{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T21:37:54Z","timestamp":1782509874599,"version":"3.54.5"},"reference-count":116,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["FOC"],"published-print":{"date-parts":[[2016,9]]},"abstract":"\n OBJECTIVE<\/jats:title>\n Diffusion tensor imaging (DTI) for the assessment of fractional anisotropy (FA) and involving measurements of mean diffusivity (MD) and apparent diffusion coefficient (ADC) represents a novel, MRI-based, noninvasive technique that may delineate microstructural changes in cerebral white matter (WM). For example, DTI may be used for the diagnosis and differentiation of idiopathic normal pressure hydrocephalus (iNPH) from other neurodegenerative diseases with similar imaging findings and clinical symptoms and signs. The goal of the current study was to identify and analyze recently published series on the use of DTI as a diagnostic tool. Moreover, the authors also explored the utility of DTI in identifying patients with iNPH who could be managed by surgical intervention.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n The authors performed a literature search of the PubMed database by using any possible combinations of the following terms: \u201cAlzheimer's disease,\u201d \u201cbrain,\u201d \u201ccerebrospinal fluid,\u201d \u201cCSF,\u201d \u201cdiffusion tensor imaging,\u201d \u201cDTI,\u201d \u201chydrocephalus,\u201d \u201cidiopathic,\u201d \u201cmagnetic resonance imaging,\u201d \u201cnormal pressure,\u201d \u201cParkinson's disease,\u201d and \u201cshunting.\u201d Moreover, all reference lists from the retrieved articles were reviewed to identify any additional pertinent articles.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n The literature search retrieved 19 studies in which DTI was used for the identification and differentiation of iNPH from other neurodegenerative diseases. The DTI protocols involved different approaches, such as region of interest (ROI) methods, tract-based spatial statistics, voxel-based analysis, and delta-ADC analysis. The most studied anatomical regions were the periventricular WM areas, such as the internal capsule (IC), the corticospinal tract (CST), and the corpus callosum (CC). Patients with iNPH had significantly higher MD in the periventricular WM areas of the CST and the CC than had healthy controls. In addition, FA and ADCs were significantly higher in the CST of iNPH patients than in any other patients with other neurodegenerative diseases. Gait abnormalities of iNPH patients were statistically significantly and negatively correlated with FA in the CST and the minor forceps. Fractional anisotropy had a sensitivity of 94% and a specificity of 80% for diagnosing iNPH. Furthermore, FA and MD values in the CST, the IC, the anterior thalamic region, the fornix, and the hippocampus regions could help differentiate iNPH from Alzheimer or Parkinson disease. Interestingly, CSF drainage or ventriculoperitoneal shunting significantly modified FA and ADCs in iNPH patients whose condition clinically responded to these maneuvers.<\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n Measurements of FA and MD significantly contribute to the detection of axonal loss and gliosis in the periventricular WM areas in patients with iNPH. Diffusion tensor imaging may also represent a valuable noninvasive method for differentiating iNPH from other neurodegenerative diseases. Moreover, DTI can detect dynamic changes in the WM tracts after lumbar drainage or shunting procedures and could help identify iNPH patients who may benefit from surgical intervention.<\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2016.6.focus16192","type":"journal-article","created":{"date-parts":[[2016,9,1]],"date-time":"2016-09-01T03:39:30Z","timestamp":1472701170000},"page":"E12","source":"Crossref","is-referenced-by-count":56,"title":["The role of diffusion tensor imaging and fractional anisotropy in the evaluation of patients with idiopathic normal pressure hydrocephalus: a literature review"],"prefix":"10.3171","volume":"41","author":[{"given":"Ioannis","family":"Siasios","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York;"},{"name":"Department of Neurosurgery, Kaleida Health, Buffalo, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eftychia Z.","family":"Kapsalaki","sequence":"additional","affiliation":[{"name":"Departments of Diagnostic