Mohammed T. Abou-Saleh

38 PRINCIPLES AND PRACTICE OF GERIATRIC PSYCHIATRYTable 7.3continuedStudy Subjects Imaging and measurement technique FindingsMurphy et al., 1996 61Salonen et al., 1997 92Yue et al., 1997 93Coffey et al., 1998 68Guttmann et al., 1998 7269 Healthy volunteers, 35 males(mean+SD age=44+23 years);34 females (mean+SD age=50+21 years). No major medical orpsychiatric illness. All right-handedMR imaging (0.5 and 1.5 tesla).Blinded volume measurements usingcomputer-assisted segmentation andtrace methodology of contiguouscoronal images (5–6 mm thick). Numberof raters not specified61 Healthy volunteers, 30–86 years old, MR imaging (1.0 tesla). Qualitative30 M, 31 F. No neurological symptoms ratings (five-point scale) of sulcalor disease; psychiatric history not and lateral ventricular enlargement.specified. Handedness not specified Linear measurement of maximumwidth of third ventricle. T 1 -weightedaxial slices (5 mm thick, 1 mm interscangap). Number of raters and raterreliabilities not specified1488 Healthy elderly volunteers fromthe Cardiovascular Health Study,65–80+years old, numbers of males andfemales not specified. Handedness notspecified. No major medical or neurologicillness (psychiatric illness notassessed)330 Elderly volunteers living independentlyin the community, 66–96 yearsold (74.98+5.09), 129 M, 201 F. Nohistory of neurologic or psychiatricillness. All right-handed72 Healthy volunteers, 18–81 years old,22 M, 50 F. No history of psychiatricillness, epilepsy, or severe headtrauma. Handedness not specifiedMueller et al., 1998 75 46 Healthy elderly volunteers. 65–74years old (6 M, 5 F), 75–84 years old(8 M, 7 F), and 85–95 years old (9 M,11 F). All functionally independent,MMSE524, and free of major medicaland neurologic illness, as well as depression.Handedness not specifiedPfefferbaum et al.,1998 77 28 Healthy male volunteers (overlapwith Pfefferbaum et al., 1994) 21–68years old (51+13.8 years). No majormedical, neurologic, or psychiatricillness. Left-handers included (n notspecified)MR imaging (0.35 or 1.5 tesla). Blindedratings of sulcal prominence (10-pointscale) and ventricular size (10-pointscale) from T 1 -weighted axial images.Good to excellent rater reliabilities, butnumber of raters not specifiedMR imaging (1.5 tesla, n=248; 0.35tesla, n=82). Blinded volume measurements(one of two raters with establishedreliabilities) using computerassistedtrace methodology of T 1 -weighted axial images (5 mm thick,no interscan gap)MR imaging (1.5 tesla). Blindedvolume measurements using computerassistedsegmentation and tracemethodology of contiguous axialimages (3 mm thick). Good interraterreliabilitiesMR imaging (1.5 tesla). Volumemeasurements (non-blind?) usingcomputer-assisted pixel segmentationof contiguous coronal images (4 mmthick). Excellent interrater reliabilities.Scanning repeated annually orbiannually over 3–9 year follow-upMR imaging (1.5 tesla). Blindedvolume measurements derived fromsemi-automated pixel segmentation ofintermediate and T 2 -weighted axialimages (n=17–20, 5 mm thick, 2.5 mminterscan gap). Scanning repeated at5 year follow-upRelative to younger subjects (age 20–35years), older subjects (60–85 years)had larger ratios of lateral ventricularvolume to IV (males=females), thirdventricular volume to IV (females>males), and peripheral CSF volume toIV (males=females). No interactionswith lateralityAge associated with increased ratings ofsulcal widening and lateral ventricularenlargement, and with width of IIIrdventricle. Interactions with sex orlaterality not reportedAge associated with increased sulcalprominence and ventricular enlargement(males=females)Adjusting for IV, age associated withincreased peripheral (sulcal) CSFvolume, lateral fissure CSF volume,lateral ventricular volume (0.95 ml/year), and IIIrd ventricular volume(0.05 ml/year). Males showed greaterage-related changes than females forperipheral CSF (2.11 ml/year vs. 0.06ml/year, respectively) and lateral fissurevolumes (0.23 ml/year vs. 0.10 ml/year,respectively). No interactions withlateralityAge associated with increased ratio oftotal CSF volume to IV. Interactionswith sex or laterality not reportedAdjusting for IV, age associated withincreased temporal horn volume, butnot with total CSF, sulcal CSF, orlateral ventricle volumes. Interactionswith sex not reported. Over thefollow-up period, significant increaseswere seen only in total CSF volume( 1.5 ml/year, females>males) andin lateral ventricular volume ( 1.4 ml/year) (males=females)Over the follow-up interval, significantincrease in volume of lateral ( 5ml,or 20%) and third ventricles, but not ofcortical sulcal CSF volume17% over the first nine decades of life. Studies using linearmeasurements show a two-fold enlargement while volumetricstudies report a four- to five-fold volume increase. The changesin the size of CSF spaces are accelerated after midlife (60years). The variance in measures of CSF spaces also increaseswith age.The majority of the studies report a progressive enlargement ofthe lateral and third ventricles with age, which ranges from lessthan one to three times their initial sizes. No relationship has beenfound thus far between aging and fourth ventriclar size. Asexpected, studies using linear measurements show the smallestchanges, while studies using planimetric and volumetric measurementsagree in finding relatively greater enlargement. The increasein ventricular size is relatively minimal until the sixth decade, afterwhich it becomes more pronounced. Finally, the variability of themeasurements of ventricular size increases with age.