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Ventricular dilation: Association with gait and cognition
Author(s) -
Palm Walter M.,
Saczynski Jane S.,
van der Grond J.,
Sigurdsson Sigurdur,
Kjartansson Olafur,
Jonsson Palmi V.,
Eiriksdottir Gudny,
Gudnason Vilmundur,
AdmiraalBehloul Faiza,
Launer Lenore J.,
van Buchem Mark A.
Publication year - 2009
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.21739
Subject(s) - medicine , cardiology , brain size , population , odds ratio , hyperintensity , magnetic resonance imaging , physical medicine and rehabilitation , physical therapy , radiology , environmental health
Objective Normal pressure hydrocephalus is characterized by gait impairment, cognitive impairment, and urinary incontinence, and is associated with disproportionate ventricular dilation. Here we report the distribution of ventricular volume relative to sulcal cerebrospinal fluid (CSF) volume, and the association of increasing ventricular volume relative to sulcal CSF volume with a cluster of gait impairment, cognitive impairment, and urinary incontinence in a stroke‐free cohort of elderly persons from the general population. Methods Data are based on 858 persons (35.4% men; age range, 66–92 years) who participated in the Age, Gene/Environment Susceptibility–Reykjavik Study. Gait was evaluated with an assessment of gait speed. Composite scores representing speed of processing, memory, and executive function were constructed from a neuropsychological battery. Bladder function was assessed with a questionnaire. Magnetic resonance brain imaging was followed by semiautomated segmentation of intracranial CSF volume. White matter hyperintensity (WMH) volume was assessed with a semiquantitative scale. For the analysis of ventricular dilation relative to the sulcal spaces, ventricular volume was divided by sulcal CSF volume (VV/SV). Results Disproportion between ventricular and sulcal CSF volume, defined as the highest quartile of the VV/SV z score, was associated with gait impairment (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.1–3.3) and cognitive impairment (OR, 1.8; 95% CI, 1.1–3.0). We did not find an association between the VV/SV z score and bladder dysfunction. Interpretation The prevalence and severity of gait impairment and cognitive impairment increases with ventricular dilation in persons without stroke from the general population, independent of WMH volume. Ann Neurol 2009;66:485–493