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The association between morphology of the brain and symptoms of suspected idiopathic normal pressure hydrocephalus (iNPH) is largely unknown. We investigated how ventricular expansion (width of the temporal horns [TH], callosal angle [CA], and Evans’ index [EI]) related to symptom severity in suspected iNPH. Participants (n = 168; 74.9 years ± SD 6.7; 55% females) from the general population underwent neurological examination, computed tomography, and neuropsychological testing. Multiple linear regression analysis revealed that wide TH was independently associated with all examined iNPH symptoms ( p  < 0.01) except for fine-motor performance, whereas a narrow CA only was associated to specific motor and cognitive functions ( p  < 0.05). TH and EI correlated significantly with incontinence (r s  0.17 and r s  0.16;  p  < 0.05). In conclusion, wide TH was significantly associated with most iNPH-symptoms. This finding potentially reflects the complex nature of the hippocampus, however further studies are needed to demonstrate functional connectivity.

Wide temporal horns are associated with cognitive dysfunction, as well as impaired gait and incontinence