scholarly journals Idiopathic normal pressure hydrocephalus: increased supplementary motor activity accounts for improvement after CSF drainage

Brain ◽  
2008 ◽  
Vol 131 (11) ◽  
pp. 2904-2912 ◽  
Author(s):  
N. Lenfeldt ◽  
A. Larsson ◽  
L. Nyberg ◽  
M. Andersson ◽  
R. Birgander ◽  
...  
Keyword(s):  
Motor Activity ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Csf Drainage

scholarly journals Association between shunt-responsive idiopathic normal pressure hydrocephalus and alcohol

2017 ◽  
Vol 127 (2) ◽  
pp. 240-248 ◽  
Author(s):  
Thu-Trang Hickman ◽  
Matthew E. Shuman ◽  
Tatyana A. Johnson ◽  
Felix Yang ◽  
Rebecca R. Rice ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Alcohol Abuse ◽  
Normal Pressure Hydrocephalus ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Bivariate Analysis ◽  
Medical Centers ◽  
Csf Drainage ◽  
Academic Medical ◽  
History Of

OBJECTIVEIdiopathic normal pressure hydrocephalus (iNPH) is characterized by ventriculomegaly, gait difficulty, incontinence, and dementia. The symptoms can be ameliorated by CSF drainage. The object of this study was to identify factors associated with shunt-responsive iNPH.METHODSThe authors reviewed the medical records of 529 patients who underwent shunt placement for iNPH at their institution between July 2001 and March 2015. Variables associated with shunt-responsive iNPH were identified using bivariate and multivariate analyses. Detailed alcohol consumption information was obtained for 328 patients and was used to examine the relationship between alcohol and shunt-responsive iNPH. A computerized patient registry from 2 academic medical centers was queried to determine the prevalence of alcohol abuse among 1665 iNPH patients.RESULTSBivariate analysis identified associations between shunt-responsive iNPH and gait difficulty (OR 4.59, 95% CI 2.32–9.09; p < 0.0001), dementia (OR 1.79, 95% CI 1.14–2.80; p = 0.01), incontinence (OR 1.77, 95% CI 1.13–2.76; p = 0.01), and alcohol use (OR 1.98, 95% CI 1.23–3.16; p = 0.03). Borderline significance was observed for hyperlipidemia (OR 1.56, 95% CI 0.99–2.45; p = 0.054), a family history of hyperlipidemia (OR 3.09, 95% CI 0.93–10.26, p = 0.054), and diabetes (OR 1.83, 95% CI 0.96–3.51; p = 0.064). Multivariate analysis identified associations with gait difficulty (OR 3.98, 95% CI 1.81–8.77; p = 0.0006) and alcohol (OR 1.94, 95% CI 1.10–3.39; p = 0.04). Increased alcohol intake correlated with greater improvement after CSF drainage. Alcohol abuse was 2.5 times more prevalent among iNPH patients than matched controls.CONCLUSIONSAlcohol consumption is associated with the development of shunt-responsive iNPH.

scholarly journals The effect of CSF drainage on ambulatory center of mass movement in idiopathic normal pressure hydrocephalus

2018 ◽  
Vol 63 ◽  
pp. 5-9 ◽  
Author(s):  
Yasutaka Nikaido ◽  
Toshihiro Akisue ◽  
Yoshinaga Kajimoto ◽  
Takuya Ikeji ◽  
Yuki Kawami ◽  
...  
Keyword(s):  
Normal Pressure Hydrocephalus ◽  
Center Of Mass ◽  
Mass Movement ◽  
Normal Pressure ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Csf Drainage

scholarly journals Systematic volumetric analysis predicts response to CSF drainage and outcome to shunt surgery in idiopathic normal pressure hydrocephalus

2021 ◽  
Author(s):  
Dan Wu ◽  
Abhay Moghekar ◽  
Wen Shi ◽  
Ari M. Blitz ◽  
Susumu Mori
Keyword(s):  
White Matter ◽  
Normal Pressure Hydrocephalus ◽  
Neurodegenerative Disorder ◽  
Brain Mri ◽  
Area Under The Curve ◽  
Normal Pressure ◽  
Volumetric Analysis ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Shunt Placement ◽  
Csf Drainage

