Brain Shape May Predict Success of Surgery for Treatable Dementia

Researchers have identified a potential new tool for predicting which patients with a treatable form of dementia will benefit most from surgery. A study from the University of Eastern Finland suggests that the three-dimensional shape of the brain's ventricles could be a key indicator.

The Challenge of iNPH

Idiopathic normal pressure hydrocephalus (iNPH) is a condition affecting older adults, marked by a classic triad of symptoms: abnormal gait, urinary urgency or incontinence, and cognitive decline. Unlike most forms of dementia, iNPH symptoms can often be improved or reversed with timely shunt surgery, which drains excess cerebrospinal fluid.

However, current neuroimaging diagnostic markers are not reliable in predicting which patients will see a positive outcome from this complex procedure.

A New Geometric Marker

In the new study, researchers analyzed brain scans from 170 iNPH patients. Using 3D imaging and machine learning, they quantified the geometric features of the brain's lateral ventricles.

They discovered that a specific geometric marker, called "asphericity," was strongly associated with better surgical outcomes from shunt surgery. Asphericity measures how much the shape of the ventricles deviates from a perfect sphere.

"Our findings suggest that quantifying the 3D geometry of the brain ventricles can provide important clues about which patients are likely to benefit from surgery," said lead author Andrius Penkauskas.

"This advancement brings us a step closer to better identifying iNPH patients who will truly benefit from complex brain surgery and sparing many from the suffering of ineffective treatment," Penkauskas added.

Publication and Funding

The study was published in the journal Fluids and Barriers of the CNS. The research received funding from the European Union's Horizon 2020 programme under the Marie Skłodowska-Curie Actions.