{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:07:34Z","timestamp":1781323654571,"version":"3.54.1"},"reference-count":45,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2023,1,12]],"date-time":"2023-01-12T00:00:00Z","timestamp":1673481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG8H0801"],"award-info":[{"award-number":["CMRPG8H0801"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004606","name":"Chang Gung Medical Foundation","doi-asserted-by":"publisher","award":["CMRPG8J1361"],"award-info":[{"award-number":["CMRPG8J1361"]}],"id":[{"id":"10.13039\/501100004606","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The classic triad of idiopathic normal pressure hydrocephalus (NPH) encompass gait disturbance, cognitive impairment, and urinary incontinence. These symptoms overlap with parkinsonism but with distinct treatment. Lacking applicable differentiation also hampers the prediction to therapeutic response. Here, we try to clarify this issue among different Parkinsonian syndromes and propose some innovative thinking while approaching a patient with parkinsonism and hydrocephalus concomitantly.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Twenty\u2010four patients with clinical probable multiple system atrophy (MSA), 34 with probable progressive supranuclear palsy (PSP), and 58 with sex\u2010 and age\u2010matched Parkinson's disease (PD) were enrolled. Evans\u2019 index (EI), callosal angle (CA), antero\u2010posterior (AP) diameter\u00a0of the midbrain, length of the midbrain tegmentum diameter (MB\n                      <jats:sup>Tegm<\/jats:sup>\n                      ), and disproportionately enlarged subarachnoid space hydrocephalus (DESH) were evaluated using the conventional MRI. Logistic regression was applied to identify the independent variables in hydrocephalus.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients with PSP had higher mean EI than those with MSA and PD. Around 38.2% of patients with PSP had accompanied hydrocephalus (EI\u00a0&gt;\u00a00.3). Parkinsonism subtypes (PD, MSA, or PSP), AP diameter\u00a0of the midbrain, and MB\n                      <jats:sup>Tegm<\/jats:sup>\n                      were significantly different among patients with and without hydrocephalus. After regression analysis, parkinsonism subtype stood out to be the most key risk factor of hydrocephalus. The comparison between patients with PSP with and without hydrocephalus did not disclose specific clinical characteristics or risk factors.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that the presence of NPH\u2010like MRI features is much higher in PSP patients, and this tendency is decided upon the determination of parkinsonism subtype. Sharing pathophysiological characteristics in these two diseases is implied. More diagnostic tools are needed to better differentiate the two diseases and decide the treatment. To closely observe hydrocephalic parkinsonism patients and well inform the possible limited shunting benefits if PSP core features appear, will be more pivotal and practical at present clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.2884","type":"journal-article","created":{"date-parts":[[2023,1,13]],"date-time":"2023-01-13T00:29:11Z","timestamp":1673569751000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Higher prevalence of idiopathic normal pressure hydrocephalus\u2010like MRI features in progressive supranuclear palsy: An imaging reminder of atypical parkinsonism"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2895-794X","authenticated-orcid":false,"given":"Mu\u2010Hui","family":"Fu","sequence":"first","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Center for Parkinson's Disease Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"},{"name":"School of Medicine National Sun Yat\u2010Sen University  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chih\u2010Cheng","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay L. H.","family":"Wu","sequence":"additional","affiliation":[{"name":"Institute for Translational Research in Biomedicine Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"},{"name":"Department of Senior Citizen Services National Tainan Institute of Nursing  Tainan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying\u2010Fa","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Center for Parkinson's Disease Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu\u2010Chih","family":"Kung","sequence":"additional","affiliation":[{"name":"Department of Nursing Meiho University  Pingtung County Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Chang","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Radiology Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia\u2010Shou","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min\u2010Yu","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Center for Parkinson's Disease Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yung\u2010Yee","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine  Kaohsiung Taiwan"},{"name":"Center for Parkinson's Disease Kaohsiung Chang Gung Memorial Hospital  Kaohsiung Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,12]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM196507152730301"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A5910"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3906\/sag-2107-86"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2022.08.007"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/ane.13205"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jocn.2016.09.004"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ana.25046"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1311488"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/bpa.12593"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000324625.00404.15"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(65)90016-X"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-8454-7-18"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26987"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000003583"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.3988\/jcn.2015.11.3.268"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.635"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-012-6745-6"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2015.10.069"},{"issue":"4","key":"e_1_2_9_20_1","first-page":"1117","article-title":"Diagnostic Approach to atypical Parkinsonian syndromes","volume":"22","author":"McFarland N. 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