دورية أكاديمية
أعرض في EDS

Prediction of shunt response in idiopathic normal pressure hydrocephalus by combined lumbar infusion test and preoperative imaging scoring.

التفاصيل البيبلوغرافية
العنوان: Prediction of shunt response in idiopathic normal pressure hydrocephalus by combined lumbar infusion test and preoperative imaging scoring.
المؤلفون: Hasselbalch SG; Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark., Carlsen JF; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Radiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Alaouie MM; Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Munch TN; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Neurosurgery, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark., Holst AV; Department of Neurosurgery, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Taudorf S; Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Rørvig-Løppentien C; Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Juhler M; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.; Department of Neurosurgery, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Waldemar G; Department of Neurology, Danish Dementia Research Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
المصدر: European journal of neurology [Eur J Neurol] 2023 Oct; Vol. 30 (10), pp. 3047-3055. Date of Electronic Publication: 2023 Jul 20.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Wiley Country of Publication: England NLM ID: 9506311 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1468-1331 (Electronic) Linking ISSN: 13515101 NLM ISO Abbreviation: Eur J Neurol Subsets: MEDLINE
أسماء مطبوعة: Publication: <2014- > : Oxford : Wiley
Original Publication: Oxford ; New York : Rapid Communications, [1994-
مواضيع طبية MeSH: Hydrocephalus, Normal Pressure*/diagnostic imaging , Hydrocephalus, Normal Pressure*/surgery, Humans ; Prospective Studies ; Retrospective Studies ; Intracranial Pressure/physiology ; Prognosis
مستخلص: Background and Purpose: Idiopathic normal pressure hydrocephalus (iNPH) is a potentially treatable disorder, but prognostic tests or biomarkers are lacking. The aim was to study the predictive power of clinical, neuroimaging and lumbar infusion test parameters (resistance to outflow R out , cardiac-related pulse amplitude PA and the PA to intracranial pressure ICP ratio).
Methods: In all, 127 patients diagnosed with iNPH who had a lumbar infusion test, a subsequent ventriculo-peritoneal shunt operation and at least 2 months of postoperative follow-up were retrospectively included. Preoperative magnetic resonance images were visually scored for NPH features using the iNPH Radscale. Preoperative and postoperative assessment was performed using cognitive testing, as well as gait and incontinence scales.
Results: At follow-up (7.4 months, range 2-20 months), an overall positive response was seen in 82% of the patients. Gait was more severely impaired at baseline in responders compared to non-responders. The iNPH Radscale score was borderline significantly higher in responders compared with non-responders, whereas no significant differences in infusion test parameters were seen between responders and non-responders. Infusion test parameters performed modestly with high positive (75%-92%) but low negative (17%-23%) predictive values. Although not significant, PA and PA/ICP seemed to perform better than R out , and the odds ratio for shunt response seemed to increase in patients with higher PA/ICP, especially in patients with lower iNPH Radscale scores.
Conclusion: Although only indicative, lumbar infusion test results increased the likelihood of a positive shunt outcome. Pulse amplitude measures showed promising results that should be further explored in prospective studies.
(© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)
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فهرسة مساهمة: Keywords: imaging; infusion test; normal pressure hydrocephalus; prediction; prognostic factors; ventriculo-peritoneal shunt
تواريخ الأحداث: Date Created: 20230711 Date Completed: 20230908 Latest Revision: 20230911
رمز التحديث: 20240628
DOI: 10.1111/ene.15981
PMID: 37433569
قاعدة البيانات: MEDLINE
الوصف
تدمد:1468-1331
DOI:10.1111/ene.15981