Quantitative cerebral water content changes after CSF removal in idiopathic normal pressure hydrocephalus

Idiopathic normal pressure hydrocephalus (iNPH) is a chronic and generally, in its early stages, a reversible disorder associated with aging. The disorder is characterised by the gradual onset of a triad of gait impairment, cognitive dysfunction, and urinary incontinence.

As the underlying pathophysiological mechanisms still remain unclear, researchers at INM-4 aim to verify the hypothesis that the exudation of cerebrospinal fluid (CSF) into periventricular white matter plays a role in iNPH and whether the clinical improvement seen after CSF removal is regulated by changes in the cerebral water content and spatial water distribution.

This project is performed in collaboration with the Department of Neurology at the RWTH Aachen University (JARA-BRAIN Group of Prof. Reetz).

The quantitative and non-invasive measurement of tissue water content using magnetic resonance imaging aids the monitoring and interpretation of the disease-related integrity of brain tissue. This method has already enabled the better characterisation of several different neurological pathologies, in which local or global disturbances in the water distribution and content were identified.

The quantification of changes in water content may help to better understand the pathophysiological basis of iNPH and thus identify predictors for the reversibility of clinical symptoms, e.g. due to reduced water content after CSF removal in disease-relevant structures, such as periventricular regions.