Preoperative and postoperative<sup>1</sup>H-MR spectroscopy changes in frontal deep white matter and the thalamus in idiopathic normal pressure hydrocephalus

Lundin, Fredrik; Tisell, Anders; Leijon, Göran; Leinhard, Olof Dahlqvist; Davidsson, Leif; Grönqvist, Anders; Wikkelsø, Carsten; Lundberg, Peter

doi:10.1136/jnnp-2012-302190

Cited by 7 publications

(4 citation statements)

References 32 publications

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“…Metabolic changes could also predict prognosis after shunt surgery in iNPH. For example, increased total choline level and decreased myo‐inositol level in the frontal deep white matter indicate clinical improvement in iNPH patients 57 …”

Section: Hypoperfusion Leads To Neurophysiological Changes In Inphmentioning

confidence: 99%

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Wang

Zhang

et al. 2020

CNS Neurosci Ther

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First defined in 1965, idiopathic normal pressure hydrocephalus (iNPH)is a surgically reversible neurological disorder in adults. It is characterized by dementia, gait disturbance, and urinary incontinence (known as Hakim's triad). 1,2 INPH is not a rare clinical entity. The prevalence of iNPH has been estimated to be 10 per 100 000 to 22 per 100 000 overall, with 1.30% in those aged ≥65 years and 5.9% in those aged ≥80 years. 3,4 One of the core features of iNPH is that the cerebrospinal fluid (CSF) pressure of an iNPH patient is within normal ranges. 2 Typical brain imaging of iNPH displays ventriculomegaly, periventricular hyperintensities, wide Sylvian fissures, narrowed subarachnoid space, and cortical sulci at the high convexity. 5 In contrast to the secondary normal pressure hydrocephalus with known etiology, the exact cause of iNPH is unknown. 6 Its specific pathogenesis also remains elusive, although several

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Section: Hypoperfusion Leads To Neurophysiological Changes In Inphmentioning

confidence: 99%

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Wang

Zhang

et al. 2020

CNS Neurosci Ther

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“…Both the improved vascular autoregulation and the enhanced capacity for metabolic clearance may be the pathophysiological substrates of delayed walking improvement in the first days after LP. 21 However, the current study was not designed to adequately address the relationship between brain structure and function in iNPH. Future investigations using neuroimaging and neurophysiological measurements in parallel are required to directly address these pathophysiological mechanisms.…”

Section: Temporal Characteristics Of Gait Improvement In Inph After Lpmentioning

confidence: 99%

Walking assessment after lumbar puncture in normal-pressure hydrocephalus: a delayed improvement over 3 days

Schniepp

Trabold²,

Romagna³

et al. 2017

JNS

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OBJECTIVE The determination of gait improvement after lumbar puncture (LP) in idiopathic normal-pressure hydrocephalus (iNPH) is crucial, but the best time for such an assessment is unclear. The authors determined the time course of improvement in walking after LP for single-task and dual-task walking in iNPH. METHODS In patients with iNPH, sequential recordings of gait velocity were obtained prior to LP (time point [TP]0), 1-8 hours after LP (TP1), 24 hours after LP (TP2), 48 hours after LP (TP3), and 72 hours after LP (TP4). Gait analysis was performed using a pressure-sensitive carpet (GAITRite) under 4 conditions: walking at preferred velocity (STPS), walking at maximal velocity (STMS), walking while performing serial 7 subtractions (dual-task walking with serial 7 [DTS7]), and walking while performing verbal fluency tasks (dual-task walking with verbal fluency [DTVF]). RESULTS Twenty-four patients with a mean age of 76.1 ± 7.8 years were included in this study. Objective responder status moderately coincided with the self-estimation of the patients with subjective high false-positive results (83%). The extent of improvement was greater for single-task walking than for dual-task walking (p < 0.05). Significant increases in walking speed were found at TP2 for STPS (p = 0.042) and DTVF (p = 0.046) and at TP3 for STPS (p = 0.035), DTS7 (p = 0.042), and DTVF (p = 0.044). Enlargement of the ventricles (Evans Index) positively correlated with early improvement. Gait improvement at TP3 correlated with the shunt response in 18 patients. CONCLUSIONS Quantitative gait assessment in iNPH is important due to the poor self-evaluation of the patients. The maximal increase in gait velocity can be observed 24-48 hours after the LP. This time point is also best to predict the response to shunting. For dual-task paradigms, maximal improvement appears to occur later (48 to 72 hours). Assessment of gait should be performed at Day 2 or 3 after LP.

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“…Postoperatively, a greater decrease in NFL correlated to a larger reduction in PVH and a more significant clinical improvement [106]. Using MR spectroscopy postoperatively, increased total choline and decreased myo-inositol in the frontal DWM was found, which could be correlated with clinical improvement [107].…”

Section: Imaging Markers Of Inph With Possible Prognostic Valuementioning

confidence: 92%

Imaging Markers for Normal Pressure Hydrocephalus: An Overview

et al. 2023

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Idiopathic bormal pressure hydrocephalus (iNPH) is a neurological syndrome that clinically presents with Hakim’s triad, namely cognitive impairment, gait disturbances, and urinary incontinence. The fact that iNPH is potentially reversible makes its accurate and early diagnosis of paramount importance. Its main imaging characteristic is the dilation of the brain’s ventricular system and the imaging parameters are also included in its diagnostic criteria along with clinical data. There is a variety of different modalities used and a great number of imaging markers that have been described while assessing iNPH patients. The present literature review attempts to describe the most important of these imaging markers and to shed some light on their role in diagnosis, differential diagnosis, and possibly prognosis of this potentially reversible neurological syndrome.

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Preoperative and postoperative¹H-MR spectroscopy changes in frontal deep white matter and the thalamus in idiopathic normal pressure hydrocephalus

Abstract: Normalisation of thalamic tNA and NAA could not be detected postoperatively. The increased tCho and decreased mIns in the FDWM postoperatively might relate to clinical improvement.

Cited by 7 publications

References 32 publications

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Walking assessment after lumbar puncture in normal-pressure hydrocephalus: a delayed improvement over 3 days

Imaging Markers for Normal Pressure Hydrocephalus: An Overview

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Preoperative and postoperative1H-MR spectroscopy changes in frontal deep white matter and the thalamus in idiopathic normal pressure hydrocephalus

Abstract: Normalisation of thalamic tNA and NAA could not be detected postoperatively. The increased tCho and decreased mIns in the FDWM postoperatively might relate to clinical improvement.

Cited by 7 publications

References 32 publications

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Pathogenesis and pathophysiology of idiopathic normal pressure hydrocephalus

Walking assessment after lumbar puncture in normal-pressure hydrocephalus: a delayed improvement over 3 days

Imaging Markers for Normal Pressure Hydrocephalus: An Overview

Contact Info

Product

Resources

About

Preoperative and postoperative¹H-MR spectroscopy changes in frontal deep white matter and the thalamus in idiopathic normal pressure hydrocephalus