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Head circumference as a useful surrogate for intracranial volume in older adults

  • Tammy T. Hshieh (a1) (a2), Meaghan L. Fox (a3) (a4), Cyrus M. Kosar (a2), Michele Cavallari (a5), Charles R. G. Guttmann (a6), David Alsop (a3), Edward R. Marcantonio (a1) (a2) (a6), Eva M. Schmitt (a2), Richard N. Jones (a2) (a7) and Sharon K. Inouye (a2) (a6)...



Intracranial volume (ICV) has been proposed as a measure of maximum lifetime brain size. Accurate ICV measures require neuroimaging which is not always feasible for epidemiologic investigations. We examined head circumference as a useful surrogate for ICV in older adults.


99 older adults underwent Magnetic Resonance Imaging (MRI). ICV was measured by Statistical Parametric Mapping 8 (SPM8) software or Functional MRI of the Brain Software Library (FSL) extraction with manual editing, typically considered the gold standard. Head circumferences were determined using standardized tape measurement. We examined estimated correlation coefficients between head circumference and the two MRI-based ICV measurements.


Head circumference and ICV by SPM8 were moderately correlated (overall r = 0.73, men r = 0.67, women r = 0.63). Head circumference and ICV by FSL were also moderately correlated (overall r = 0.69, men r = 0.63, women r = 0.49).


Head circumference measurement was strongly correlated with MRI-derived ICV. Our study presents a simple method to approximate ICV among older patients, which may prove useful as a surrogate for cognitive reserve in large scale epidemiologic studies of cognitive outcomes. This study also suggests the stability of head circumference correlation with ICV throughout the lifespan.


Corresponding author

Correspondence should be addressed to: Tammy T. Hshieh, M.D. Division of Aging, Brigham and Women's Hospital, One Brigham Circle, 3rd floor, 02120, Boston, MA, USA. Phone: 401-536-6075; Fax: 617-525-7739. Email:


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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
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