Radiology,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kostas N.","family":"Fountas","sequence":"additional","affiliation":[{"name":"Neurosurgery, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggeliki","family":"Fotiadou","sequence":"additional","affiliation":[{"name":"Medicine, University of Thessaly, Larisa, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Dorsch","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York;"},{"name":"Department of Neurosurgery, Kaleida Health, Buffalo, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal","family":"Vakharia","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York;"},{"name":"Department of Neurosurgery, Kaleida Health, Buffalo, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Pollina","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York;"},{"name":"Department of Neurosurgery, Kaleida Health, Buffalo, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vassilios","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York;"},{"name":"Department of Neurosurgery, Kaleida Health, Buffalo, New York; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-focus16192","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \u201cnormal\u201d cerebrospinal-fluid pressure\u2014a treatable syndrome","volume":"273","author":"Adams","year":"1965"},{"key":"b2-focus16192","series-title":"Acta Pathol Jpn","first-page":"97","article-title":"Normal pressure hydrocephalus. Neuropathological study","volume":"37","author":"Akai","year":"1987"},{"key":"b3-focus16192","series-title":"J Comput Assist Tomogr","first-page":"392","article-title":"Apparent diffusion coefficient and cerebrospinal fluid flow measurements in patients with hydrocephalus","volume":"32","author":"Anik","year":"2008"},{"key":"b4-focus16192","series-title":"NMR Biomed","first-page":"456","article-title":"Diffusion-tensor MRI: theory, experimental design and data analysis\u2014a technical review","volume":"15","author":"Basser","year":"2002"},{"key":"b5-focus16192","series-title":"Neurosurgery","first-page":"497","article-title":"Frontal brain and leptomeningeal biopsy specimens correlated with cerebrospinal fluid outflow resistance and B-wave activity in patients suspected of normal-pressure hydrocephalus","volume":"40","author":"Bech","year":"1997"},{"key":"b6-focus16192","series-title":"Mov Disord","first-page":"508","article-title":"Parkinsonian syndromes associated with hydrocephalus: case reports, a review of the literature, and pathophysiological hypotheses","volume":"9","author":"Curran","year":"1994"},{"key":"b7-focus16192","series-title":"Acta Radiol","first-page":"992","article-title":"Relationship between cerebrospinal fluid flow, ventricles morphology, and DTI properties in internal capsules: differences between Alzheimer's disease and normal-pressure hydrocephalus","volume":"55","author":"Daouk","year":"2014"},{"key":"b8-focus16192","series-title":"Can J Neurol Sci","first-page":"121","article-title":"Neuropathological changes in chronic adult hydrocephalus: cortical biopsies and autopsy findings","volume":"24","author":"Del Bigio","year":"1997"},{"key":"b9-focus16192","series-title":"Acta Neurochir Suppl","first-page":"29","article-title":"Changes of fractional anisotropy and apparent diffusion coefficient in patients with idiopathic normal pressure hydrocephalus","volume":"113","author":"Demura","year":"2012"},{"key":"b10-focus16192","series-title":"Invest Radiol","first-page":"287","article-title":"Direct in vivo observation of transventricular absorption in the hydrocephalic dog using magnetic resonance imaging","volume":"29","author":"Deo-Narine","year":"1994"},{"key":"b11-focus16192","series-title":"Neurol Res","first-page":"581","article-title":"Axonal damage associated with enlargement of ventricles during hydrocephalus: a silver impregnation study","volume":"23","author":"Ding","year":"2001"},{"key":"b12-focus16192","series-title":"Neurology","first-page":"1621","article-title":"The FAB: A Frontal Assessment Battery at bedside","volume":"55","author":"Dubois","year":"2000"},{"key":"b13-focus16192","series-title":"J Neurol Sci","first-page":"307","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics","volume":"2","author":"Hakim","year":"1965"},{"key":"b14-focus16192","series-title":"Neurosurgery","first-page":"917","article-title":"Diffusion tensor imaging in patients with adult chronic idiopathic