Structural volumetry in NPH diagnostics and treatment—future or dead end?

Vlasák, Aleš; Skalický, Petr; Mládek, Arnošt; Vrána, J.; Beneš, Vladimı́r; Bradáč, Ondřej

doi:10.1007/s10143-020-01245-y

Cited by 11 publications

(10 citation statements)

References 49 publications

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“…Also, attentional functions seem to be less severely impaired in AD patients rather than memory [31], unlike in iNPH where the attention along with psychomotor speed is theorized to be impaired quite early in the process [14]. On the other hand, in Frontotemporal Lobar Degeneration (FTLD), the cognitive decline is manifested by the impairment in executive functions and slower psychomotor speed much like we observe in iNPH [30]. Nevertheless, for example Diehl and Kurz [32] found in their study that patients with frontotemporal dementia performed better in visuoconstructional abilities not only in comparison to AD group but also performed equally in comparison to healthy control group.…”

Section: Discussionmentioning

confidence: 52%

Comparison of Decline In Different Cognitive Domain In Patients With Normal Pressure Hydrocephalus

Rýdlo,

Bubeníková,

Häcklová

et al. 2023

Preprint

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Objectives We sought to describe the cognitive profile of patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) using a comprehensive neuropsychological battery. Based on age and education correlated norms, we aimed to compare performance in each measured cognitive domain: executive functions (EFs), verbal memory (VM), non-verbal memory (nVM), visuospatial abilities (VA) and attention/psychomotor speed (A/PS). Methods Patients diagnosed with iNPH underwent comprehensive neuropsychological evaluation before shunting. Their performance was compared to the age and education correlated norms. Correlation of different cognitive domains in iNPH profile was performed. Results A total of 53 iNPH patients (73.21 ± 5.48 years) were included in the study. All of the measured cognitive domains were significantly damaged. The most affected domains were EFs and VM (p < 0.001 and p < 0.001, respectively). A/PS domain was affected milder than EFs and VM (p < 0.001). The least affected domains were nVM (p < 0.001) and VA (p < 0.001). Conclusion Patients with iNPH are affected in all cognitive domains and the cognitive decline is uneven across these domains. The impairment of memory was shown to depend on the presented material. VM was shown to be much more severely affected than nVM and along with VM, EFs were shown to be the most affected. A/PS speed was shown to be less affected than VM and EFs and the least affected domains were nVM and VA.

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Section: Discussionmentioning

confidence: 52%

Comparison of Decline In Different Cognitive Domain In Patients With Normal Pressure Hydrocephalus

Rýdlo,

Bubeníková,

Häcklová

et al. 2023

Preprint

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“…Spontaneous recall seems to be impaired in both, AD [ 18 , 35 ] and iNPH, however, in iNPH the role of clue is crucial and should normalize the memory performance as it is theorized as subcortical type of cognitive decline [ 5 ]. It might be due to a fact that iNPH does not typically affect the hippocampus as AD does [ 36 ]. Saito et al [ 18 ] highlight the episodic part of memory to be more impaired in AD than in iNPH and also depict visuoconstructional abilities as more damaged in iNPH than AD.…”

Section: Discussionmentioning

confidence: 99%

Comparison of decline in different cognitive domain in patients with normal pressure hydrocephalus

Rýdlo,

Bubeníková,

Häcklová

et al. 2024

Neurosurg Rev

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We sought to describe the cognitive profile of patients with Idiopathic Normal Pressure Hydrocephalus (iNPH) using a comprehensive neuropsychological battery. Based on age and education correlated norms, we aimed to compare performance in each measured cognitive domain: executive functions (EFs), verbal memory (VM), non-verbal memory (nVM), visuoconstructional abilities (VA) and attention/psychomotor speed (A/PS). Patients diagnosed with iNPH underwent comprehensive neuropsychological evaluation before shunting. Their performance was compared to the age and education correlated norms. Correlation of different cognitive domains in iNPH profile was performed. A total of 53 iNPH patients (73.21 ± 5.48 years) were included in the study. All of the measured cognitive domains were significantly damaged. The most affected domains were EFs and VM (p<0.001 and p<0.001, respectively). A/PS domain was affected milder than EFs and VM (p<0.001). The least affected domains were nVM (p<0.001) and VA (p<0.001). Patients with iNPH are affected in all cognitive domains and the cognitive decline is uneven across these domains. The impairment of memory was shown to depend on the presented material. VM was shown to be much more severely affected than nVM and along with VM, EFs were shown to be the most affected. A/PS speed was shown to be less affected than VM and EFs and the least affected domains were nVM and VA.

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“…Using different methods of measurement, several authors have seen a decrease in ventricular volume (VV) following shunt surgery. [11][12][13][14][15][16] After surgery, a larger proportional reduction in VV has been reported when compared with ABBREVIATIONS iNPH = idiopathic normal pressure hydrocephalus; IQR = interquartile range; MMSE = Mini Mental State Examination; PL = performance level; ROC = receiver operating characteristic; TUG = Timed Up and Go; VV = ventricular volume.…”

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confidence: 99%

Volumetric effect of shunt adjustments in normal pressure hydrocephalus: a randomized, double-blind trial

Lidén,

Farahmand,

Laurell

2024

Journal of Neurosurgery

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OBJECTIVE MRI volumetry could be used as an alternative to invasive tests of shunt function. In this study, the authors aimed to assess the difference in ventricular volume (VV) before and after surgery and at different performance levels (PLs) of the shunt. METHODS This study was a randomized, double-blind trial with a crossover design. The study sample consisted of 36 patients (25 men, 11 women) with a median age of 76 years. All patients had idiopathic normal pressure hydrocephalus (iNPH) and received a Strata shunt at the regional hospital in Östersund, Sweden, with an initial PL of 1.5. Participants underwent MRI with volumetric sequences before surgery and four times postoperatively: at 1 month before randomization to either PL 1.0 (n = 15) or 2.5 (n = 17); at 2 months before crossover to PL 2.5 or 1.0; at 3 months before lowering the PL to 0.5; and finally, at 3 months and 1 day after surgery before resetting the PL to 1.5. VV was measured semiautomatically using quantitative MRI. Both the patient and the examiner of clinical tests and volumetry were blinded to the PL. RESULTS VV changed significantly between the presurgical level (median 129 ml) and the different shunt settings, i.e., PL 1.0 (median 115 ml), 1.5 (median 120 ml), and 2.5 (median 128 ml; p < 0.001). A unidirectional change in VV was observed for all participants between PL 1.0 and PL 2.5 (median 12 ml, range 2.1–40.7 ml, p < 0.001). No significant change was noted in VV after 24 hours at PL 0.5. Eight participants had asymptomatic subdural effusions at PL 1.0. CONCLUSIONS The consistent decrease in VV after shunt surgery and between PL 2.5 and 1.0 supports the idea that MRI volumetry could be a noninvasive method for evaluating shunt function in iNPH, preventing unnecessary shunt revisions. However, further studies on retest variability of VV as well as verification against advanced testing of shunt function are needed before a clinical implementation of this method can be performed. Clinical trial registration no.: NCT04599153 (ClinicalTrials.gov)

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Structural volumetry in NPH diagnostics and treatment—future or dead end?

Cited by 11 publications

References 49 publications

Comparison of Decline In Different Cognitive Domain In Patients With Normal Pressure Hydrocephalus

Comparison of Decline In Different Cognitive Domain In Patients With Normal Pressure Hydrocephalus

Comparison of decline in different cognitive domain in patients with normal pressure hydrocephalus

Volumetric effect of shunt adjustments in normal pressure hydrocephalus: a randomized, double-blind trial

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