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Structural and functional connectivity in hydrocephalus: a scoping review

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Abstract

Optimizing the treatment of hydrocephalus remains a major challenge in adult and pediatric neurosurgery. Currently, clinical treatment relies heavily on anatomic imaging of ventricular size and clinical presentation. The emergence of functional and structural brain connectivity imaging has provided the basis for a new paradigm in the management of hydrocephalus. Here we review the pertinent advances in this field. Following PRISMA-ScR guidelines for scoping reviews, we searched PubMed for relevant literature from 1994 to April 2023 using hydrocephalus and MRI-related terms. Included articles reported original MRI data on human subjects with hydrocephalus, while excluding non-English or pre-1994 publications that didn't match the study framework. The review identified 44 studies that investigated functional and/or structural connectivity using various MRI techniques across different hydrocephalus populations. While there is significant heterogeneity in imaging technology and connectivity analysis, there is broad consensus in the literature that 1) hydrocephalus is associated with disruption of functional and structural connectivity, 2) this disruption in cerebral connectivity can be further associated with neurologic compromise 3) timely treatment of hydrocephalus restores both cerebral connectivity and neurologic compromise. The robustness and consistency of these findings vary as a function of patient age, hydrocephalus etiology, and the connectivity region of interest studied. Functional and structural brain connectivity imaging shows potential as an imaging biomarker that may facilitate optimization of hydrocephalus treatment. Future research should focus on standardizing regions of interest as well as identifying connectivity analysis most pertinent to clinical outcome.

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Acknowledgements

We would like to acknowledge the Masonic Institute of the Developing Brain for the ongoing support in pediatric connectivity studies.

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There were no funding sources for this scoping review.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Minnesota, Minneapolis, MN, USA

    Isabela Peña Pino, Robert A. McGovern III, Clark C. Chen & Carolina Sandoval-Garcia

  2. University of Minnesota Medical School, Minneapolis, MN, USA

    Emily Fellows

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  1. Isabela Peña Pino
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  2. Emily Fellows
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  3. Robert A. McGovern III
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  4. Clark C. Chen
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  5. Carolina Sandoval-Garcia
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Contributions

IPP, CSG made substantial contributions to the conception an design of the work, IPP, CSG, EF, RAM, CCC participated in the acquisition, analysis, and interpretation of data; IPP, CSG, RAM, CCC drafted the work and revised it critically for important intellectual content; IPP, CSG, EF, RAM, CCC approved the version to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Correspondence to Carolina Sandoval-Garcia.

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Peña Pino, I., Fellows, E., McGovern, R.A. et al. Structural and functional connectivity in hydrocephalus: a scoping review. Neurosurg Rev 47, 201 (2024). https://doi.org/10.1007/s10143-024-02430-z

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