hydrocephalus","volume":"66","author":"Hattingen","year":"2010"},{"key":"b15-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"97","article-title":"White matter alteration in idiopathic normal pressure hydrocephalus: tract-based spatial statistics study","volume":"33","author":"Hattori","year":"2012"},{"key":"b16-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"274","article-title":"Different patterns of fornix damage in idiopathic normal pressure hydrocephalus and Alzheimer disease","volume":"33","author":"Hattori","year":"2012"},{"key":"b17-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1681","article-title":"Altered microstructure in corticospinal tract in idiopathic normal pressure hydrocephalus: comparison with Alzheimer disease and Parkinson disease with dementia","volume":"32","author":"Hattori","year":"2011"},{"key":"b18-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1867","article-title":"Differences in microstructural alterations of the hippocampus in Alzheimer disease and idiopathic normal pressure hydrocephalus: a diffusion tensor imaging study","volume":"31","author":"Hong","year":"2010"},{"key":"b19-focus16192","series-title":"NMR Biomed","first-page":"570","article-title":"Applications of diffusion-weighted and diffusion tensor MRI to white matter diseases\u2014a review","volume":"15","author":"Horsfield","year":"2002"},{"key":"b20-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1168","article-title":"Differential diagnosis of normal pressure hydrocephalus by MRI mean diffusivity histogram 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study","volume":"258","author":"Kanno","year":"2011"},{"key":"b25-focus16192","series-title":"Acta Neurochir Suppl","first-page":"39","article-title":"Quantification of normal CSF flow through the aqueduct using PC-cine MRI at 3T","volume":"113","author":"Kapsalaki","year":"2012"},{"key":"b26-focus16192","series-title":"Brain Nerve","first-page":"429","article-title":"[Current state of diagnosis and treatment of idiopathic normal pressure hydrocephalus.]","volume":"68","author":"Kazui","year":"2016"},{"key":"b27-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1496","article-title":"Differential diagnosis of idiopathic normal pressure hydrocephalus from other dementias using diffusion tensor imaging","volume":"32","author":"Kim","year":"2011"},{"key":"b28-focus16192","series-title":"Clin Neurol Neurosurg","first-page":"369","article-title":"Correlates of local cerebral blood flow (CBF) in normal pressure hydrocephalus patients before and after shunting\u2014a retrospective analysis of [15O]H2O PET-CBF studies in 65 patients","volume":"110","author":"Klinge","year":"2008"},{"key":"b29-focus16192","series-title":"Neurol Med Chir (Tokyo)","first-page":"601","article-title":"White matter characteristics of idiopathic normal pressure hydrocephalus: a diffusion tensor tract-based spatial statistic study","volume":"53","author":"Koyama","year":"2013"},{"key":"b30-focus16192","series-title":"Neurol Med Chir (Tokyo)","first-page":"68","article-title":"Diffusion tensor imaging of idiopathic normal pressure hydrocephalus: a voxel-based fractional anisotropy study","volume":"52","author":"Koyama","year":"2012"},{"key":"b31-focus16192","series-title":"Acta Neurol Scand","first-page":"190","article-title":"Quantitative SPECT cisternography in normal pressure hydrocephalus","volume":"90","author":"Larsson","year":"1994"},{"key":"b32-focus16192","series-title":"J Neurosurg Pediatr","first-page":"56","article-title":"Longitudinal diffusion-weighted imaging in infants with hydrocephalus: decrease in tissue water diffusion after cerebrospinal fluid diversion","volume":"4","author":"Leliefeld","year":"2009"},{"key":"b33-focus16192","series-title":"Brain","first-page":"2904","article-title":"Idiopathic normal pressure hydrocephalus: increased supplementary motor activity accounts for improvement after CSF drainage","volume":"131","author":"Lenfeldt","year":"2008"},{"key":"b34-focus16192","series-title":"Neurosurgery","first-page":"1586","article-title":"Diffusion tensor imaging reveals supplementary lesions to frontal white matter in idiopathic normal pressure hydrocephalus","volume":"68","author":"Lenfeldt","year":"2011"},{"key":"b35-focus16192","series-title":"Clin Neuropsychol","first-page":"73","article-title":"Neuroimaging of white matter in aging and