Abstract Objectives Idiopathic normal pressure hydrocephalus (INPH) is a neurodegenerative disorder characterized by excess cerebrospinal fluid (CSF) in the ventricles, which can be diagnosed by invasive CSF drainage test and treated by shunt placement. Here, we aim to investigate the diagnostic and prognostic power of systematic volumetric analysis based on brain structural MRI for INPH. Methods We performed a retrospective study with a cohort of 104 probable INPH patients who underwent CSF drainage tests and another cohort of 41 INPH patients who had shunt placement. High-resolution T1-weighted images of the patients were segmented using an automated pipeline into 283 structures that are grouped into different granularity levels for volumetric analysis. Volumes at multi-granularity levels were used in a recursive feature elimination model to classify CSF drainage responders and non-responders. We then used pre-surgical brain volumes to predict Tinetti and MMSE scores after shunting, based on the least absolute shrinkage and selection operator. Results The classification accuracy of differentiating the CSF drainage responders and non-responders increased as the granularity increased. The highest diagnostic accuracy was achieved at the finest segmentation with a sensitivity/specificity/precision/accuracy of 0.89/0.91/0.84/0.90 and an area under the curve of 0.94. The predicted post-surgical neurological scores showed high correlations with the ground truth, with r = 0.80 for Tinetti and r = 0.88 for MMSE. The anatomical features that played important roles in the diagnostic and prognostic tasks were also illustrated. Conclusions We demonstrated that volumetric analysis with fine segmentation could reliably differentiate CSF drainage responders from other INPH-like patients, and it could accurately predict the neurological outcomes after shunting. Key Points • We performed a fully automated segmentation of brain MRI at multiple granularity levels for systematic volumetric analysis of idiopathic normal pressure hydrocephalus (INPH) patients. • We were able to differentiate patients that responded to CSF drainage test with an accuracy of 0.90 and area under the curve of 0.94 in a cohort of 104 probable INPH patients, as well as to predict the post-shunt gait and cognitive scores with a coefficient of 0.80 for Tinetti and 0.88 for MMSE. • Feature analysis showed the inferior lateral ventricle, bilateral hippocampus, and orbital cortex are positive indicators of CSF drainage responders, whereas the posterior deep white matter and parietal subcortical white matter were negative predictors.

scholarly journals Neuropsychiatric Symptoms in Patients with Idiopathic Normal Pressure Hydrocephalus

2009 ◽  
Vol 21 (3-4) ◽  
pp. 165-174 ◽  
Author(s):  
Yumiko Kito ◽  
Hiroaki Kazui ◽  
Yoshihiko Kubo ◽  
Tetsuhiko Yoshida ◽  
Masahiko Takaya ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Motor Activity ◽  
Frontal Lobe ◽  
Normal Pressure Hydrocephalus ◽  
Neuropsychiatric Symptoms ◽  
Normal Pressure ◽  
Neuropsychiatric Symptom ◽  
Idiopathic Normal Pressure Hydrocephalus ◽  
Neuropsychiatric Inventory ◽  
Prevalent Symptom

Objective:To clarify the characteristics of neuropsychiatric symptoms in patients with idiopathic normal pressure hydrocephalus (iNPH).Methods:Neuropsychiatric symptoms of 64 iNPH patients with mild triad symptoms from three kinds of hospitals were evaluated with the Neuropsychiatric Inventory (NPI) and compared with 126 patients with Alzheimer’s disease (AD).Results:The most frequently observed neuropsychiatric symptom in the iNPH patients was apathy followed by anxiety and aggression. No symptom was more prevalent or more severe in iNPH than in AD. The severity of cognitive impairment was correlated with both aberrant motor activity and apathy.Conclusions:Neuropsychiatric symptoms were mild in patients with iNPH and apathy was the most prevalent symptom. The correlation between neuropsychiatric symptoms and cognitive impairment in iNPH appears to arise from a common pathology in the frontal lobe.

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