Ventricular volume: Clinical utility for assessing current and future cognition and gait

Oct. 02, 2020

An increase in ventricle size is associated with degenerative brain disease and gait. A clinically relevant measure of ventricle size could facilitate the evaluation of current and future cognition and gait.

Mayo Clinic researchers have found that ventricular volume measures are clinically more useful than the Evans index standard linear ratio in indicating current and future gait and cognition. From MRI scans of 1,774 participants in the Mayo Clinic Study of Aging, the researchers calculated various ventricle size measurements:

  • Frontal horn width divided by widest width of skull inner table (Evans index)
  • Total ventricular volume
  • Frontal horn and total ventricular volume as ratios of intracranial volume

Gait was measured by a timed 25-foot walk, and cognition by a composite of psychometric tests.

The researchers also evaluated variables associated with the measure of ventricle size, as well as gait and cognition associations with magnetic resonance imaging (MRI) of extraventricular findings seen in normal-pressure hydrocephalus — specifically, disproportionate enlargement of subarachnoid space (DESH) and focal sulcal dilations (FSDs). Ventricular volume measures had a stronger association with gait and cognition measures than did Evans index. In decreasing order of strength of association with ventricle size were DESH, FSDs, white matter hyperintensity volume ratio, age, male sex, cortical thickness and education.

The researchers note that ventricular volume measures can be generated automatically; their inclusion on MRI reports would allow a clinician to be more objective in determining whether a patient's ventricles are enlarged. Information about a patient's ratios of ventricular and frontal horn volumes to total intracranial volume would alert a physician to the patient's likely diminished gait and cognition, and a risk of more-rapid decline in the next few years.

This study was published in Neurology in 2020.

For more information

Mayo Clinic Study of Aging. Mayo Clinic.

Crook JE, et al. Linear vs volume measures of ventricle size: Relation to present and future gait and cognition. Neurology. 2020;94:e549.