dementia","volume":"21","author":"Malloy","year":"2007"},{"key":"b36-focus16192","series-title":"Neurology","first-page":"576","article-title":"Three-year survival and functional outcome of patients with idiopathic adult hydrocephalus syndrome","volume":"55","author":"Malm","year":"2000"},{"key":"b37-focus16192","series-title":"Fluids Barriers CNS","first-page":"20","article-title":"Diffusion tensor imaging in elderly patients with idiopathic normal pressure hydrocephalus or Parkinson's disease: diagnosis of gait abnormalities","volume":"9","author":"Marumoto","year":"2012"},{"key":"b38-focus16192","series-title":"J Neurol Neurosurg Psychiatry","first-page":"395","article-title":"Functional and magnetic resonance imaging correlates of corpus callosum in normal pressure hydrocephalus before and after shunting","volume":"78","author":"Matar\u00f3","year":"2007"},{"key":"b39-focus16192","series-title":"J Neurosurg","first-page":"1427","article-title":"An update on research priorities in hydrocephalus: overview of the third National Institutes of Health-sponsored symposium \u201cOpportunities for Hydrocephalus Research: Pathways to Better Outcomes.\u201d","volume":"123","author":"McAllister","year":"2015"},{"key":"b40-focus16192","series-title":"Dement Geriatr Cogn Disord","first-page":"71","article-title":"Association between cognitive impairment and gait disturbance in patients with idiopathic normal pressure hydrocephalus","volume":"20","author":"Miyoshi","year":"2005"},{"key":"b41-focus16192","series-title":"Brain","first-page":"965","article-title":"Pattern of white matter regional cerebral blood flow and autoregulation in normal pressure hydrocephalus","volume":"127","author":"Momjian","year":"2004"},{"key":"b42-focus16192","series-title":"Neuroradiology","first-page":"971","article-title":"Microstructural changes of the corticospinal tract in idiopathic normal pressure hydrocephalus: a comparison of diffusion tensor and diffusional kurtosis imaging","volume":"55","author":"Nakanishi","year":"2013"},{"key":"b43-focus16192","series-title":"Acta Radiol","first-page":"614","article-title":"Effect of surgery on periventricular white matter in normal pressure hydrocephalus patients: comparison of two methods of DTI analysis","volume":"55","author":"Nicot","year":"2014"},{"key":"b44-focus16192","series-title":"J Neurol","first-page":"640","article-title":"CSF drainage ameliorates the motor deficit in normal pressure hydrocephalus: evidence from the analysis of grasping movements","volume":"253","author":"Nowak","year":"2006"},{"key":"b45-focus16192","series-title":"Acta Neurochir Suppl","first-page":"197","article-title":"Delta-ADC (apparent diffusion coefficient) analysis in patients with idiopathic normal pressure hydrocephalus","volume":"114","author":"Osawa","year":"2012"},{"key":"b46-focus16192","series-title":"Acta Radiol","first-page":"622","article-title":"The influence of lumbar spinal drainage on diffusion parameters in patients with suspected normal pressure hydrocephalus using 3T MRI","volume":"55","author":"Reiss-Zimmermann","year":"2014"},{"key":"b47-focus16192","series-title":"J Neurol Neurosurg Psychiatry","first-page":"79","article-title":"Cognitive deficits in progressive supranuclear palsy, Parkinson's disease, and multiple system atrophy in tests sensitive to frontal lobe dysfunction","volume":"57","author":"Robbins","year":"1994"},{"key":"b48-focus16192","series-title":"J Neurol","first-page":"280","article-title":"Callosal and corticospinal tract function in patients with hydrocephalus: a morphometric and transcranial magnetic stimulation study","volume":"245","author":"R\u00f6richt","year":"1998"},{"key":"b49-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"409","article-title":"MR imaging of the hippocampus in normal pressure hydrocephalus: correlations with cortical Alzheimer's disease confirmed by pathologic analysis","volume":"21","author":"Savolainen","year":"2000"},{"key":"b50-focus16192","series-title":"Acta Neurochir (Wien)","first-page":"849","article-title":"Prevalence of Alzheimer's disease in patients investigated for presumed normal pressure hydrocephalus: a clinical and neuropathological study","volume":"141","author":"Savolainen","year":"1999"},{"key":"b51-focus16192","series-title":"Curr Neurol Neurosci Rep","first-page":"371","article-title":"Normal pressure hydrocephalus: diagnosis and treatment","volume":"8","author":"Shprecher","year":"2008"},{"key":"b52-focus16192","series-title":"Lancet