Mohammed T. Abou-Saleh

34 PRINCIPLES AND PRACTICE OF GERIATRIC PSYCHIATRYTable 7.3.Aging and changes in size of CSF spacesStudy Subjects Imaging and measurement technique FindingsBarron et al., 1976 7Earnest et al., 1979 79135 Volunteers, 9 months–90 years old,equal gender distribution in all agegroups (8 M, 7 F per decade). Nohistory of neurological disease;psychiatric history not reported.Handedness not specified59 Volunteer retirees, 60–99 years old,11 M, 48 F. Living independentlyand free of neurological disease.Handedness not specifiedJacoby et al., 1980 19 50 Healthy elderly volunteers, 62–88years old, 10 M, 40 F. No historyof significant psychiatric or neurologicillness. Handedness not specifiedMeese et al., 1980 80Cala et al., 1981 20Soininen et al., 1982 81Zatz et al., 1982a 12Gado et al., 1983 14Laffey et al., 1984 11160 Healthy ‘volunteers’, 1–71 yearsold, 10 M and 10 F in each decade.No additional data provided115 Volunteers, 15–40 years old,62 M, 53 F. No history of migraine,head trauma, or excessive alcoholintake (no additional details provided).All but eight subjects right-handed85 Volunteers, 53 from community and32 from nursing home, 75+7 yearsold, 23 M, 62 F. No neurological disease(no additional details provided)123 Volunteers, 10–90 years old,49 M, 74 F. No history of neurologicalor major medical disease. Handednessnot specified12 Elderly volunteers, 64–81 years old,9 M, 3 F. No additional clinical dataprovided212 Elderly volunteers, 65–89 years old,110 M; 102 F. No evidence of alcoholism,dementia, or neurologic illnessComputed tomography (CT). Planimetricdetermination of ventricular–brain ratio (VBR) by single rater(average of three measurements) fromPolaroid photographAge associated with increased VBR andwith increased variability in VBR.Interactions with sex or laterality notreportedCT. Linear and planimetric measures of Subjects 80 years or older (n=29) hadventricular size at three different levels, larger ratio of ventricular size to intracranialsize than did younger subjectsfrom photographs. Linear measurementsof four largest sulci. No (n=30). The sum of the widths of theadditional data providedfour sulci was greater in older subjectsthan in younger subjects. Interactionswith sex or laterality not reportedCT. Ratings (small, normal, enlarged)of ventricular size from films by singleblinded rater (rater reliability notreported). Planimetric determination ofventricular–skull ratio and Evans’s ratiofrom films by single rater (average ofthree measurements) with establishedreliabilitiesCT. Linear measurements of ventricularsize and sulcal width from four axialslices (no additional data provided)CT. (n=two scanners). Planimetricmeasurements of ventricular–skull ratioat level of frontal horns (no additionaldetails provided). Axial slices (13 mmthick)CT. Linear measurements (from films?)of ventricular and sulcal size. Axialslices (n=8–12, 8 mm thick). Noadditional details providedCT. Volume measurement derived fromcomputer-assisted pixel segmentationtechnique (ASI-II program). Axial slices(n=9, 10 mm thick, 10 mm interscangap)CT. Volume measurements derivedfrom computer-assisted pixel segmentationtechnique (seventh axial slices,8 mm thick). Linear measurements fromaxial images. Number of raters and raterreliabilities not specifiedCT. Qualitative rating (six-point scale)of ventricular enlargement and sulcalwidening from films, by two experiencedradiologists with established reliabilities8 (16%) Subjects were rated as having‘enlarged’ lateral ventricles. No significantcorrelation between age andventricular–skull ratio or Evans’s ratio.Interactions with sex or laterality notreported. Adjusting for age, no relationbetween any CT measure and performanceon the Hodkinson test ofmemory and orientationApparent age-related changes in somemeasures of ventricular size and sulcalwidth, but these changes not analyzedstatistically. Interactions with sex orlaterality not reportedNo relationship between age andventricular–skull ratio. Interactionswith sex or laterality not reportedAge correlated with ratios of ventricularwidth to skull width (frontal horn indexand cella media index). Age correlatedwith mean width of four largest sulci.Correlations were found between acomposite neuro-psychological testscore and the size of the lateral and IIIrdventricles, the left Sylvian fissure, andthe right temporal horn, but the effectsof age were not controlled. Interactionswith sex or laterality not reportedAge significantly associated with increasedventricular volume (males=females),even after controlling for intracranialvolume (IV). Increased variability ofventricular size with age. Age associatedwith increased sulcal CSF volume, evenafter controlling for IVDuring 1 year follow-up, ratio ofventricular volume to IV increasedsignificantly by an average of 3.7%. Nosignificant changes in linear measures ofventricular size (VBR, IIIrd ventricularratio, frontal horn ratio). During 1 yearfollow-up, ratio of sulcal volume to IVincreased significantly by an average of13%. Interactions with sex or lateralitynot reportedAge associated with increased ventricularsize. No association between age andratings of sulcal widening. Interactionswith sex or laterality not reportedcontinued