. In summary, our data in IPD-patients demonstrated a correlation of cognitive function and ventricular diameter in TCS and MRI comparable to the studies in MS and HIV-patients.

Conclusions:
Our results suggest that TCS measurement of ventricular diameter represents a quick, low priced and simple method as a surrogate marker of brain atrophy associated in IPD with age and cognitive function. Future investigations may define the value of TCS ventricular diameter measurement for evaluation of cognitive dysfunction in IPD in routine clinical practice.

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