Neurol","first-page":"506","article-title":"Alzheimer's disease, normal-pressure hydrocephalus, and senescent changes in CSF circulatory physiology: a hypothesis","volume":"2","author":"Silverberg","year":"2003"},{"key":"b53-focus16192","series-title":"J Neurol Neurosurg Psychiatry","first-page":"289","article-title":"Comparative analysis of the gait disorder of normal pressure hydrocephalus and Parkinson's disease","volume":"70","author":"Stolze","year":"2001"},{"key":"b54-focus16192","series-title":"Acta Neurol Scand","first-page":"417","article-title":"White matter changes in normal pressure hydrocephalus and Binswanger disease: specificity, predictive value and correlations to axonal degeneration and demyelination","volume":"105","author":"Tullberg","year":"2002"},{"key":"b55-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1171","article-title":"Diffusion imaging in obstructive hydrocephalus","volume":"24","author":"Ulu\u011f","year":"2003"},{"key":"b56-focus16192","series-title":"J Neurol Neurosurg Psychiatry","first-page":"503","article-title":"The value of temporary external lumbar CSF drainage in predicting the outcome of shunting on normal pressure hydrocephalus","volume":"72","author":"Walchenbach","year":"2002"},{"key":"b57-focus16192","series-title":"J Neurol Neurosurg Psychiatry","first-page":"655","article-title":"High resolution SPECT with [99mTc]-d,l-HM-PAO in normal pressure hydrocephalus before and after shunt operation","volume":"56","author":"Waldemar","year":"1993"},{"issue":"2 Dementia","key":"b58-focus16192","series-title":"Continuum (Minneap Minn)","first-page":"579","article-title":"Diagnosis and treatment of idiopathic normal pressure hydrocephalus","volume":"22","author":"Williams","year":"2016"},{"key":"b1-focus16192","series-title":"N Engl J Med","first-page":"117","article-title":"Symptomatic occult hydrocephalus with \u201cnormal\u201d cerebrospinal-fluid pressure\u2014a treatable syndrome","volume":"273","author":"Adams","year":"1965"},{"key":"b2-focus16192","series-title":"Acta Pathol Jpn","first-page":"97","article-title":"Normal pressure hydrocephalus. Neuropathological study","volume":"37","author":"Akai","year":"1987"},{"key":"b3-focus16192","series-title":"J Comput Assist Tomogr","first-page":"392","article-title":"Apparent diffusion coefficient and cerebrospinal fluid flow measurements in patients with hydrocephalus","volume":"32","author":"Anik","year":"2008"},{"key":"b4-focus16192","series-title":"NMR Biomed","first-page":"456","article-title":"Diffusion-tensor MRI: theory, experimental design and data analysis\u2014a technical review","volume":"15","author":"Basser","year":"2002"},{"key":"b5-focus16192","series-title":"Neurosurgery","first-page":"497","article-title":"Frontal brain and leptomeningeal biopsy specimens correlated with cerebrospinal fluid outflow resistance and B-wave activity in patients suspected of normal-pressure hydrocephalus","volume":"40","author":"Bech","year":"1997"},{"key":"b6-focus16192","series-title":"Mov Disord","first-page":"508","article-title":"Parkinsonian syndromes associated with hydrocephalus: case reports, a review of the literature, and pathophysiological hypotheses","volume":"9","author":"Curran","year":"1994"},{"key":"b7-focus16192","series-title":"Acta Radiol","first-page":"992","article-title":"Relationship between cerebrospinal fluid flow, ventricles morphology, and DTI properties in internal capsules: differences between Alzheimer's disease and normal-pressure hydrocephalus","volume":"55","author":"Daouk","year":"2014"},{"key":"b8-focus16192","series-title":"Can J Neurol Sci","first-page":"121","article-title":"Neuropathological changes in chronic adult hydrocephalus: cortical biopsies and autopsy findings","volume":"24","author":"Del Bigio","year":"1997"},{"key":"b9-focus16192","series-title":"Acta Neurochir Suppl","first-page":"29","article-title":"Changes of fractional anisotropy and apparent diffusion coefficient in patients with idiopathic normal pressure hydrocephalus","volume":"113","author":"Demura","year":"2012"},{"key":"b10-focus16192","series-title":"Invest Radiol","first-page":"287","article-title":"Direct in vivo observation of transventricular absorption in the hydrocephalic dog using magnetic resonance imaging","volume":"29","author":"Deo-Narine","year":"1994"},{"key":"b11-focus16192","series-title":"Neurol