Anat Cell Biol.  2024 Mar;57(1):45-60. 10.5115/acb.23.219.

In search of subcortical and cortical morphologic alterations of a normal brain through aging: an investigation by computed tomography scan

• Ghorbanlou M
• Moradi F
• Kazemi-Galougahi MH
• Abdollahi M

• KMID: 2554240
• DOI: http://doi.org/10.5115/acb.23.219

Abstract

Morphologic changes in the brain through aging, as a physiologic process, may involve a wide range of variables including ventricular dilation, and sulcus widening. This study reports normal ranges of these changes as standard criteria. Normal brain computed tomography scans of 400 patients (200 males, 200 females) in every decade of life (20 groups each containing 20 participants) were investigated for subcortical/cortical atrophy (bicaudate width [BCW], third ventricle width [ThVW], maximum length of lateral ventricle at cella media [MLCM], bicaudate index [BCI], third ventricle index [ThVI], and cella media index 3 [CMI3], interhemispheric sulcus width [IHSW], right hemisphere sulci diameter [RHSD], and left hemisphere sulci diameter [LHSD]), ventricular symmetry. Distribution and correlation of all the variables were demonstrated with age and a multiple linear regression model was reported for age prediction. Among the various parameters of subcortical atrophy, BCW, ThVW, MLCM, and the corresponding indices of BCI, ThVI, and CMI3 demonstrated a significant correlation with age (R 2 ≥0.62). All the cortical atrophy parameters including IHSW, RHSD, and LHSD demonstrated a significant correlation with age (R 2 ≥0.63). This study is a thorough investigation of variables in a normal brain which can be affected by aging disclosing normal ranges of variables including major ventricular variables, derived ventricular indices, lateral ventricles asymmetry, cortical atrophy, in every decade of life introducing BW, ThVW, MLCM, BCI, ThVI, CMI3 as most significant ventricular parameters, and IHSW, RHSD, LHSD as significant cortical parameters associated with age.

Keyword

Brain; Multidetector computed tomography; Aging; Cerebral ventricles

Figure

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  Fig. 1 Ventricular parameters. A1, maximum width of frontal horns; A2, maximum inner diameter of cranium; A3, maximum inner diameter of cranium at the level of A1; B1, minimum bicaudate width at the level of A1; B2, maximum inner diameter of cranium at the level of B1; C1, bioccipital width of occipital horns of lateral ventricles; C2, maximum inner diameter of cranium at the level of C1; D1, maximum width of third ventricle; D2, maximum inner diameter of cranium at the level of D1; E1, bitemporal width of temporal horns of lateral ventricles; E2, maximum inner diameter of cranium at the level of E1; F1, maximum width of lateral ventricles at the level of cella media; F2, maximum inner diameter of cranium at the level of F1; G1, maximum length of lateral ventricles at the level of cella media; G2, maximum inner diameter of cranium at the level of G1; H, width of neural tissue between lateral ventricles at cella media. *Third ventricle, ***temporal horn of left lateral ventricle.

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  Fig. 2 Symmetry of frontal horn of lateral ventricles. a, width of right frontal horn; b, width of left frontal horn.

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  Fig. 3 Cortical atrophy (sulcus widening). a, interhemispheric sulcus; b–f, right hemisphere sulci width.

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  Fig. 4 Distribution of three significant major ventricular parameter with age. (A) Total bicaudate width distribution with age (R2=0.67), (B) bicaudate width distribution within age groups (*vs. 1–9 yr [P≤0.05]), (C) computed tomography (CT) images showing bicaudate width through aging (double head dashed arrow shows bicaudate width in an 85 year old male). (D) Total third ventricle width distribution with age (R2=0.64), (E) third ventricle width distribution within age groups (*vs. 1–9 yr, 10–19 yr, and 20–29 yr; #vs. 30–39 yr, 40–49 yr, and 50–59 yr; @vs. 60–69 yr and 70–79 yr [P≤0.05]), (F) CT images showing third ventricle width through aging (double head dashed arrow shows third ventricle width in a 92 year old male). (G) Total maximum length of lateral ventricle at cella media distribution with age (R2=0.62), (H) maximum length of lateral ventricle at cella media distribution within age groups (*vs. 1–9 yr, #vs. 10–19 yr, 20–29 yr, 30–39 yr, and 40–49 yr [P≤0.05]), (I) CT images showing maximum length of lateral ventricle at cella media through aging (double head dashed arrow shows maximum length of lateral ventricle at cella media in a 92 year old male). Left column diagrams demonstrate linear interpolation and line of best fit from linear regression. Right column diagrams demonstrate male, female, and mean distribution within age groups (data are shown as mean±SD).

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  Fig. 5 Frontal horn asymmetry.

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  Fig. 6 Distribution of six significant derived ventricular indices with age. (A) Total Evans’ index distribution with age (R2=0.56), (B) Evans’ index distribution within age groups (*vs. 1–9 yr, #vs. 10–19 yr, @vs. 20–29 yr, 30–39 yr, and 40–49 yr [P≤0.05]), (C) total bifrontal index distribution with age (R2=0.44), (D) bifrontal index width distribution within age groups (*vs. 1–9 yr, #vs. 10–19 yr, 20–29 yr, and 30–39 yr (P≤0.05]), (E) total bicaudate width distribution with age (R2=0.70), (F) bicaudate width distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, 30–39 yr, and 40–49 yr; @vs. 50–59 yr, 60–69 yr, and 70–79 yr [P≤0.05]). (G) Total cella media index 3 distribution with age (R2=0.64), (H) cella media index 3 distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, and 30–39 yr; @vs. 40–49 yr, 50–59 yr, and 60–69 yr [P≤0.05]). (I) Total cella media index 4 distribution with age (R2=0.60), (J) cella media index 4 within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, and 30–39 yr [P≤0.05]). (K) Total third ventricle index distribution with age (R2=0.65), (L) third ventricle index distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, 30–39 yr, and 40–49 yr; @vs. 50–59 yr and 60–69 yr [P≤0.05]). Left column diagrams demonstrates linear interpolation and line of best fit from linear regression. Right column diagrams demonstrate male, female, and mean distribution within age groups (data are shown as mean±SD).

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  Fig. 7 Distribution of cortical atrophy parameters with age. (A) Total interhemispheric sulcus width distribution with age (R2=0.63), (B) interhemispheric sulcus width distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, and 30–39 yr; @vs. 40–49 yr and 50–59 yr [P≤0.05]). (C) Total right hemisphere sulci diameter distribution with age (R2=0.74), (D) right hemisphere sulci diameter distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, and 30–39 yr; @vs. 40–49 yr and 50–59 yr [P≤0.05]). (E) Total left hemisphere sulci diameter distribution with age (R2=0.73), (F) left hemisphere sulci diameter distribution within age groups (*vs. 1–9 yr; #vs. 10–19 yr, 20–29 yr, and 30–39 yr; @vs. 40–49 yr and 50–59 yr [P≤0.05]). Left column diagrams demonstrates linear interpolation and line of best fit from linear regression. Right column diagrams demonstrate male, female, and mean of male and female distribution within age groups.

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  Fig. 8 Cortical atrophy in right hemisphere in each decade of life.

Reference

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