INTRODUCTION Our previous community-based study demonstrated that some individuals with AVIM [asymptomatic ventriculomegaly with features of idiopathic normal pressure hydrocephalus (iNPH) on magnetic resonance imaging (MRI)] progressed to iNPH in several years. In this hospital-based study, we investigated the progression rate from AVIM to iNPH and its possible predictors. METHODS We conducted a prospective study of participants with AVIM from several medical institutions/hospitals in Japan. AVIM is defined as "asymptomatic ventriculomegaly with features of iNPH on MRI"; in the present study, asymptomatic was defined as "0 (no symptoms) or 1 (presence of only subjective, but not objective, symptoms) on the iNPH Grading Scale (iNPH-GS)." We also measured possible predicting factors for AVIM-to-iNPH progression, including age, sex, body weight, blood pressure, diabetes mellitus, dyslipidemia, history of mental disease/head injury/sinusitis/smoking/alcohol-intake, Evans index, and the presence of DESH (disproportionately enlarged subarachnoid-space hydrocephalus) findings on brain MRI, and analyzed these potential predictive values. RESULTS In 2012, 93 participants with AVIM were registered and enrolled in the study. Of these, 52 participants were able to be tracked for three years (until 2015). Of the 52 participants, 27 (52%) developed iNPH during the follow-up period (11 definite, 6 probable, and 10 possible iNPH), whereas 25 participants remained asymptomatic in 2015. Among the possible predictive factors examined, the baseline scores of iNPH-GS predicted the AVIM-to-iNPH progression. CONCLUSIONS The multicenter prospective study demonstrated that the progression rate from AVIM to iNPH was ~17% per year, and the baseline scores of iNPH-GS predicted the AVIM-to-iNPH progression.

中文翻译：

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以特发性正常压力脑积水为特征的无症状脑室扩大进展速度的多中心前瞻性研究

引言 我们之前基于社区的研究表明，一些 AVIM [无症状脑室扩大，磁共振成像 (MRI) 上具有特发性正常压力脑积水 (iNPH) 的特征] 在几年内进展为 iNPH。在这项基于医院的研究中，我们调查了从 AVIM 到 iNPH 的进展率及其可能的预测因素。方法 我们对来自日本多家医疗机构/医院的 AVIM 参与者进行了前瞻性研究。AVIM 被定义为“无症状的脑室扩大，在 MRI 上具有 iNPH 的特征”；在本研究中，无症状被定义为“iNPH 分级量表 (iNPH-GS) 上的 0（无症状）或 1（仅存在主观症状，而非客观症状）”。我们还测量了 AVIM 到 iNPH 进展的可能预测因素，包括年龄、性别、体重、血压、糖尿病、血脂异常、精神疾病史/头部损伤/鼻窦炎/吸烟/饮酒、埃文斯指数和脑 MRI 上存在的 DESH（不成比例地扩大的蛛网膜下腔积水）发现，并分析了这些潜在的预测值。结果 2012 年，93 名 AVIM 参与者注册并参加了研究。其中，52 名参与者能够被跟踪三年（直到 2015 年）。在 52 名参与者中，27 名 (52%) 在随访期间发展为 iNPH（11 名确定、6 名可能和 10 名可能 iNPH），而 25 名参与者在 2015 年仍无症状。 在检查的可能预测因素中，基线评分为iNPH-GS 预测了 AVIM 到 iNPH 的进展。