Res","first-page":"581","article-title":"Axonal damage associated with enlargement of ventricles during hydrocephalus: a silver impregnation study","volume":"23","author":"Ding","year":"2001"},{"key":"b12-focus16192","series-title":"Neurology","first-page":"1621","article-title":"The FAB: A Frontal Assessment Battery at bedside","volume":"55","author":"Dubois","year":"2000"},{"key":"b13-focus16192","series-title":"J Neurol Sci","first-page":"307","article-title":"The special clinical problem of symptomatic hydrocephalus with normal cerebrospinal fluid pressure. Observations on cerebrospinal fluid hydrodynamics","volume":"2","author":"Hakim","year":"1965"},{"key":"b14-focus16192","series-title":"Neurosurgery","first-page":"917","article-title":"Diffusion tensor imaging in patients with adult chronic idiopathic hydrocephalus","volume":"66","author":"Hattingen","year":"2010"},{"key":"b15-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"97","article-title":"White matter alteration in idiopathic normal pressure hydrocephalus: tract-based spatial statistics study","volume":"33","author":"Hattori","year":"2012"},{"key":"b16-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"274","article-title":"Different patterns of fornix damage in idiopathic normal pressure hydrocephalus and Alzheimer disease","volume":"33","author":"Hattori","year":"2012"},{"key":"b17-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1681","article-title":"Altered microstructure in corticospinal tract in idiopathic normal pressure hydrocephalus: comparison with Alzheimer disease and Parkinson disease with dementia","volume":"32","author":"Hattori","year":"2011"},{"key":"b18-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1867","article-title":"Differences in microstructural alterations of the hippocampus in Alzheimer disease and idiopathic normal pressure hydrocephalus: a diffusion tensor imaging study","volume":"31","author":"Hong","year":"2010"},{"key":"b19-focus16192","series-title":"NMR Biomed","first-page":"570","article-title":"Applications of diffusion-weighted and diffusion tensor MRI to white matter diseases\u2014a review","volume":"15","author":"Horsfield","year":"2002"},{"key":"b20-focus16192","series-title":"AJNR Am J Neuroradiol","first-page":"1168","article-title":"Differential diagnosis of normal pressure hydrocephalus by MRI mean diffusivity histogram analysis","volume":"34","author":"Ivkovic","year":"2013"},{"key":"b21-focus16192","series-title":"Neurology","first-page":"592","article-title":"Vascular factors in suspected normal pressure hydrocephalus: a population-based study","volume":"86","author":"Jaraj","year":"2016"},{"key":"b22-focus16192","series-title":"Neuroradiology","first-page":"5","article-title":"Directional diffusion of corticospinal tract supports therapy decisions in idiopathic normal-pressure hydrocephalus","volume":"56","author":"Jurcoane","year":"2014"},{"key":"b23-focus16192","series-title":"J Clin Neurol","first-page":"1","article-title":"Small vessel disease and subcortical vascular dementia","volume":"2","author":"Kalaria","year":"2006"},{"key":"b24-focus16192","series-title":"J Neurol","first-page":"1949","article-title":"White matter involvement in idiopathic normal pressure hydrocephalus: a voxel-based diffusion tensor imaging 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retrospective analysis of [15O]H2O PET-CBF studies in 65 patients","volume":"110","author":"Klinge","year":"2008"},{"key":"b29-focus16192","series-title":"Neurol Med Chir (Tokyo)","first-page":"601","article-title":"White matter characteristics of idiopathic normal pressure hydrocephalus: a diffusion tensor tract-based spatial statistic study","volume":"53","author":"Koyama","year":"2013"},{"key":"b30-focus16192","series-title":"Neurol Med Chir (Tokyo)","first-page":"68","article-title":"Diffusion tensor imaging of idiopathic normal pressure hydrocephalus: a voxel-based fractional anisotropy study","volume":"52","author":"Koyama","year":"2012"},{"key":"b31-focus16192","series-title":"Acta Neurol Scand","first-page":"190","article-title":"Quantitative SPECT cisternography in normal pressure hydrocephalus","volume":"90","author":"Larsson","year":"1994"},{"key":"b32-focus16192","series-title":"J Neurosurg Pediatr","first-page":"56","article-title":"Longitudinal diffusion-weighted imaging 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