Elucidation of the pathophysiology of idiopathic normal pressure hydrocephalus by advanced diffusion MRI

• Project/Area Number: 17K16486
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Multi-year Fund
• Research Field: Radiation science
• Research Institution: Juntendo University
• Principal Investigator: Irie Ryusuke 順天堂大学, 医学部, 助教 (30750210)
• Project Period (FY): 2017-04-01 – 2021-03-31
• Project Status: Completed (Fiscal Year 2020)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2018: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000); Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000)
• Keywords: 特発性正常圧水頭症 / 拡散MRI / 脳画像解析 / 核磁気共鳴画像（ＭＲＩ）

Outline of Final Research Achievements

We conducted a study on diffusion MRI of idiopathic normal pressure hydrocephalus (iNPH) patients to analyze changes in the brain microstructure of iNPH. By combining the latest method called advanced diffusion MRI in addition to the conventional diffusion MRI method, white matter damage and degeneration occur in the brain of iNPH patients in a wider range of cerebral white matter than previously considered in the analysis. We were able to confirm the validity of a model in which the corticospinal tract are compressed by the enlarged ventricle. We also incorporated machine learning into our research and conducted research on image classification with Alzheimer's disease, for which clinical differentiation from NPH is a problem.

Academic Significance and Societal Importance of the Research Achievements

特発性正常圧水頭症(iNPH)は治療可能な認知症という呼び名もある通り、早期診断、早期治療介入により患者QOLの向上へ寄与することができる。一方で、その病態生理は未解明な部分が多く、非侵襲的な手法であるMRIによって早期診断に役立てる指標の同定を目指すことは意義が大きい。iNPHにおける脳神経線維の画像評価はこれまでにも行われてきたが、病態を的確に説明する指標は確立されておらず、病態解明と早期診断の両面から疾患の理解に迫ることができた。

Research Products

• [Journal Article] Guidelines for Management of Idiopathic Normal Pressure Hydrocephalus (Third Edition): Endorsed by the Japanese Society of Normal Pressure Hydrocephalus (2021)
  • Author(s): NAKAJIMA Madoka、YAMADA Shigeki、MIYAJIMA Masakazu、Kazunari Ishii, ..... Chihiro Akiba, Kaito Kawamura, ...Hajime Arai. The research committee of idiopathic normal pressure hydrocephalus
  • Journal Title: Neurologia medico-chirurgica Volume: 61 Issue: 2 Pages: 63-97
  • DOI: 10.2176/nmc.st.2020-0292
  • NAID: 130007986452
  • ISSN: 0470-8105, 1349-8029
  • Peer Reviewed / Open Access
• [Journal Article] Accelerated acquisition of carotid MR angiography using 3D gradient-echo imaging with two-point Dixon (2020)
  • Author(s): Irie Ryusuke、Amemiya Shiori、Ueyama Tsuyoshi、Suzuki Yuichi、Kamiya Kouhei、Takao Hidemasa、Mori Harushi、Abe Osamu
  • Journal Title: Neuroradiology Volume: 62 Issue: 10 Pages: 1345-1349
  • DOI: 10.1007/s00234-020-02452-6
  • Peer Reviewed / Open Access
• [Journal Article] A Novel Deep Learning Approach with a 3D Convolutional Ladder Network for Differential Diagnosis of Idiopathic Normal Pressure Hydrocephalus and Alzheimer’s Disease (2020)
  • Author(s): Irie Ryusuke、Otsuka Yujiro、Hagiwara Akifumi、Kamagata Koji、Kamiya Kouhei、Suzuki Michimasa、Wada Akihiko、Maekawa Tomoko、Fujita Shohei、Kato Shimpei、Nakajima Madoka、Miyajima Masakazu、Motoi Yumiko、Abe Osamu、Aoki Shigeki
  • Journal Title: Magnetic Resonance in Medical Sciences Volume: 19 Issue: 4 Pages: 351-358
  • DOI: 10.2463/mrms.mp.2019-0106
  • NAID: 130007948913
  • ISSN: 1347-3182, 1880-2206
  • Peer Reviewed / Open Access
• [Presentation] Evaluating microstructure of the corticospinal tract in normal pressure hydrocephalus with diffusion MRI using oscillating gradient spin-echo (2019)
  • Author(s): Irie R, Kamiya K, Hori M, Suzuki M, Kamagata K, Maekawa T, Fujita S, Takenaka Y, Fukunaga I, Nakajima M, Miyajima M, Murata K, Aoki S
  • Organizer: ISMRM 27th Annual Meeting & Exhibition
  • Int'l Joint Research
• [Presentation] Residual extraction approach in the deep learning with 3D convolutional ladder network for differential diagnosis of idiopathic normal pressure hydrocephalus and Alzheimer’s disease (2018)
  • Author(s): Irie R, Otsuka Y, Kamagata K, Suzuki M, Wada A, Hori M, Maekawa T, Fujita S, Andica C, Nakajima M, Miyajima M, Motoi Y, Aoki S
  • Organizer: RSNA 104th Scientific Assembly and Annual Meeting
  • Int'l Joint Research
• [Presentation] Deep learning-based image classification - focusing on iNPH and AD (2018)
  • Author(s): Irie R
  • Organizer: AIMS Neuroimaging in Chicago 2018
  • Invited
• [Presentation] Oscillating gradient spin-echo (OGSE)法を用いた正常圧水頭症患者の皮質脊髄路の評価 (2018)
  • Author(s): 入江隆介, 神谷昂平, 堀正明, 鈴木通真, 鎌形康司, 福永一星, 武中祐樹, 村田勝俊, 中島円, 宮嶋雅一, 青木茂樹
  • Organizer: 第48回日本神経放射線学会
• [Presentation] 特発性正常圧水頭症患者の白質線維におけるg-ratioの推定 (2018)
  • Author(s): 入江隆介、神谷昂平、堀正明、鈴木通真、鎌形康司、萩原彰文、武中祐樹、齊藤麻美、中島 円、宮嶋雅一、青木茂樹
  • Organizer: 第47回日本神経放射線学会
• [Presentation] Imaging of idiopathic normal pressure hydrocephalus (2017)
  • Author(s): Irie R
  • Organizer: 3rd Frontiers of Neuroimaging Symposium
  • Int'l Joint Research / Invited
• [Presentation] MTsat法を用いた特発性正常圧水頭症患者の白質ミエリン量の推定 (2017)
  • Author(s): Ryusuke Irie, Kouhei Kamiya, Masaaki Hori, Michimasa Suzuki, Akifumi Hagiwara, Tomoko Maekawa, Saori Koshino, Issei Fukunaga, Syo Murata, Takashi Iwasaki, Yuki Takenaka, Moeko Horita, Madoka Nakajima, Masakazu Miyajima, Shigeki Aoki
  • Organizer: 第45回日本磁気共鳴医学会大会