{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:20:53Z","timestamp":1792794053589,"version":"4.5.0"},"reference-count":65,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T00:00:00Z","timestamp":1604620800000},"content-version":"vor","delay-in-days":310,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Oslo University Hospital \u2013 Rikshospitalet","id":[{"id":"https:\/\/ror.org\/00j9c2840","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Disturbed clearance of toxic metabolites from the brain via cerebrospinal fluid is emerging as an important mechanism behind dementia and neurodegeneration. To this end, magnetic resonance imaging work-up of dementia diseases is largely focused on anatomical derangements of the brain. This study explores magnetic resonance imaging biomarkers of cerebrospinal fluid tracer dynamics in patients with the dementia subtype idiopathic normal pressure hydrocephalus and a cohort of reference subjects. All study participants underwent multi-phase magnetic resonance imaging up to 48\u2009h after intrathecal administration of the contrast agent gadobutrol (0.5\u2009ml, 1\u2009mmol\/ml), serving as cerebrospinal fluid tracer. Imaging biomarkers of cerebrospinal fluid tracer dynamics (i.e. ventricular reflux grades 0\u20134 and clearance) were compared with anatomical magnetic resonance imaging biomarkers of cerebrospinal fluid space anatomy (Evans\u2019 index, callosal angle and disproportional enlargement of subarachnoid spaces hydrocephalus) and neurodegeneration (Schelten\u2019s medial temporal atrophy scores, Fazeka\u2019s scores and entorhinal cortex thickness). The imaging scores were also related to a pulsatile intracranial pressure score indicative of intracranial compliance. In shunt-responsive idiopathic normal pressure hydrocephalus, the imaging biomarkers demonstrated significantly altered cerebrospinal fluid tracer dynamics (ventricular reflux grades 3\u20134 and reduced clearance of tracer), deranged cerebrospinal fluid space anatomy and pronounced neurodegeneration. The altered MRI biomarkers were accompanied by pressure indices of impaired intracranial compliance. In conclusion, we present novel magnetic resonance imaging biomarkers characterizing idiopathic normal pressure hydrocephalus pathophysiology, namely measures of cerebrospinal fluid molecular redistribution and clearance, which add information to traditional imaging scores of cerebrospinal fluid space anatomy and neurodegeneration.<\/jats:p>","DOI":"10.1093\/braincomms\/fcaa187","type":"journal-article","created":{"date-parts":[[2020,11,6]],"date-time":"2020-11-06T08:31:16Z","timestamp":1604651476000},"source":"Crossref","is-referenced-by-count":56,"title":["<b>Magnetic resonance imaging biomarkers of cerebrospinal fluid tracer dynamics<\/b>\n                    \u2002\n                    <b>in idiopathic normal pressure hydrocephalus<\/b>"],"prefix":"10.1093","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6881-9280","authenticated-orcid":false,"given":"Per Kristian","family":"Eide","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway"},{"name":"Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Are H","family":"Pripp","sequence":"additional","affiliation":[{"name":"Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geir","family":"Ringstad","sequence":"additional","affiliation":[{"name":"Department of Radiology, Oslo University Hospital- Rikshospitalet, Oslo, Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,11,6]]},"reference":[{"key":"2020122200592491300_fcaa187-B1","first-page":"105","article-title":"MR cisternography: is it useful in the diagnosis of normal-pressure hydrocephalus and the selection of \u201cgood shunt responders\u201d?","volume":"17","author":"Algin","year":"2011","journal-title":"Diag Interv Radiol (Ankara, Turkey)"},{"key":"2020122200592491300_fcaa187-B2","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1111\/j.1600-0404.2007.00982.x","article-title":"Prevalence of probable idiopathic normal pressure hydrocephalus in a Norwegian population","volume":"118","author":"Brean","year":"2008","journal-title":"Acta Neurol Scand"},{"key":"2020122200592491300_fcaa187-B3","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ejrad.2017.07.013","article-title":"The Evans' Index revisited: new cut-off levels for use in radiological assessment of ventricular enlargement in the elderly","volume":"95","author":"Brix","year":"2017","journal-title":"Eur J Radiol"},{"key":"2020122200592491300_fcaa187-B4","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1016\/j.jalz.2010.12.008","article-title":"Frequency of Alzheimer's disease pathology at autopsy in patients with clinical normal pressure hydrocephalus","volume":"7","author":"Cabral","year":"2011","journal-title":"Alzheimer's Dement"},{"key":"2020122200592491300_fcaa187-B5","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1111\/febs.15148","article-title":"P-glycoprotein: a role in the export of amyloid-beta in Alzheimer's disease?","volume":"287","author":"Chai","year":"2020","journal-title":"FEBS J"},{"key":"2020122200592491300_fcaa187-B6","volume-title":"Gadobutrol. 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