Patient‐Informed Biomechanical Modeling Reveals Mechanical Mechanism of Brain Damage in Idiopathic Normal Pressure Hydrocephalus
4 affiliations
- 1HEAD Lab, Dyson School of Design Engineering Imperial College London London UK
- 2Department of Brain Sciences Imperial College London London UK
- 3UK Dementia Research Institute Care Research and Technology Centre Imperial College London and the University of Surrey London UK
- 4Department of Neurology Imperial College Healthcare NHS Trust London UK
Abstract
Idiopathic normal pressure hydrocephalus (iNPH) is a globally growing neurological disorder in older adults that is radiologically characterized by enlargement of ventricles. However, it remains unknown whether ventricular enlargement can produce biomechanical loading large enough to drive brain morphological changes and tissue damage. Here, we develop an anatomically detailed biomechanical model of aging human brain and apply ventricular enlargement using a three‐dimensional displacement field derived from MRI of iNPH patients and age‐matched controls. The model accurately reproduces radiological markers of iNPH, including Evans index, callosal angle, and high‐convexity sulcal narrowing. It further predicts large mechanical strains in the periventricular white matter, particularly within the corona radiata, corpus callosum, and anterior thalamic radiations, tracts consistently implicated in iNPH imaging abnormalities. These findings provide strong evidence that ventricular enlargement induces mechanical strain that contributes to iNPH brain abnormalities, which can potentially be reversed by reducing strain following shunting surgery. The biomechanical brain model forms the foundation of a predictive digital platform and future “digital twin” technology to support diagnosis, patient stratification, and treatment planning in iNPH.
Related
- Parkinsonism in Idiopathic Normal Pressure Hydrocephalus or Hydrocephalic Presentation in Parkinson's Disease: A Report of Three Cases
- Altered hippocampal morphology and its association with gait impairment in idiopathic normal-pressure hydrocephalus
- Cerebrospinal fluid surfactant protein-G in neurodegenerative dementia: A comparative study with idiopathic normal-pressure hydrocephalus.
- Cerebrospinal fluid shunt outcomes in patients with idiopathic normal pressure hydrocephalus and an Evans index below 0.3: a prospective study
- Systems biology prioritizes drug candidates for an interferon-response-high monocyte state in idiopathic normal pressure hydrocephalus
BibTeX
@article{darvishi2026patientinformed,
title = {{Patient‐Informed Biomechanical Modeling Reveals Mechanical Mechanism of Brain Damage in Idiopathic Normal Pressure Hydrocephalus}},
author = {Vahid Darvishi and Martina Del Giovane and Michael C. B. David and Balvinder K. Dhillon and Magdalena A. Kolanko and Anastasia Gontsarova and Paresh A. Malhotra and Christopher Carswell and David J. Sharp and Mazdak Ghajari},
journal = {Smart medicine},
year = {2026},
month = oct,
doi = {10.1002/smmd.70060},
url = {https://europepmc.org/article/PMC/PMC13720981},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient‐Informed Biomechanical Modeling Reveals Mechanical Mechanism of Brain Damage in Idiopathic Normal Pressure Hydrocephalus
AU - Vahid Darvishi
AU - Martina Del Giovane
AU - Michael C. B. David
AU - Balvinder K. Dhillon
AU - Magdalena A. Kolanko
AU - Anastasia Gontsarova
AU - Paresh A. Malhotra
AU - Christopher Carswell
AU - David J. Sharp
AU - Mazdak Ghajari
PY - 2026
DA - 2026/10/01
JO - Smart medicine
DO - 10.1002/smmd.70060
UR - https://europepmc.org/article/PMC/PMC13720981
AB - Idiopathic normal pressure hydrocephalus (iNPH) is a globally growing neurological disorder in older adults that is radiologically characterized by enlargement of ventricles. However, it remains unknown whether ventricular enlargement can produce biomechanical loading large enough to drive brain morphological changes and tissue damage. Here, we develop an anatomically detailed biomechanical model of aging human brain and apply ventricular enlargement using a three‐dimensional displacement field derived from MRI of iNPH patients and age‐matched controls. The model accurately reproduces radiological markers of iNPH, including Evans index, callosal angle, and high‐convexity sulcal narrowing. It further predicts large mechanical strains in the periventricular white matter, particularly within the corona radiata, corpus callosum, and anterior thalamic radiations, tracts consistently implicated in iNPH imaging abnormalities. These findings provide strong evidence that ventricular enlargement induces mechanical strain that contributes to iNPH brain abnormalities, which can potentially be reversed by reducing strain following shunting surgery. The biomechanical brain model forms the foundation of a predictive digital platform and future “digital twin” technology to support diagnosis, patient stratification, and treatment planning in iNPH.
SN - 2751-1863
SN - 2751-1871
ER -