Ryan M Gallagher1, Jodie Marquez2, Peter Osmotherly3. 1. John Hunter Hospital Physiotherapy Department, Hunter New England Local Health District, Newcastle, Australia; School of Health Sciences, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia. Electronic address: Ryan.gallagher@hnehealth.nsw.gov.au. 2. School of Health Sciences, The University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia. 3. School of Health Sciences, The University of Newcastle, Newcastle, Australia.
Abstract
OBJECTIVES: To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH). PATIENTS AND METHODS: Prospective observational study of 74 iNPH patients undergoing a CSF TT for consideration of a ventricular peritoneal shunt. Patients who were offered surgical intervention were classified as responders. Patients were assessed with a battery of cognitive and upper limb assessments prior to and following a CSF TT. The Timed up and go cognition (TUG-C), Montreal Cognitive assessment (MoCA) and 9-hole peg test were utilised. RESULTS: 40 patients were classified responders. Significant differences were identified for responders for the MoCA (0.62 points) and TUG-C (-6.02 s). Only the executive function and orientation sub scores of the MoCA showed significant changes for responders. The 9 hole peg test mean change of 4.33 s for responders was not significant. Non-responder change scores for the MoCA (0.22 points), TUG-C (0.3 s) and 9 hole peg test (2.58 s) were not significant. CONCLUSION: The TUG-C has the potential to identify change in patients resulting from a CSF TT. While statistically significant change was found for the MoCA, a mean change of less than 1 point on this scale is unlikely to be clinically relevant. Similarly, the 9 hole peg test cannot be endorsed as an assessment tool for identifying changed performance in iNPH.
OBJECTIVES: To determine which cognitive and upper limb assessments can identify change in patients undergoing a Cerebrospinal fluid (CSF) tap test (TT) diagnosed with idiopathic Normal Pressure Hydrocephalus (iNPH). PATIENTS AND METHODS: Prospective observational study of 74 iNPH patients undergoing a CSF TT for consideration of a ventricular peritoneal shunt. Patients who were offered surgical intervention were classified as responders. Patients were assessed with a battery of cognitive and upper limb assessments prior to and following a CSF TT. The Timed up and go cognition (TUG-C), Montreal Cognitive assessment (MoCA) and 9-hole peg test were utilised. RESULTS: 40 patients were classified responders. Significant differences were identified for responders for the MoCA (0.62 points) and TUG-C (-6.02 s). Only the executive function and orientation sub scores of the MoCA showed significant changes for responders. The 9 hole peg test mean change of 4.33 s for responders was not significant. Non-responder change scores for the MoCA (0.22 points), TUG-C (0.3 s) and 9 hole peg test (2.58 s) were not significant. CONCLUSION: The TUG-C has the potential to identify change in patients resulting from a CSF TT. While statistically significant change was found for the MoCA, a mean change of less than 1 point on this scale is unlikely to be clinically relevant. Similarly, the 9 hole peg test cannot be endorsed as an assessment tool for identifying changed performance in iNPH.
Authors: A K Ahmed; M Luciano; A Moghekar; J Shin; N Aygun; H I Sair; D Rigamonti; A M Blitz Journal: AJNR Am J Neuroradiol Date: 2018-10-25 Impact factor: 3.825
Authors: Jani Sirkka; Marita Parviainen; Henna-Kaisa Jyrkkänen; Anne M Koivisto; Laura Säisänen; Tuomas Rauramaa; Ville Leinonen; Nils Danner Journal: Acta Neurochir (Wien) Date: 2021-07-08 Impact factor: 2.216