{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T19:27:57Z","timestamp":1778614077588,"version":"3.51.4"},"reference-count":40,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,10,28]],"date-time":"2011-10-28T00:00:00Z","timestamp":1319760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To elucidate the pathophysiology of urinary dysfunction in idiopathic normal\u2010pressure hydrocephalus (iNPH) by single\u2010photon emission computed tomography (SPECT) and statistical brain mapping.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Urinary symptoms were observed and <jats:italic>N<\/jats:italic>\u2010isopropyl\u2010<jats:italic>p<\/jats:italic>\u2010[<jats:sup>123<\/jats:sup>I]\u2010iodoamphetamine (IMP)\u2010SPECT imaging was performed in 97 patients with clinico\u2010radiologically definite iNPH. The patients included 56 men and 41 women; mean age, 74 years. The statistical difference in normalized mean tracer counts was calculated and visualized between patients with urinary dysfunction of severer degrees (&gt;grade 2\/4) and milder degrees (&lt;grade 1\/4) according to the urinary subscales of the iNPH grading scales.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was a significant decrease in tracer activity in the right\u2010side\u2010dominant bilateral frontal cortex and the left inferior temporal gyrus in the severe urinary dysfunction group (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). In order to minimize the effects of gait and cognitive dysfunction, we performed similar analysis among subjects with little or no such dysfunction, and obtained the same results (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05) as described above.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Urinary dysfunction was found to be closely related with right frontal hypoperfusion in iNPH using [<jats:sup>123<\/jats:sup>I]\u2010IMP SPECT. This right frontal area is one of the critical areas for regulating micturition. While secondary incontinence can result from gait disturbance or dementia, there may also be a neurogenic mechanism underlying urinary dysfunction, which is a significant burden in patients with iNPH and their caregivers. Neurourol. 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