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The Ventricular System Enlarges Abnormally in the Seventies, Earlier in Men, and First in the Frontal Horn: A Study Based on More Than 3,000 Scans

Authors
  • Currà, Antonio1
  • Pierelli, Francesco2
  • Gasbarrone, Riccardo3
  • Mannarelli, Daniela4
  • Nofroni, Italo5
  • Matone, Vittoria6
  • Marinelli, Lucio7, 8
  • Trompetto, Carlo7, 8
  • Fattapposta, Francesco4
  • Missori, Paolo6
  • 1 Academic Neurology Unit, A. Fiorini Hospital, Terracina, (LT), Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome—Polo Pontino, Rome , (Italy)
  • 2 Academic Neuro-Rehabilitation Unit, ICOT, Latina, IRCCS Neuromed and Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome—Polo Pontino, Rome , (Italy)
  • 3 Department of Chemical Engineering, Materials & Environment, Sapienza University of Rome, Rome , (Italy)
  • 4 Neurology Unit, Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome , (Italy)
  • 5 Department of Public Health and Infectious Diseases, Medical Statistics and Biometry, Sapienza University of Rome, Rome , (Italy)
  • 6 Neurosurgery Unit, Department of Human Neurosciences, Policlinico Umberto I, Sapienza University of Rome, Rome , (Italy)
  • 7 Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova , (Italy)
  • 8 Department of Neuroscience, IRCCS Ospedale Policlinico San Martino, Genova , (Italy)
Type
Published Article
Journal
Frontiers in Aging Neuroscience
Publisher
Frontiers Media SA
Publication Date
Nov 05, 2019
Volume
11
Identifiers
DOI: 10.3389/fnagi.2019.00294
Source
Frontiers
Keywords
Disciplines
  • Neuroscience
  • Original Research
License
Green

Abstract

Objectives: To detect on computed tomography (CT) brain scans the trajectories of normal and abnormal ventricular enlargement during aging. Methods: For each 1-year age cohort, we assessed in 3,193 axial CT scans the Evans’ index (EI) in the anterior frontal horns and the parieto-occipital (POR) and temporal ratio (TR) in the posterior and inferior horns. Cut-off values for abnormal enlargement were based on previous clinical studies. Results: The mean age associated with normal linear measures was 71 years. Values for all three measures increased with age, showing a linear relationship below—but not above—each cut-off value. The mean age of participants with abnormal enlargement on CT progressed from 79 years for EI to 83 years for POR to 87 years for TR. These results suggested that ventricular dilatation progresses in an age–location relationship. First comes enlargement of the frontal horns (13.8% of scans), followed by the parieto-occipital horns (15.1% of scans) and then temporal horn enlargement (6.8% of scans). Scans from men displayed abnormal values earlier than scans from women (on average 6 years). Risk increased 5.1% annually for abnormal EI, 9.0% for abnormal POR, and 11% for abnormal TR (all p < 0.001). The most frequent agreement between categories (normal–abnormal) for values of neuroimaging measures was identified for POR–TR. Conclusion: The results of this large radiological study suggest that the ventricular system enlarges progressively during aging, and in a subset of patients follows an abnormal consecutive geometric dilatation, influenced by age and sex.

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