Tiberiu Laticevschi1, Alma Lingenberg2, Stéphane Armand3, Alessandra Griffa2, Frédéric Assal4, Gilles Allali5. 1. Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1206 Geneva, Switzerland. Electronic address: tlaticevschi@gmail.com. 2. Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. 3. Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1206 Geneva, Switzerland; Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. 4. Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1206 Geneva, Switzerland; Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland. 5. Faculty of Medicine, University of Geneva, rue Michel-Servet 1, 1206 Geneva, Switzerland; Department of Clinical Neurosciences, Division of Neurology, Geneva University Hospitals, rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland; Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, USA.
Abstract
BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) presents typical radiological signs that have been summarised in a semi-quantitative scale named the iNPH Radscale. However, the iNPH Radscale's predictive value for response to cerebrospinal fluid (CSF) tap test has never been studied. This study aims to investigate if the iNPH Radscale can predict locomotion improvement after CSF tap test. METHODS: A total of 100 patients with iNPH (age: 76.3 ± 7.9, gender: 36% female) were included in this retrospective study. Two raters, blinded to the response of the CSF tap test, evaluated the iNPH Radscale and its seven subitems (Evan's index, callosal angle, size of temporal horns, narrow high-convexity sulci, dilated Sylvian fissures, focally dilated sulci, and periventricular hypodensities). Locomotion improvement was assessed by the Timed Up and Go (TUG) performed before, and 24 h after, the CSF tap test. RESULTS: The iNPH Radscale (total score) was similar between the CSF tap test responders and non-responders (responders: 8.31 ± 1.96, non-responders: 9.18 ± 2.51, p = 0.128). However, the temporal horns score was smaller in the responders group (1.66 ± 0.57 versus 1.94 ± 0.24, p = 0.045), even after adjusting for age, gender, education level, white matter changes, and global cognition (β: -0.250, C.I. 95%: [-3.185; -0.161], p = 0.031). CONCLUSION: The iNPH Radscale (total score) does not predict locomotion improvement after CSF tap test, while a smaller temporal horns score at baseline is associated with a positive tap test responder status.
BACKGROUND: Idiopathic normal pressure hydrocephalus (iNPH) presents typical radiological signs that have been summarised in a semi-quantitative scale named the iNPH Radscale. However, the iNPH Radscale's predictive value for response to cerebrospinal fluid (CSF) tap test has never been studied. This study aims to investigate if the iNPH Radscale can predict locomotion improvement after CSF tap test. METHODS: A total of 100 patients with iNPH (age: 76.3 ± 7.9, gender: 36% female) were included in this retrospective study. Two raters, blinded to the response of the CSF tap test, evaluated the iNPH Radscale and its seven subitems (Evan's index, callosal angle, size of temporal horns, narrow high-convexity sulci, dilated Sylvian fissures, focally dilated sulci, and periventricular hypodensities). Locomotion improvement was assessed by the Timed Up and Go (TUG) performed before, and 24 h after, the CSF tap test. RESULTS: The iNPH Radscale (total score) was similar between the CSF tap test responders and non-responders (responders: 8.31 ± 1.96, non-responders: 9.18 ± 2.51, p = 0.128). However, the temporal horns score was smaller in the responders group (1.66 ± 0.57 versus 1.94 ± 0.24, p = 0.045), even after adjusting for age, gender, education level, white matter changes, and global cognition (β: -0.250, C.I. 95%: [-3.185; -0.161], p = 0.031). CONCLUSION: The iNPH Radscale (total score) does not predict locomotion improvement after CSF tap test, while a smaller temporal horns score at baseline is associated with a positive tap test responder status.
Authors: J F Carlsen; A D L Backlund; C A Mardal; S Taudorf; A V Holst; T N Munch; A E Hansen; S G Hasselbalch Journal: AJNR Am J Neuroradiol Date: 2021-12-30 Impact factor: 3.825
Authors: Santhosh G Thavarajasingam; Mahmoud El-Khatib; Mark Rea; Salvatore Russo; Johannes Lemcke; Lana Al-Nusair; Peter Vajkoczy Journal: Acta Neurochir (Wien) Date: 2021-07-08 Impact factor: 2.216