Mohammed T. Abou-Saleh

36 PRINCIPLES AND PRACTICE OF GERIATRIC PSYCHIATRYTable 7.3.continuedStudy Subjects Imaging and measurement technique FindingsSullivan et al., 1993 86Shear et al., 1995 87Elwan et al., 1996 88Grant et al., 1987 89Condon et al., 1988 29Yoshii et al., 1988 30Jernigan et al., 1990 33114 Healthy volunteers, 21–82 yearsold (51.2+17.7 years), 84 M, 30 F.No history of major medical, neurologic,or psychiatric illness. 90%Right-handed35 Healthy volunteers (included inSullivan et al., 1993), 67.4+7.4 yearsold, 23 M, 12 F. No history of majormedical, neurologic, or psychiatricillness88 Healthy ‘lower middle class’volunteers, 40–76 years old (54.8+9.6years), 57 M, 31 F. No major medical,neurologic, or psychiatric illness. Allright-handed64 Healthy volunteers, 18–64 yearsold, 25 M, 39 F. No history ofneurological disease; psychiatrichistory not reported. Handednessnot specified40 Volunteers, 20–60 years old,20 M, 20 F. No additional detailsprovided58 Healthy volunteers, 21–81 years old,29 M, 29 F. Neurologic andpsychiatric histories not reported.Handedness not specified58 Healthy volunteers, 8–79 years old,35 M, 23 F. No neurologic, psychiatric,or medical (e.g. diabetes mellitus andheart disease) illness. Handedness notspecifiedWahlund et al., 1990 90 24 Healthy elderly volunteers, 75–85years old (mean=79 years), 8 M, 16 F.No evidence of neurologic or psychiatricillness. Handedness not specifiedGur et al., 1991 3769 Healthy volunteers, 18–80 years old,34 M, 35 F. No neurologic orpsychiatric illness. 66 Right-handed;three left-handedCT. Volume measurements derivedfrom computer-assisted pixelsegmentation technique (modification ofGado et al., 1983). Axial slices (n=10,10 mm thick). 10 neuropsychologicaltests (MMSE, Trail Making Test A andB, WAIS-R subtests—Information,Digit Span, Vocabulary, Digit Symbol,Picture Completion, Block Design,and Object Assembly)CT. Longitudinal within-subjectfollow-up, using blinded volumemeasurements per technique of Sullivanet al., 1993. High rater reliabilitiesCT. Multiple distance measurements(no additional details provided)Magnetic resonance (MR) imaging(0.15 tesla). Mathematically derivedestimate of ventricular volume andCSF volume from signal intensitymeasurements made on single sagittalslice (number of raters not specified)MR imaging (0.15 tesla). Volumemeasurement (two raters) derivedfrom computer-assisted pixel segmentationof contiguous sagittal slices(variable slice thickness and number)MR imaging (1.0 tesla). Blinded globalratings (four-point scale) of lateralventricular enlargement from inversionrecovery films (axial slices, n unspecified,10 mm thick, 3 mm interscan gap).Numbers of raters and rater reliabilitiesnot specifiedMR imaging (1.5 tesla). Volumeestimates (one of two raters) derivedfrom computer-assisted pixelclassification of multiple spin-echoaxial images (5 mm thick, 2.5 mminterscan gap)MR imaging (0.02 tesla). Visual ratings(5-point scale) of CSF spaces onT 2 -weighted axial films (slice=10 mmthick, no gap) by 2 raters (blind?)with established reliabilities. Areameasurements based upon computerassistedpixel classification technique,from single axial section at level ofbasal gangliaMR imaging (1.5 tesla). Volumemeasurements (any two of four raters)derived from segmentation techniquebased on two-feature pixel classificationof multiple spin-echo axial images(5 mm thick, contiguous)Age correlated with total and thirdventricular volume, even after adjustmentsfor head size (males=females).No correlation between age relatedchanges in total or third ventricularvolume and performance on 10neuropsychological tests. Age correlatedwith increased CSF volume in Sylvianfissure and in vertex, frontal andparieto-occipital sulci (males=females).Over mean (+SD) follow-up of 2.6(+0.96) years, increases were observedin CSF volumes of frontal sulci(0.31 ml/year), Sylvian fissure(0.58 ml/year), parieto-occipital sulci(0.05 ml/year), and ventricular system(0.61 ml/year). Interactions with sexnot reportedAge correlated with maximum width ofIIIrd ventricle. Interactions with sexor laterality not reportedAge associated with increased ventricularvolume in males, but not females;however, this apparent gender differencewas not tested statistically. Interactionswith laterality not reported. Ageassociated with increased total (ventricularplus cisternal) cranial CSFvolume (males=females). No controlfor size of brain or headFor males but not females, age correlatedwith ratio of total ventricular volumeto IV, total CSF volume to IV, and totalsulcal CSF volume to IVAge correlated with ratings of lateralventricular enlargement (males=females). Interactions with lateralitynot reportedAge associated with increased ratio ofventricular CSF volume to IV. Ageassociated with increased ratio ofsulcal CSF volume to IV. Interactionswith sex or laterality not reportedNo correlation between age and visualratings or area measurements ofsulcal CSF or lateral ventricle CSFsizeOlder (555 years) subjects (n=26) hadlarger total CSF volume (males>females), larger ratio of ventricularCSF volume to IV (males=females),and larger ratio of sulcal CSF volumeto IV (males>females). Effects of ageon ratio of ventricular CSF volume toIV were asymmetric (L>R) in malesbut not in femalescontinued